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Keywords:

  • corneal biomechanics;
  • glaucoma;
  • intraocular pressure;
  • optic nerve head

Abstract

Background:  To investigate the association between corneal biomechanics and optic nerve head morphology in newly diagnosed primary open-angle glaucoma patients.

Design:  Hospital based prospective study.

Participants:  Forty-two untreated newly diagnosed primary open-angle glaucoma patients.

Methods:  Patients underwent corneal hysteresis measurement using the Ocular Response Analyzer and confocal scanning laser ophthalmoscopy for optic nerve head topography evaluation. One eye was selected randomly for analysis. Data collected included age, race, gender, intraocular pressure and central corneal thickness.

Main Outcome Measures:  Multiple regression analysis (controlling for baseline intraocular pressure and disc area) was used to investigate factors associated with the following optic nerve head topographic parameters: linear cup-to-disc ratio and mean cup depth.

Results:  Mean age of participants was 66.7 ± 11.8 years. Corneal hysteresis was the only factor significantly associated with both mean cup depth (correlation coefficient [r] = −0.34, P = 0.03) and cup-to-disc ratio (r = −0.41, P = 0.01). Central corneal thickness was significantly associated with mean cup depth (r = −0.35, P = 0.02), but not with cup-to-disc ratio (r = −0.25, P = 0.13). Although a trend towards a positive association between age and cup-to-disc ratio was identified (r = 0.26, P = 0.08), age was not significantly associated with mean cup depth (r = 0.06, P = 0.72). When comparing fellow eyes of patients with bilateral glaucoma, the eye with higher corneal hysteresis had smaller cup-to-disc ratio in 75% of the cases.

Conclusions:  In untreated newly diagnosed primary open-angle glaucoma patients, those with thinner corneas and mainly lower corneal hysteresis values had a larger cup-to-disc ratio and deeper cup, independently of intraocular pressure values and disc size.