Central Corneal Thickness as a Predictor of Visual Field Loss in Primary Open Angle Glaucoma for a Hispanic Population

Abstract

Background Primary Open Angle Glaucoma is a multi-factorial disease with a devastating impact on the quality of life of the patient in the moderate and severe stages of the disease. Identifying risk factors for the development of moderate to severe visual field loss may decrease the proportion of patients that experience the severe forms of this disease. Purpose To evaluate whether the central corneal thickness correlates inversely with the severity of visual field loss in Primary Open Angle Glaucoma. Methods Retrospective review of 308 charts of patients seen during a six-week period by a glaucoma specialist in his community practice in a large Hispanic area. Patients were classified as normal, ocular hypertensive, and those with Primary Open Angle Glaucoma. Odds ratios and 95% confidence interval were calculated to evaluate risk factors associated to ocular hypertension and Primary Open Angle Glaucoma. Finally, a multivariate polytomous regression model was used to evaluate central corneal thickness as an independent predictor of outcome after adjustment for age and hypertension. Statistical significance was set at p<0.05. Results Patients with Primary Open Angle Glaucoma show a statistically significant inverse correlation between central corneal thickness and the severity of the visual field damage. Conclusion Thinner corneas could be considered a risk factor for the severity of visual field loss in Primary Open Angle Glaucoma.

Correlation between central corneal thickness and visual field defects, cup to disc ratio and retinal nerve fiber layer thickness in primary open angle glaucoma patients

“…This confirmed CCT as an independent risk factor for glaucomatous VF defects 17. Other studies also highlighted significant negative correlation between CCT and VF parameters 5,6. Same was found in patients with chronic PACG by Hong S et al, who found thin corneas showing more progression in VF defects 18.…”

“…The glaucomatous damage is assessed by detection of Visual Field (VF) defects, which shows the glaucomatous damage in functional terms. Humphrey Visual Field (HVF) is an automated perimetry widely used to detect VF defects and monitor glaucoma progression 6. The indices like mean deviation (MD) and Pattern Standard Deviation (PSD) show the damage of glaucoma in relation to normal population, and despite their limitations, are widely used in grading and staging of glaucoma 7.…”

Emerging risk factors for glaucoma onset and progression

“…One caveat, however, is the difficulty in separating CCT from its effect on IOP measurement, given that gold-standard Goldmann applanation pressure measurements are related to CCT. Regardless, multiple studies consistently identify CCT as an independent risk factor in multivariable modeling (Chauhan et al, 2005;De Moraes et al, 2011;Fernandez-Bahamonde et al, 2011;Francis et al, 2008;Manni et al, 2008). These include the OHTS and the combined OHTS and EGPS datasets (Gordon et al, 2007;Medeiros et al, 2005;Miglior et al, 2007a).…”

Is there a Relationship Between Sleep Apnea and Central Corneal Thickness?

“…8 As is widely known, intraocular pressure (IOP) remains the most important and the only risk factor associated with the development of glaucoma that is treatable. 9 The relationship between IOP and central corneal thickness (CCT) has been widely discussed in the literature. [10][11][12] Although the relationship between CCT and stage of glaucoma damage seems to be related to IOP measuring error, recent studies recognize CCT as an intrinsic ocular factor in the pathogenesis and progression of glaucoma.…”