Central corneal thickness and progression of the visual field and optic disc in glaucoma

Abstract

Aims: To determine whether central corneal thickness (CCT) is a significant predictor of visual field and optic disc progression in open angle glaucoma. Methods: Data were obtained from a prospective study of glaucoma patients tested with static automated perimetry and confocal scanning laser tomography every 6 months. Progression was determined using a trend based approach called evidence of change (EOC) analysis in which sectoral ordinal scores based on the significance of regression coefficients of visual field pattern deviation and neuroretinal rim area over time are summed. Visual field progression was also determined using the event based glaucoma change probability (GCP) analysis using both total and pattern deviation. Results: The sample contained 101 eyes of 54 patients (mean (SD) age 56.5 (9.8) years) with a mean follow up of 9.2 (0.7) years and 20.7 (2.3) sets of examinations every 6 months. Lower CCT was associated with worse baseline visual fields and lower mean IOP in the follow up. In the longitudinal analysis CCT was not correlated with the EOC scores for visual field or optic disc change. In the GCP analyses, there was a tendency for groups classified as progressing to have lower CCT compared to nonprogressing groups. In a multivariate analyses accounting for IOP, the opposite was found, whereby higher CCT was associated with visual field progression. None of the independent factors were predictive of optic disc progression. Conclusions: In this cohort of patients with established glaucoma, CCT was not a useful index in the risk assessment of visual field and optic disc progression.

Differences in central corneal thickness between the paired eyes and the severity of the glaucomatous damage

“…Kim and Chen 23 and Herndon et al 6 proved the association of thinner central cornea values with VF progression in glaucoma patients. Jonas et al 7 and Chauhan et al 24 found an association between lower CCT and worse baseline VF, but the lower CCT was not associated with the progression of glaucomatous optic nerve neuropathy.…”

Corneal thickness and visual field damage in glaucoma patients

“…9 The IOP value measured with 24 found an association among lower CCT and worse base line VF, but the lower CCT was not associated with progression of glaucomatous optic nerve neuropathy.…”

Frequency-Doubling Technology Perimetry for Detection of the Development of Visual Field Defects in Glaucoma Suspect Eyes

“…As shown in some studies, the association of baseline IOP measurement and central corneal thickness with VF progression may not always be significant in patients with glaucoma. 17,[21][22][23][24] In fact, only average RNFL thickness and number of clock hours of abnormal RNFL measurements obtained at the baseline were accountable for SAP and FDT perimetry progression. We showed that for each micrometer reduction in average RNFL thickness, there was a 14% increase in risk for progression in SAP, and 15% increase in risk for progression in FDT perimetry.…”