Analyzing biomechanical parameters of the cornea with glaucoma severity in open-angle glaucoma.
OBJECTIVE
The purpose was to investigate a possible association of corneal hysteresis (CH) and corneal resistance factor (CRF) with open-angle glaucoma and the severity of disease.


METHODS
In this prospective cross-sectional study we recruited 86 open-angle glaucoma patients, 16 patients with ocular hypertension (OHT,) and 44 age-matched controls. Each participant had a complete glaucoma workup including measurements with the Ocular Response Analyzer and computerized perimetry with the Humphrey 30-2 SITA Standard program. Visual field damage was based on mean deviation (MD) and considered as early glaucomatous with a MD > - 6 dB, moderate glaucomatous between -6 and -12 dB and advanced glaucomatous < -12 dB. The association between ORA parameters, glaucoma, and disease severity was evaluated using univariate and multivariate linear regression analyses.


RESULTS
There was a statistically significant correlation between the biomechanical parameters and intraocular pressure, central corneal thickness, axial length, and age. On average, glaucoma patients had the lowest adjusted CH (8.96 ± 1.43 mmHg) and CRF (9.07 ± 1.93 mmHg) values in comparison to OHT patients (CH: 10.2 ± 1.5 mmHg; CRF: 10.6 ± 2.1 mmHg) and controls (CH: 9.7 ± 1.4 mmHg; CRF: 10.2 ± 1.9 mmHg). This difference was statistically significant (CH: p = 0.003; CRF: p = 0.008). There was also a statistically significant difference in adjusted CH (p = 0.001) and CRF (p = 0.004) values between the controls and the visual field groups, with the lowest values being in the most advanced group.


CONCLUSIONS
Before interpreting corneal biomechanical parameters, it seems important to adjust the measured data for their underlying influencing factors. Glaucoma patients with lower adjusted CH and CRF probably have more advanced disease and should, therefore, be treated more aggressively and monitored more carefully and frequently.
Department of Ophthalmology, Medical Faculty Carl Gustav Carus, Technische Universität, Fetscherstrasse 74, 01307, Dresden, Germany. karin.pillunat@uniklinikum-dresden.de.
Karin R
KR
Pillunat
Department of Ophthalmology, Medical Faculty Carl Gustav Carus, Technische Universität, Fetscherstrasse 74, 01307, Dresden, Germany.
Cosima
C
Hermann
Department of Ophthalmology, Medical Faculty Carl Gustav Carus, Technische Universität, Fetscherstrasse 74, 01307, Dresden, Germany.
Eberhard
E
Spoerl
Department of Ophthalmology, Medical Faculty Carl Gustav Carus, Technische Universität, Fetscherstrasse 74, 01307, Dresden, Germany.
Lutz E
LE
Pillunat
D000368:Aged; D001696:Biomechanical Phenomena; D003315:Cornea / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D014065:Tonometry, Ocular; D014794:Visual Fields
Corneal hysteresis; Corneal resistance factor; Ocular response analyzer; Open-angle glaucoma; Visual field severity