title: Structural and biomechanical corneal differences between patients suffering from primary congenital glaucoma and healthy volunteers.
abstract: OBJECTIVE
  To determine whether a set of ocular morphometric and biomechanical variables are able to discriminate between healthy volunteers and patients suffering from primary congenital glaucoma (PCG).
  
  
  METHODS
  Case-control study in which 66 patients with PCG and 94 age-matched healthy subjects were evaluated using ocular response analyser (ORA) to record corneal biomechanical properties. Topographic corneal variables were obtained using the Pentacam in both groups. To determine the ability to discern between both groups, a multivariate binary logistic model was constructed. The outcome was the diagnosis of PCG and the predictors; the corneal variables analysed along with their first-term interactions. Sensitivity and specificity of this model along with the area under the receiver characteristic operating curve (AUC of ROC) were determined.
  
  
  RESULTS
  The best model to discriminate between both groups included the following predictors: corneal hysteresis (CH), corneal resistance factor (CRF), posterior maximum elevation (PME), anterior maximum elevation (AME) and central corneal thickness (CCT). This model, for a cut-point of 50%, presents a sensitivity of 86.67%, a specificity of 86.89% and an AUC of the ROC curve of 93.16% [95% confidence interval (CI): 88.97-97.35]. The adjusted odds ratios of those predictors which showed a significant discriminating capacity were as follows: for CH, 0.27 (95% confidence interval: 0.15-0.46); for CRF, 2.13 (95% CI: 1.33-3.40); for PME, 1.06 (95% CI: 1.01-1.12); and for AME, 1.35 (95% CI: 1.10-1.66).
  
  
  CONCLUSIONS
  Corneal hysteresis (CH), CRF, PME and AME are able to discern between patients with PCG and healthy controls. This fact suggests that there are structural and biomechanical differences between these groups.
authors: Ophthalmology Department, Clinico San Carlos University Hospital, Sanitary Research Institute of the San Carlos Clinical Hospital, Madrid, Spain.
authors: Lucía
authors: L
authors: Perucho-González
authors: Ophthalmology Department, Clinico San Carlos University Hospital, Sanitary Research Institute of the San Carlos Clinical Hospital, Madrid, Spain.
authors: Federico
authors: F
authors: Sáenz-Francés
authors: Ophthalmology Department, Clinico San Carlos University Hospital, Sanitary Research Institute of the San Carlos Clinical Hospital, Madrid, Spain.
authors: Laura
authors: L
authors: Morales-Fernández
authors: Ophthalmology Department, Clinico San Carlos University Hospital, Sanitary Research Institute of the San Carlos Clinical Hospital, Madrid, Spain.
authors: José María
authors: JM
authors: Martínez-de-la-Casa
authors: Ophthalmology Department, Clinico San Carlos University Hospital, Sanitary Research Institute of the San Carlos Clinical Hospital, Madrid, Spain.
authors: Carmen D
authors: CD
authors: Méndez-Hernández
authors: Ophthalmology Department, Clinico San Carlos University Hospital, Sanitary Research Institute of the San Carlos Clinical Hospital, Madrid, Spain.
authors: Enrique
authors: E
authors: Santos-Bueso
authors: Glaucoma Department, Moorfields Eye Hospital & Great Ormond Street Hospital for Children, London, UK.
authors: John L
authors: JL
authors: Brookes
authors: Ophthalmology Department, Clinico San Carlos University Hospital, Sanitary Research Institute of the San Carlos Clinical Hospital, Madrid, Spain.
authors: Julián
authors: J
authors: García-Feijoó
mesh_terms: D002675:Child, Preschool; D003315:Cornea / Q000473:pathology* / Q000503:physiopathology*; D019781:Corneal Topography; D004548:Elasticity; D005260:Female; D005901:Glaucoma / Q000151:congenital / Q000175:diagnosis* / Q000503:physiopathology; D064368:Healthy Volunteers; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D012189:Retrospective Studies
keywords: Pentacam; corneal biomechanics; corneal topography; ocular response analyser; primary congenital glaucoma