• African;
  • central corneal thickness;
  • corneal hysteresis;
  • glaucoma;
  • intraocular pressure;
  • ocular response analyzer


Purpose:  To compare corneal hysteresis (CH) and corneal resistance factor (CRF) measured with the Ocular Response Analyzer® tonometer (ORA) between (i) African normals and treated primary open-angle glaucoma (POAG) patients and (ii) between normals and treated POAG Caucasians. To analyse the correlation of CH and CRF with visual field (VF) defects in the two groups.

Methods:  This comparative study included 59 African (29 (POAG), 30 normals) and 55 Caucasians (30 POAG and 25 normals) subjects. Goldmann applanation tonometry (GAT) and ORA measurements were performed in a randomized sequence. Visual field was tested with the Swedish interactive threshold algorithms standard strategy of the Humphrey perimeter. Hoddap classification was used to estimate the severity of VF defects.

Results:  Primary open-angle glaucoma Africans were younger than POAG Caucasians (p < 0.001). Goldmann applanation tonometry and central corneal thickness (CCT) did not differ significantly between the four subgroups. African normals had lower CH than Caucasian controls (p < 0.001). CH was 9.2 ± 1.1 and 8.3 ± 1.7 mmHg respectively in POAG Caucasians and Africans (p < 0.001). African controls had higher ORA corneal-compensated intraocular pressure (IOPcc) than Caucasian controls (p < 0.001). Primary open-angle glaucoma Africans had higher IOPcc values than Caucasian POAGs (p < 0.001). CH and IOPcc were associated with race (p < 0.001) but not with CCT. Based on mean deviation values (MD), POAG Africans had more severe VF defects. CH was correlated with MD (r = 0.442; p = 0.031) and severity of VF defects only in POAG Africans (= −0.464; p = 0.013).

Conclusions:  African normal subjects and POAG patients had an altered CH, which is associated with a significant underestimation of GAT IOP. This may potentially contribute to the earlier development and greater severity of glaucoma damage in Africans compared with Caucasians at diagnosis.