Comparing Corneal Variables in Healthy Subjects and Patients with Primary Open-Angle Glaucoma

Saenz-Frances, Federico; Garcia-Feijó, Julian; Jáñez, Luis; Borrego-Sanz, Lara; Martinez-de-la-Casa, José M.; Fernandez-Vidal, Ana; Méndez-Hernández, Carmen; Santos-Bueso, E.; Reche-Frutos, J; García–Sánchez, J.

doi:10.1167/iovs.10-6660

Cited by 11 publications

(15 citation statements)

References 48 publications

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“…Well-described risk factors for POAG include elevated intraocular pressure (IOP), advancing age, African and Hispanic ancestry [1], reduced central corneal thickness [1]–[5], and a positive family history. Recent studies suggest that lower cerebrospinal fluid pressure (CSFP) may contribute to the risk of developing open angle glaucoma, including both POAG and normal tension glaucoma [6]–[8].…”

Section: Introductionmentioning

confidence: 99%

Cerebrospinal Fluid Pressure Decreases with Older Age

et al. 2012

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PurposeClinical studies implicate low cerebrospinal fluid pressure (CSFP) or a high translaminar pressure difference in the pathogenesis of primary open angle glaucoma (POAG) and normal tension glaucoma (NTG). This study was performed to examine the effect of age, sex, race and body mass index (BMI) on CSFP.MethodsElectronic medical records from all patients who had a lumbar puncture (LP) performed at the Mayo Clinic from 1996–2009 were reviewed. Information including age, sex, race, height and weight, ocular and medical diagnoses, intraocular pressure (IOP) and LP opening pressure was obtained. Patients using medications or with medical diagnoses known to affect CSFP, and those who underwent neurosurgical procedures or where more than one LP was performed were excluded from analysis.ResultsElectronic medical records of 33,922 patients with a history of having an LP during a 13-year period (1996–2009) were extracted. Of these, 12,118 patients met all entry criteria. Relative to mean CSFP at age group 20–49 (mean 11.5±2.8 mmHg), mean CSFP declined steadily after age 50, with percent reduction of 2.5% for the 50–54 age group (mean 11.2±2.7 mmHg, p<0.002) to 26.9% for the 90–95 group (mean 8.4±2.4 mmHg, p<0.001). Females had lower CSFP than males throughout all age groups. BMI was positively and independently associated with CSFP within all age groups.ConclusionThere is a sustained and significant reduction of CSFP with age that begins in the 6th decade. CSFP is consistently lower in females. BMI is positively and independently associated with CSFP in all age groups. The age where CSFP begins to decline coincides with the age where the prevalence of POAG increases. These data support the hypothesis that reduced CSFP may be a risk factor for POAG and may provide an explanation for the mechanism that underlies the age-related increase in the prevalence of POAG and NTG.

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Section: Introductionmentioning

confidence: 99%

Cerebrospinal Fluid Pressure Decreases with Older Age

et al. 2012

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“…In contrast to this approach, in a previous study, we designed a model of corneal thickness by zones that consisted of a circle centred at the corneal apex and several circumferential rings concentric to this circle until the limbus was reached (central circumference and concentric rings had 1 mm of diameter). This model proved effective to discriminate between cases of POAG and healthy controls (ROC curve AUC of 0.711; IC 95%: 0.622–0.801;Saenz‐Frances et al. 2011).…”

Section: Discussionmentioning

confidence: 97%

“…Our choice of a circular design with concentric rings was based on the circular contour of the cornea itself and the circumferential contour of the cones of the Goldmann and dynamic contour tonometers. However, this circumferential design posed some theoretical problems: first, the shape of the cornea is not an exact circle; second, this design determined that the most eccentric ring was incomplete and the ring immediately concentric to it did not have a homogeneous thickness (Saenz‐Frances et al. 2011).…”

Section: Discussionmentioning

confidence: 99%

“…This study was designed to characterize several zoning models of corneal thickness in both healthy controls and patients with POAG and to analyse their effect on Dynamic Contour Tonometry (DCT), Goldmann applanation tonometry (GAT) and rebound tonometry (RT). The zoning models proposed consist in contrast to our previous model (Saenz‐Frances et al. 2011, 2012) in circular concentric zones (centred at the corneal apex), whose contour is adapted to the geometric contour of the cornea of each subject.…”

Section: Introductionmentioning

confidence: 99%

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Characterization of the thickness of different corneal zones in glaucoma: effect on dynamic contour, Goldmann and rebound tonometries

Saenz-Frances

Jáñez

Borrego-Sanz

et al. 2013

Acta Ophthalmologica

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. Purpose: To characterize five models of corneal thickness circular zoning in a sample of healthy controls and a sample of patients with primary open‐angle glaucoma (POAG) and to determine their effect on Goldmann (GAT), dynamic contour (DCT) and rebound tonometers (RT). Methods: The study participants were 122 controls and 129 cases. Five corneal thickness zoning models (A, B, C, D and E) were constructed. The partitioning pattern consisted of a circle centred at the corneal apex and several concentric rings, until the limbus; the contours of each ring followed the geometry of the corneal contour of each participant. In Model A, the central circle was 1 mm in diameter and five concentric rings were established. Mean was obtained for each zone for both samples and compared between them using a t‐test. The effect on the tonometers of central cornel thickness (CCT) and mean thickness of the zones generated was determined through several linear regression models (one per tonometer and per sample). Results: According to a t‐test, cases and controls differ in zones I [mean difference (MD): 17.93 μm], V (MD: 25.52 μm) and VI (MD: 31.78 μm) of model A (higher values in the cases sample). RT was affected by CCT (controls: B = 0.089; cases: B = 0.081). DCT was affected by zone IV of model A (controls: B = −0.029; cases: B = −0.012). GAT was affected by CCT (controls: B = 0.043; cases: B = 0.025) and zone III of model A (controls: B = −0.045; cases: B = −0.033). Conclusion: Our results highlight the importance of the thickness of other regions of the cornea different from its main centre in discriminating between healthy controls and patients with POAG and in IOP measurements made using DCT, GAT and RT.

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“…However, while much attention has been paid to the method used to determine IOP and its reliability, the influence that the different systems used to measure CCT may have on IOP variations has not been subject to such rigorous validation [19,20]. …”

Section: Discussionmentioning

confidence: 99%

Agreement between Central Corneal Thickness Measured Using Pentacam, Ultrasound Pachymetry, Specular Microscopy and Optic Biometer Lenstar LS 900 and the Influence of Intraocular Pressure

Borrego-Sanz

Sáenz-Francés²,

Bermúdez-Vallecilla³

et al. 2014

Ophthalmologica

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Purpose: To compare central corneal thickness (CCT) values obtained by Lenstar (LE), Pentacam (PC), specular microscopy (SM) and ultrasound pachymetry (UP) in healthy corneas and study their influence on intraocular pressure (IOP) readings determined by Goldmann applanation tonometry (GAT). Methods: CCT was measured in 76 healthy subjects by LE, PC, SM and UP. We established Lin's concordance correlation coefficient (ρ-C) between different techniques. The influence of CCT on GAT was established through univariate linear regression models, IOP being the dependent variable. Results: The highest ρ-C was found between LE and SM at 0.94 (95% CI: 0.91-0.96) and between LE and UP at 0.95 (95% CI: 0.94-0.97). IOP readings showed less variability when CCT was determined using LE (7.7%, B = 0.16; 95% CI: 0.004-0.28). Conclusions: Although CCT values obtained with UP, PC, SM and LE show good correlation, these methods are not completely interchangeable. The amount of IOP variation differs when CCT is determined using LE or SM.

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Comparing Corneal Variables in Healthy Subjects and Patients with Primary Open-Angle Glaucoma

Cited by 11 publications

References 48 publications

Cerebrospinal Fluid Pressure Decreases with Older Age

Cerebrospinal Fluid Pressure Decreases with Older Age

Characterization of the thickness of different corneal zones in glaucoma: effect on dynamic contour, Goldmann and rebound tonometries

Agreement between Central Corneal Thickness Measured Using Pentacam, Ultrasound Pachymetry, Specular Microscopy and Optic Biometer Lenstar LS 900 and the Influence of Intraocular Pressure

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