Purpose To evaluate the role of corneal hysteresis (CH) as a risk factor for the rate of visual field progression in a cohort of glaucoma patients followed prospectively over time. Design Prospective observational cohort study. Participants The study group included 114 eyes of 68 glaucoma patients followed for an average of 4.0 ± 1.1 years. Visual fields were obtained with standard automated perimetry. Included eyes had a median number of 7 (range: 5 to 12) tests during follow-up. Methods CH measurements were acquired at baseline using the Ocular Response Analyzer (Reichert Instruments, Depew, NY, USA). Evaluation of rates of visual field change during follow-up was performed using the Visual Field Index (VFI). Linear mixed models were used to investigate the relationship between rates of visual field loss and baseline CH, baseline intraocular pressure (IOP) and central corneal thickness (CCT), while adjusting for potentially confounding factors. An interaction term between IOP and CH was included in the model to investigate whether the effect of IOP on rates of progression depended on the level of CH. Main Outcome Measures Effects of CH, IOP and CCT on rates of VFI loss over time. Results CH had a significant effect on rates of visual field progression over time. In the univariable model including only CH as a predictive factor along with time and their interaction, each 1mmHg lower CH was associated with 0.25%/year faster rate of VFI decline over time (P<0.001). The multivariable model showed that the effect of IOP on rates of progression depended on CH. Eyes with high IOP and low CH were at increased risk for having fast rates of disease progression. CH explained a larger proportion of the variation in slopes of VFI change than CCT (17.4% versus 5.2%, respectively). Conclusion CH measurements were significantly associated with risk of glaucoma progression. Eyes with lower CH had faster rates of visual field loss than those with higher CH. The prospective longitudinal design of this study supports the role of CH as an important factor to be considered in the assessment of the risk of progression in glaucoma patients.

The results demonstrate that approximately 10% of the senior population in the Shihpai district has a correctable visual impairment. Thus, it is important to educate the public about the importance of regular examination and the possibility of improving visual acuity by wearing glasses.

To investigate the association between body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters) and cataract in a metropolitan Asian elderly population. Design: Population-based cross-sectional study. Agerelated cataract was defined as any type of lens opacity (ie, nuclear, cortical, and posterior subcapsular opacity) with a Lens Opacities Classification System III grade of more than 2 in one or both eyes. Weight and height were measured by intensively trained interviewers. Results: A total of 2045 subjects 65 years and older in Shihpai, Taipei, were invited to participate, and 1361 (66.6%) completed the survey. Of the subjects, 806 were diagnosed as having age-related cataracts. With a BMI of less than 21.3 as a reference point (odds ratio [OR], 1.00), a U-shaped relationship between BMI and nuclear opacity was demonstrated. A reverse U-shaped relationship was shown for cortical opacity. In the final multiple logistic regression models, BMI and BMI 2 were significantly related to nuclear opacity (BMI data: OR, 0.73 [95% confidence interval {CI}, 0.54-0.98]; and BMI 2 data: OR, 1.01 [95% CI, 1.00-1.01]) and cortical opacity (BMI data: OR, 1.52 [95% CI, 1.04-2.34]; and BMI 2 data: OR, 0.99 [95% CI, 0.98-0.99]). Neither BMI nor BMI 2 was related to posterior subcapsular opacity. Conclusion: Body mass index is an independent risk factor for nuclear and cortical opacities, but in reverse direction to each other.

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