Central corneal pachymetry and visual field progression in patients with open-angle glaucoma

Abstract

Purpose To investigate the association between corneal pachymetry and visual field progression in patients with chronic open-angle glaucoma. Design Retrospective case–control study. Participants Eighty-eight patients with primary open-angle glaucoma, pseudoexfoliative glaucoma, pigmentary glaucoma, or normal-tension glaucoma, followed for an average of 8 years, who had visual field loss and progression as defined by modified Anderson criteria. Cases with progression were matched for race, diagnosis, and age at pachymetry with controls who did not have progression. Methods Progression was defined by use of the modified Anderson criteria. Central corneal thickness (CCT) was determined by ultrasound pachymetry. Main outcome measures Visual field progression and corneal pachymetry. Results The mean CCT in patients with visual field progression was significantly lower than the mean CCT in patients who did not progress (529±36 μm vs. 547±35 μm; P = 0.02). Those with thinner CCT were more likely to progress than those with thicker CCT as identified by Cox proportional hazards regression analysis ( P = 0.01; hazard ratio, 1.44 for a 40-μm thinner CCT; 95% confidence interval, 1.12–1.80), and CCT was the only risk factor identified to be significantly associated with visual field progression. Conclusions In this case–control patient population, visual field progression in patients with open-angle glaucoma was significantly associated with thinner CCT.