Recovery of Corneal Hysteresis After Reduction of Intraocular Pressure in Chronic Primary Angle-Closure Glaucoma

Sun, Lei; Shen, Meixiao; Wang, Jianhua; Fang, Aiwu; Xu, Aiqin; Fang, Haizhen; Liu, Fan

doi:10.1016/j.ajo.2009.01.008

Cited by 97 publications

(90 citation statements)

References 26 publications

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“…However, because CH values appear to be considerably influenced by very high levels of IOP, this finding may not apply in eyes with IOP 432 mm Hg. In addition, it is likely that CH response to IOP is quite variable in individual patients, 31 and thus IOP may have more substantial influence on CH in some patients compared with others. Further investigation is required to better understand the complex relationship between CH and IOP.…”

Section: Discussionmentioning

confidence: 99%

Combining corneal hysteresis with central corneal thickness and intraocular pressure for glaucoma risk assessment

Pensyl

Sullivan-Mee

Torres-Monte

et al. 2012

Eye

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Purpose To determine whether adjusting corneal hysteresis (CH) values for central corneal thickness (CCT) and intraocular pressure (IOP) improves its capability to differentiate primary open-angle glaucoma (POAG) from ocular hypertension (OH). Methods This prospective, observational, cross-sectional study included 169 eyes of 169 subjects with a diagnosis of POAG (n ¼ 81) or OH (n ¼ 88). We utilized the Ocular Response Analyzer (ORA), Pascal Dynamic Contour Tonometer (DCT), Goldmann applanation tonometer (GAT), and ORA ultrasound pachymeter to obtain CH, IOP, and CCT values. Correlational, regression, and t-test analyses were conducted before and after the sample was divided into low, intermediate, and thick CCT subgroups. Results In the full sample, CH and CCT were moderately correlated (r ¼ 0.44, Po0.001). Although both were related to diagnosis in univariate regression analysis, only CH was independently related to glaucoma diagnosis in multivariate analysis. After the sample was divided into CCT tertiles, CH was significantly lower in POAG vs OH eyes within all three CCT subgroups, and CH was the only multivariate variable that differentiated POAG from OH in each CCT subgroup. Moreover, the relationship between CH and diagnosis was more robust within the CCT subgroups compared with the full sample, suggesting that integrating CCT into CH interpretation is beneficial. Adjusting CH for IOP did not aid diagnostic precision in this study. ConclusionOur findings suggest that combining CH and CCT for glaucoma risk assessment improves diagnostic capability compared to using either factor alone. Conversely, adjusting CH for IOP provided no clear clinical benefit in this study.

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Section: Discussionmentioning

confidence: 99%

Combining corneal hysteresis with central corneal thickness and intraocular pressure for glaucoma risk assessment

Pensyl

Sullivan-Mee

Torres-Monte

et al. 2012

Eye

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“…In vivo corneal biomechanical evaluation was first described by Luce (17) in 2005, with the development of the Ocular Response Analyzer (ORA, Reichert Ophthalmic Instruments, Depew, New York, USA). A number of researchers published diverse and exciting new data regarding corneal hysteresis (CH) and corneal resistance factor (CRF) in healthy and pathological conditions (18)(19)(20)(21)(22) . If ORA proves that "fragile" corneas are more susceptible than "strong" corneas to developing ectasia in the future, then the best use for such data in refractive surgery would be in preoperative screening.…”

Section: Ability Of Corneal Biomechanical Metrics and Anterior Segmenmentioning

confidence: 99%

Ability of corneal biomechanical metrics and anterior segment data in the differentiation of keratoconus and healthy corneas

Fontes¹,

Ambrósio²,

Jardim³

et al. 2010

Arq. Bras. Oftalmol.

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Purpose: To evaluate the sensitivity, specificity, and test accuracy of corneal biomechanical metrics and anterior segment data in differentiating keratoconus from healthy corneas. Methods: Comparative case series. Patients with and without keratoconus (gender and age-matched) were submitted for complete eye examinations including corneal hysteresis (CH) and corneal resistance factor (CRF) as measured by the Ocular Response Analyzer and anterior segment data as gathered through Pentacam assessments. The anterior segment data measurement included average central keratometric readings (K-Ave), corneal astigmatism (CA), central corneal thickness (CCT), anterior chamber depth (AC depth) and corneal volume (CV). All parameters were assessed, compared and analyzed. A receiver operating characteristic (ROC) curve was used to identify the best cutoff point by which to maximize the sensitivity and specificity of discriminating keratoconus from normal corneas for each data category. Results: Seventy seven eyes from forty three patients (24 male, 19 female) with keratoconus and eighty six eyes from forty three (24 male, 19 female) healthy controls were enrolled. ROC curve analysis showed poor overall predictive accuracy for all studied parameters in differentiating keratoconus from normal corneas. The highest sensitivity (79.2%) was obtained for both AC depth and CH (cutoff points 3.22 mm and 9.39 mmHg respectively). The best specificity (89.5%) and test accuracy (80.34%) were obtained for CA (cutoff point of 2.2 D). Conclusion: When considered together, studied parameters showed statistical differences between groups. However, when considered independently they presented low sensitivity, specificity and test accuracy in differentiating keratoconus from healthy corneas. Keywords: Cornea; Corneal diseases; Corneal topography; Biomechanics; Keratoconus. RESUMOObjetivo: Avaliar a sensibilidade, especificidade e acurácia de parâmetros biomecânicos e anatômicos do segmento anterior isolados na diferenciação de córneas saudáveis e com ceratocone. Métodos: Estudo tipo série de casos comparativa. Pacientes com ceratocone e controles saudáveis foram pareados (idade e sexo) e submetidos a exame oftalmológico completo, incluindo avaliação biomecânica (ORA) e tomográfica (Pentacam). Ceratometria central média, astigmatismo corneano, espessura corneana central, profundidade da câmara anterior, volume corneano, CH e CRF foram estabelecidos, avaliados e comparados. Curvas ROC (Receiver operating characteristic) foram utilizadas para identificar o melhor valor de corte que apresentasse a maior sensibilidade e especificidade na discriminação entre ceratocone e córneas saudáveis para cada dado estudado. Resultados: Setenta e sete olhos de 43 pacientes com ceratocone (24 homens e 19 mulheres) e 86 olhos de pacientes saudáveis (24 homens e 19 mulheres) foram incluídos no estudo. Curvas ROC mostraram baixa acurácia na predição do diagnóstico de ceratocone em todos os parâmetros isolados estudados. Maior sensibilidade encontrada foi 79,...

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“…In a comparative study of ORA parameters, Narayanaswamy et al 5 observed no significant differences in CH between POAG and PACG, but the CH was lower in POAG and PACG when compared to normal. Sun et al 9 also reported lower CH in their study on 40 PACG subjects compared to normal controls. However, it is not known if these parameters are related to glaucoma severity in PACG.…”

mentioning

confidence: 72%

Lack of Association Between Corneal Hysteresis and Corneal Resistance Factor With Glaucoma Severity in Primary Angle Closure Glaucoma

Nongpiur

Png

Chiew

et al. 2015

Invest. Ophthalmol. Vis. Sci.

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Citation: Nongpiur ME, Png O, Chiew JW, et al. Lack of association between corneal hysteresis and corneal resistance factor with glaucoma severity in primary angle closure glaucoma. Invest Ophthalmol Vis Sci. 2015;56:6879-6885. DOI:10.1167/ iovs.15-17930 PURPOSE. We investigated the association between corneal hysteresis (CH) and corneal resistance factor (CRF) with glaucoma severity in primary angle closure glaucoma (PACG). METHODS.We recruited 204 subjects with PACG. Each subject underwent CH and CRF measurements using the Ocular Response Analyzer (ORA), optic nerve head topography measurement using scanning laser ophthalmoscopy, and visual field assessment. Glaucoma severity was based on the visual field mean deviation (MD) and classified as mild (71), moderate (55), and severe (78).RESULTS. The mean age 6 SD of study subjects was 68.7 6 8.9 years, with most being Chinese (n ¼ 186; 91.2%). Corneal hysteresis and CRF were lowest in the severe PACG group (9.32 6 1.86 and 9.50 6 1.67 mm Hg) followed by moderate PACG (9.38 6 1.88 and 9.73 6 1.88 mm Hg) and mild PACG (9.47 6 1.90 and 9.85 6 1.75 mm Hg) respectively, but the differences were not significant (P ¼ 0.89 and P ¼ 0.46, respectively). There was a significant positive correlation between CH and central corneal thickness (CCT; correlation coefficient [r] ¼ 0.26, P < 0.001), CRF and CCT (r ¼ 0.43, P < 0.001), and negative correlation between CRF and vertical cup-disc ratio (VCDR; r ¼ À0.20, P ¼ 0.004), and CRF with cup-disc area (r ¼ À0.14, P ¼ 0.04). Corneal hysteresis and CRF were not correlated with MD (r ¼ 0.01 for CH, r ¼ 0.1 for CRF). After multivariate analyses, adjusting for age, sex, CCT, axial length, intraocular pressure, and number of glaucoma medication, no significant associations were noted between CH and CRF with MD, VCDR, disc area, rim area, or cup area.CONCLUSIONS. Corneal biomechanical parameters measured by the ORA are not associated with severity of glaucoma in PACG.

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Recovery of Corneal Hysteresis After Reduction of Intraocular Pressure in Chronic Primary Angle-Closure Glaucoma

Cited by 97 publications

References 26 publications

Combining corneal hysteresis with central corneal thickness and intraocular pressure for glaucoma risk assessment

Combining corneal hysteresis with central corneal thickness and intraocular pressure for glaucoma risk assessment

Ability of corneal biomechanical metrics and anterior segment data in the differentiation of keratoconus and healthy corneas

Lack of Association Between Corneal Hysteresis and Corneal Resistance Factor With Glaucoma Severity in Primary Angle Closure Glaucoma

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