A Prospective Longitudinal Study to Investigate Corneal Hysteresis as a Risk Factor for Predicting Development of Glaucoma

Kim

Invest. Ophthalmol. Vis. Sci.

et al. 2019

Citation: Lee KM, Kim T-W, Lee EJ, Girard MJA, Mari JM, Weinreb RN. Association of corneal hysteresis with lamina cribrosa curvature in primary open angle glaucoma. Invest Ophthalmol Vis Sci. 2019;60:4171-4177. https://doi.org/10.1167/iovs.19-27087 PURPOSE. To investigate whether corneal biomechanical properties are associated with the lamina cribrosa (LC) curvature in eyes with primary open angle glaucoma (POAG). METHODS.Corneal biomechanical properties and LC curvature were assessed in 65 treatmentnaïve POAG patients. Corneal biomechanical properties, including corneal hysteresis (CH), corneal resistance factor (CRF), and corneal-compensated intraocular pressure (IOPcc), were measured using an ocular response analyzer (ORA; Reichert Ophthalmic Instruments). LC curvature was assessed by measuring the LC curvature index (LCCI) on B-scan images obtained using spectral-domain optical coherence tomography (OCT). The LCCI was determined by measuring LC curve depth on the anterior LC surface and the width of the reference line. RESULTS.The LCCI was correlated with CH (P ¼ 0.001), CRF (P ¼ 0.012) and IOPcc (P ¼ 0.001) in the univariate analysis. To adjust multicollinearity, principal component analysis was performed, and multivariate regression analyses were conducted using one variable from each component. The larger LCCI was associated with larger IOPcc (P < 0.001), smaller CRF (P ¼ 0.001) and smaller CH (P < 0.001). CONCLUSIONS.Lower CH was associated with a more posteriorly curved LC in treatment naïve POAG patients. This finding may provide a basic explanation for the reported association between CH and an increased risk for glaucoma development and progression, and support a potential value of CH for risk assessment for glaucoma.

Section: Discussionmentioning

confidence: 99%

Association of Corneal Hysteresis With Lamina Cribrosa Curvature in Primary Open Angle Glaucoma

Kim

Invest. Ophthalmol. Vis. Sci.

et al. 2019

“…A lower CH is associated with the risk of developing glaucoma (Susanna et al. ), with glaucoma progression (Medeiros et al. ) as well as the severity of the disease (Pillunat et al.…”

Section: Introductionmentioning

confidence: 99%

A new biomechanical glaucoma factor to discriminate normal eyes from normal pressure glaucoma eyes

Pillunat

Herber

Spoerl

et al. 2019

Acta Ophthalmologica

Background To test the ability of the newly calculated Dresden biomechanical glaucoma factor (DBGF) based on dynamic corneal response (DCR) deformation and corneal thickness parameters, to discriminate between healthy and normal pressure glaucoma (NPG) eyes. Methods Seventy healthy and 70 NPG patients of Caucasian origin were recruited for this multicentre cross‐sectional pilot study, which included both eyes for analysis. Logistic regression analysis with generalized estimating equation (GEE) models to account for correlations between eyes and a threefold cross‐validation were performed to determine the optimal combination of Corvis ST parameters in order to separate normal from NPG eyes. Results The DBGF was calculated using 5 Corvis ST parameters, which showed the best discrimination power: deformation amplitude ratio progression, highest concavity time, pachymetry slope, the biomechanically corrected intraocular pressure and pachymetry. In a threefold cross‐validation, the receiver operating characteristic (ROC) curve confirmed an area under the curve (AUC) of 0.814 with a sensitivity of 76% and a specificity of 77% using a logit cut‐off value of a DBGF = 0.5. Conclusion The DBGF shows to be sensitive and specific to discriminate healthy from NPG eyes. Since diagnosis of NPG is often challenging, the DBGF may help with the differential diagnosis of NPG in daily clinical practice. Therefore, it might be considered as a new possible screening method for NPG.

“…This prompted our decision to separately evaluate male and female groups, as well as older and younger, groups. Other studies have already demonstrated that low CH is associated with glaucoma progression 3,4 . Here, we evaluated the relationship between systemic antioxidative status and CH; to the best of our knowledge, this is the first study to do so.…”

Section: Discussionmentioning

confidence: 86%

“…Even when IOP is stable, optic nerve head damage can vary between individuals due to differing susceptibility to glaucomatous damage 2 . Some researchers have found that glaucoma progression is related to specific material properties of the cornea, such as the strength of corneal viscoelastic damping, known as corneal hysteresis (CH) 3,4 . CH can be measured by temporarily inducing a concave deformation in the cornea with a pulse of air.…”

mentioning

confidence: 99%

The association between oxidative stress and corneal hysteresis in patients with glaucoma

Uchida

Himori

Hashimoto

et al. 2020

Sci Rep

Systemic antioxidative status has been implicated in glaucoma pathogenesis. Additionally, corneal hysteresis (cH) may contribute to glaucoma progression. Here, we evaluated the relationship between biological antioxidant potential (BAP) and CH. This study included 103 patients with open-angle glaucoma (oAG). We used a free radical analyzer to measure BAp, and an ocular response analyzer to measure cH and corneal resistance factor (cRf). We evaluated the relationship between systemic oxidative stress and other clinical parameters with Spearman's rank correlation test and a multiregression analysis. BAp was not correlated to either cH or cRf in the male or female oAG patients. BAP was correlated to both CH and CRF in the female OAG patients older than 57 years (r = 0.51, P = 0.003; r = 0.49, P = 0.004), but uncorrelated in the female OAG patients younger than 57 years. Multiple regression analysis revealed that BAp independently contributed to cH (P = 0.025) and CRF (P = 0.015) in the older female OAG patients. Systemic oxidative stress may significantly affect the viscoelasticity of the cornea in older female OAG patients. Future studies are needed to confirm that low systemic antioxidative status and low corneal hysteresis contribute to glaucoma pathogenesis.