Canadian perspectives in glaucoma management: The role of central corneal thickness

Behki, Rama; Damji, Karim F.; Crichton, Andrew

doi:10.3129/can.j.ophthalmol.06-108

Cited by 10 publications

(6 citation statements)

References 41 publications

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“…There is much interest currently in studying the cornea of glaucoma patients and investigating whether either its thickness or the curvature may play a role (Behki et al. 2007).…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of exfoliation syndrome in the Reykjavik Eye Study

Arnarsson

2009

Acta Ophthalmologica

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Exfoliation syndrome (XFS) is a major risk factor for glaucoma. It is characterized by a pathological accumulation of polymorphic fibrillar material in the anterior segment of the eye. It is likely that the increase in intraocular pressure (IOP) seen in XFS patients is at least in part because of flakes of material clogging up the trabecular meshwork, and thereby increasing the resistance to outflow and increasing IOP. XFS glaucoma progresses more rapidly, is more resistant to medical treatment and has worse prognosis than other glaucomas. The prevalence of XFS has been found to vary greatly between different studies, raising the possibility of racial and/or environmental modulators. XFS has also been linked to other changes in ophthalmological structures such as; changes in central corneal thickness (CCT), steeper corneal curvature (CC) and nuclear lens opacifications. Some studies have found XFS to be associated with systemic diseases, mostly cardiovascular and cerebrovascular. Exposure to ultra-violet (UV) light has also been investigated as a possible culprit, along with several other plausible factors. The aim of the present study was to determine the prevalence and 5-year incidence of XFS, to establish possible risk factors and/or concomitant symptoms and finally to investigate the relationship between XFS and glaucomatous changes. The Reykjavík Eye Study (RES) is a prospective study based on a random sample from the Icelandic national population sample. The baseline examination was performed in the autumn of 1996, when 1045 persons older than 50 years participated. Of these, 846 (88.2% of survivors) participated in a follow-up 5 years later. All participants went through a standard examination protocol, and answered a comprehensive questionnaire on health and life style. In the prevalence study, XFS was found in 10.7% of subjects, more frequently in women and older persons. Five years later, a further 5.2% of those that participated in the follow-up study and had no signs of XFS at baseline were diagnosed having XFS. We found a strong correlation between IOP and XFS. No difference was found in the anterior segment parameters measured, but there was a significant loss of neural tissue in the XFS as demonstrated by measurements of cup/disk ratio. In conclusion, we find XFS to be frequent among Icelanders, increasing with age and more in women. Our diagnostic criteria are reliable over time. We have also identified possible risk factors that point to a role of antioxidants in the development of XFS. We find changes in corneal curvature and thickness more related to age than XFS.

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“…There is much interest currently in studying the cornea of glaucoma patients and investigating whether either its thickness or the curvature may play a role (Behki et al. 2007).…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of exfoliation syndrome in the Reykjavik Eye Study

Arnarsson

2009

Acta Ophthalmologica

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“…2005) Jonas & Papastathopoulos (1997) found the optic disc to be slightly smaller in eyes with PEX than in eyes without PEX. There has been much interest recently in the role of central corneal thickness (CCT) in the management of glaucoma (Behki et al. 2007).…”

Section: Introductionmentioning

confidence: 99%

Pseudoexfoliation in the Reykjavik Eye Study: prevalence and related ophthalmological variables

Arnarsson

Damji

Sverrisson

et al. 2007

Acta Ophthalmologica Scandinavica

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131

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. Purpose: To examine the age and sex‐specific prevalence of pseudoexfoliation syndrome (PEX) and its relationship with some ophthalmological variables. Methods: We carried out a population‐based study using a random sample taken from the national population census for citizens of Reykjavik, aged ≥ 50 years. A total of 1045 individuals participated in all parts of the study. Pseudoexfoliation was established by slit‐lamp examination with a maximally dilated pupil carried out by two experienced ophthalmologists, who were masked to one another’s results except in cases of disagreement where they had to reach a consensus. Results: In all, 108 (10.7%) persons were found to have PEX in at least one eye. Prevalence increased from 2.5% in those aged 50–59 years to 40.6% in those aged ≥ 80 years. Women were more frequently affected than men (12.3% versus 8.7%). This difference remained statistically significant after controlling for the effect of age (p < 0.001). Eyes with PEX were found to have higher intraocular pressure (IOP) than eyes without PEX (p < 0.05). However, PEX was not found to be related to central corneal thickness, anterior chamber depth, lens thickness, nuclear lens opacifications or optic disc morphology in a multivariate model. Conclusions: Pseudoexfoliation is an age‐related phenomenon commonly found in Iceland. It is more commonly found in women than in men and is associated with elevated IOP.

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“…It is widely accepted that intraocular pressure (IOP) readings are overestimated in eyes with a thicker cornea and underestimated with thinner cornea. [1] CCT also provides valuable information in risk profiling patients with ocular hypertension (OHT) and suspect glaucoma, [2] since a thinner CCT is associated with a greater risk of conversion of OHT to glaucoma and increased risk of glaucoma progression. [3] Evaluation of CCT is also useful in the diagnosis and monitoring of corneal dystrophies [4] and prior to refractive surgery, to ensure that the thickness of the residual corneal bed after surgery is sufficient to minimise the risk of postoperative corneal ectasia.…”

Section: Introductionmentioning

confidence: 99%

Repeatability and agreement of central corneal thickness measurements with a new handheld non-contact pachymeter

Lawrenson

Gill

Masuid

et al. 2023

Preprint

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Purpose: To compare the repeatability of central corneal thickness (CCT) measurements taken with a new hand-held pachymeter (Occuity PM1 Pachymeter) and to assess its agreement with ultrasound biometry and two commercially available optical biometers in participants with normal eyes. Methods: Three consecutive CCT measurements of the right eye of 105 participants with normal corneas were acquired by the PM1 pachymeter, Lenstar LS900 and Oculus Pentacam HR in a random order. This was followed by three measurements with a hand-held ultrasound pachymeter (UP) (Pachmate-2). Repeatability and the repeatability limit were calculated with each device and Bland-Altman limits of agreement (LoA) were determined for the PM1 pachymeter compared to the other devices. Results: The mean CCT (SD) was 551.04 SD 33.43 μm, 558.62 SD 31.46 μm, 549.41 SD 31.00 μm, and 539.73 SD 29.50 μm for the PM1 pachymeter, UP, Lenstar and Pentacam, respectively. The repeatability limits (expressed as the within subject SD for repeat measurements) were 14.02, 13.68, 4.99 and 9.90 μm respectively. The closest agreement was between the PM1 and Lenstar (mean difference = 1.63 μm with LoA 10.72 μm below and 13.97 μm above the readings obtained with the Lenstar. The PM1 underestimated CCT compared to UP (mean difference = 7.58 μm, LoA 24.63 μm below and 9.47 μm above UP. The agreement was lowest between the PM1 and Pentacam (mean difference= -11.30 μm, LoA between 4.29 μm and 26.89 μm). Conclusions: The PM1 pachymeter shows excellent precision for CCT measurements across a range of corneal thicknesses in normal eyes and provides a safe and easy to use alternative to ultrasound pachymetry.

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Canadian perspectives in glaucoma management: The role of central corneal thickness

Cited by 10 publications

References 41 publications

Epidemiology of exfoliation syndrome in the Reykjavik Eye Study

Epidemiology of exfoliation syndrome in the Reykjavik Eye Study

Pseudoexfoliation in the Reykjavik Eye Study: prevalence and related ophthalmological variables

Repeatability and agreement of central corneal thickness measurements with a new handheld non-contact pachymeter

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