Abstract

BackgroundTo compare corneal hysteresis (CH) measurements between patients with glaucoma, ocular hypertension (OHT) and glaucoma-like optic discs (GLD)- defined as a cup to disc ratio greater than or equal to 0.6 with normal intraocular pressure (IOP) and visual fields. The secondary aim was to investigate whether corneal resistance factor (CRF) and central corneal thickness (CCT) differ between patient groups.MethodsIn this cross sectional study a total of 123 patients (one eye each) were recruited from a glaucoma outpatient department to undergo ocular response analyser (ORA) testing and ultrasound pachymetry as well as clinical examination. A One-way Analysis of Covariance (ANCOVA) was conducted to evaluate the mean difference in CH between the three diagnostic groups (glaucoma, OHT and GLD) correcting for potential confounding factors, IOP and age. Analysis was repeated for CRF and CCT.ResultsThere was a significant difference in mean CH across the three diagnosis groups; F(2, 115) = 96.95; p < 0.001. Mean CH significantly higher for GLD compared to glaucoma (mean difference 1.83, p < 0.001), and significantly higher for OHT compared to glaucoma (mean difference 2.35, p < 0.001). Mean CH was slightly lower in patients with GLD than those with OHT but this difference was not statistically significant. A similar pattern was seen when the analysis was repeated for CRF and CCT.ConclusionsHigher CH in GLD and OHT compared to glaucoma suggests increased viscoelasticity of ocular tissues may have a protective role against glaucoma.

Highlights

  • To compare corneal hysteresis (CH) measurements between patients with glaucoma, ocular hypertension (OHT) and glaucoma-like optic discs (GLD)- defined as a cup to disc ratio greater than or equal to 0.6 with normal intraocular pressure (IOP) and visual fields

  • There is a higher percentage of females (67.9%) in the GLD group compared to the OHT (53.4%) and glaucoma (45.5%) groups, and the GLD patients were a little younger on average than patients in the other two groups

  • Mean Goldmann-corrected IOP measured with Ocular Response Analyser (ORA) was higher in the GLD group (19.9 mmHg) than in the OHT and glaucoma groups (17.4 and 17.6 mmHg respectively)

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Summary

Introduction

To compare corneal hysteresis (CH) measurements between patients with glaucoma, ocular hypertension (OHT) and glaucoma-like optic discs (GLD)- defined as a cup to disc ratio greater than or equal to 0.6 with normal intraocular pressure (IOP) and visual fields. Corneal resistance factor (CRF) reflects the elastic properties of the cornea i.e. its ability to deform reversibly under stress and appears to be an indicator of corneal resistance. Both can be measured using the Ocular Response Analyser (ORA) (Reichert, Corp.; NY, USA) which involves applying an air pulse of a defined magnitude to the surface of the cornea and measuring the difference between the two applantation measurements during corneal deformity and return to its original configuration [6]

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