Corneal hysteresis (CH) measured with Ocular Response Analyzer (Reichert: ORA) has been reported to be closely related to the glaucomatous visual field (VF) progression. The air pulse applied to an eye not only induces corneal deformation, but also whole eye motion (WEM), which may result in an inaccurate measurement of CH. Here we investigated the influence of air pulse-driven WEM measured with the Corivs ST (CST®, OCULUS) on the relationship between CH and VF progression in primary open angle-glaucoma patients. Using the CST parameters of the maximal WEM displacement (WEM-d) and the time to reach that displacement (WEM-t), the eyes were classified into subgroups (WEM-d low- and high-group, and WEM-t short- and long-group). For the whole population and all subgroups, the optimal linear mixed model to describe mean of total deviation (mTD) progression rate with eight reliable VFs was selected from all combinations of seven parameters including CH. As a result, optimal models for the mTD progression rate included CH in the whole population, the WEM-d low- group and the WEM-t short-group, but not in the WEM-d high-group and the WEM-t long-group. Our findings indicated association between CH and glaucomatous progression can be weakened because of large WEM.

Purpose We have recently reported that the retinal stretch due to myopia is closely related to the peripapillary retinal arteries angle (PRAA) (Yamashita et al., Invest Ophthalmol Vis Sci 2013;54:5481–5488). The purpose of the current study was to investigate the relationship between retinal artery position and Ocular Response Analyzer (ORA) waveform parameters. Methods In 43 eyes of 41 healthy subjects, ORA measurements were carried out and the PRAA was calculated from fundus photographs. Then, the variables related to PRAA were identified from 40 variables of age, axial length (AL), keratometry, ORA corneal hysteresis (CH), ORA corneal resistant factor (CRF), and 35 ORA waveform parameters, using the Lasso regression and model selection with the second-order bias-corrected Akaike information criterion index. Results The optimal model for PRAA included AL, CRF, and three ORA waveform parameters (aindex, w2, and slew1). This optimal model was significantly better than the model with AL-only, the model only with AL and CH, and the model only with AL and CRF ( P < 0.0001, P < 0.0001, P < 0.0001, respectively; analysis of variance). Conclusions The PRAA was significantly better represented by using AL and ORA parameters including waveform parameters, compared with AL alone, with AL and CH alone, and with AL and CRF alone. Translational Relevance ORA waveform, which represents corneal biomechanical properties, was associated with myopic retinal stretch.

PURPOSE.To investigate the relationship between biomechanical glaucoma factor (BGF) measured with Corvis ST and glaucomatous visual field (VF) progression, compared to corneal hysteresis (CH) measured with ocular response analyzer using a longitudinal dataset of primary open-angle glaucoma (POAG). The discriminative powers of BGF and CH were also compared using a cross-sectional dataset. METHODS.The longitudinal dataset included 166 POAG eyes. The rate of VF change during the follow-up period was evaluated using the mean of 52 pointwise total deviations in the Humphrey 24-2 field test. Variables associated with the VF progression rate were identified from BGF, CH, age, baseline VF severity, and intraocular pressure during the VF follow-up period by identifying the optimal model. The cross-sectional dataset included 68 POAG eyes and 68 healthy eyes. Using this dataset, the area under the curve (AUC) values of the receiver-operating curve were compared between CH and BGF. RESULTS.The optimal multivariate linear mixed model to describe the VF rate included age and CH, but not BGF. Between POAG and healthy eyes, CH was statistically different (P < 0.001), although this was not the case with BGF. The AUC values were 0.61 and 0.71 for BGF and CH, respectively (P = 0.027). CONCLUSIONS.CH, but not BGF, was associated with VF progression in POAG patients under treatment. BGF was not useful to discriminate POAG between treated and normal eyes.

Whole field trend analysis can miss local VF progression. Cluster trend analysis appears as robust as mTD trend analysis and useful to assess both sectorial and whole field progression. Cluster-based trend analyses, in particular the definition of two or more progressing cluster, may help clinicians to detect glaucomatous progression in a timelier manner than using a whole field trend analysis, without significantly compromising specificity.