Abstract
BackgroundCentral corneal thickness (CCT) has long been implicated to affect glaucoma predisposition. Several reports have identified that thinner CCT is a risk factor for open-angle glaucoma, and that CCT can be very variable between different ethnic groups. In this study, we aim to identify the relation between CCT and different glaucoma parameters in different types of glaucoma in an Arabian ethnicity.MethodsWe classified our participants into four main groups: primary open-angle glaucoma (POAG), primary angle-closure glaucoma (PACG), pseudoexfoliative glaucoma (PXFG), and a control group. We obtained demographics, intraocular pressure (IOP), cup to disc ratio (CDR), visual field mean deviation (MD) and pattern standard deviation (PSD), CCT, and retinal nerve fiber layer (RNFL) thickness for each participant.ResultsWe included A total of 119 eyes with glaucoma, including POAG (54 eyes), PXFG (31 eyes) and PACG (34 eyes), we also included 57 control eyes. We found that PACG eyes have the thinnest CCT. Mean measurements of CCT for our groups were: 538.31 μm (SD = 36.30) in eyes with POAG, 544.45 μm (SD = 28.57) in eyes with PXFG, 506.91 μm (SD = 34.55) in eyes with PACG and 549.63 μm (SD = 42.9) in the control group. We found that CCT is significantly correlated with CDR (p = 0.012, r = − 0.231), MD (p < 0.001, r = 0.327),and RNFL thickness (p = .007, r = .283).ConclusionIn Arabian ethnicity, PACG patients have the thinnest CCT compared to other types of glaucoma, namely POAG and PXFG. We demonstrated that glaucomatous eyes with thinner corneas will probably have more advanced glaucomatous optic neuropathy. Our results emphasize the importance of taking ethnicity into account upon glaucoma management.
Highlights
Central corneal thickness (CCT) has long been implicated to affect glaucoma predisposition
A diagnosis of primary open-angle glaucoma (POAG) or primary angle-closure glaucoma (PACG) was made based on intraocular pressure (IOP), gonioscopy and both characteristic visual field (VF) defects, and optic nerve changes (enlarged cup to disc ratio (CDR), localized notch, and disc hemorrhage) in at least 1 eye as well as Ocular Coherence tomography (OCT) showing thinning of Retinal Nerve Fiber Layer (RNFL)
As visual field defect is an important outcome in glaucoma, we found that both cup to disc ratio (CDR) and retinal nerve fiber layer (RNFL) thickness, as measured by Optical Coherence Tomography, are the main factors associated with lower mean deviations on visual field testing
Summary
Central corneal thickness (CCT) has long been implicated to affect glaucoma predisposition. Glaucoma is the second leading cause of blindness in the world, after cataracts, and is the leading cause of blindness among African-Americans [1]. It is generally classified into open-angle and closed-angle glaucoma, and both can be either primary or secondary. 5.9 and 5.3 million will be blind from irreversible optic nerve damage associated with POAG and PACG, respectively [1]. This means that early detection and identification of risk factors are key elements in controlling the disease and preventing its progression. Secondary open-angle glaucoma is another entity with diverse types, but Pseudoexfoliation glaucoma (PXFG) is currently the leading cause of secondary open-angle glaucoma with a prevalence reaching 40% in patients over the age of 80 [2], and is highly dependent on race and ethnicity [3]
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