Thicker Central Corneal Thickness Research Articles

Corneal Endothelial Morphology and Ocular Biometric Indexes in Premature Children With and Without Retinopathy of Prematurity.

The purpose of this study was to analyze human corneal endothelial cells (HCECs) morphology and ocular biometrics in premature (PM) children with or without retinopathy of prematurity (ROP). Retrospective data on patient demographics, HCECs status, and ocular biometrics with at least 2 visits between 2016 and 2021 were reviewed. The main outcomes were endothelial cell density (ECD), coefficient of variation (CV), hexagonal cell ratio (HEX), central corneal thickness (CCT), axial length, anterior chamber depth, keratometry, corneal diameter, pupil diameter, and refraction status. Generalized estimating equation was used to evaluate the differences between PM no-ROP and ROP groups. We also analyzed the trend of ECD, CV, HEX, and CCT change with age between groups. The study included 173 PM patients without ROP and 139 patients with ROP. A total of 666 and 544 measurements were recorded in the PM no-ROP and ROP groups, respectively. The ROP group had higher spherical power, myopic spherical equivalent (SE), and steeper steep keratometry (K; P < 0.05). The ROP group had higher CV (P = 0.0144), lower HEX (P = 0.0012) and thicker CCT (P = 0.0035). In the HCECs parameters, the ROP group had slower ECD decrement (P < 0.0001), faster CV decrement (P = 0.0060), and faster HEX increment (P = 0.0001). A difference in corneal morphology changes between the ROP and PM no-ROP groups were prominent in patients with lower gestational age (GA) in the subgroup analysis. Worse HCECs morphology and higher myopic status were initially observed in patients with prior ROP but not in PM patients with no-ROP. ECD and HCECs morphology improved with age, especially in patients with low GA.

Refraction and ocular biometric parameters in 3-to 6-year-old preschool children : a large-scale population-based study in Chengdu, China

PurposeTo understand the ocular biometric parameters characteristics and refractive errors in 3-to 6-year-old preschool children in Chengdu, China, and to investigate the prevalence of refractive errors.MethodA school-based cross-sectional study was conducted in Chengdu from 2020 to2022 with a total of 666 kindergartens. All children were measured by non-cycloplegic autorefraction and uncorrected visual acuity (UCVA) and ocular biometric parameters. Finally, univariate linear regression models were used to analyze the relationship between ocular biometric parameters and refraction.ResultsA total of 108,578 preschool children aged 3–6 underwent examinations, revealing a myopia prevalence of 6.1%. The mean axial length (AL), keratometry (K), corneal radius (CR), axial length/corneal radius (AL/CR) Ratio, central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), and vitreous chamber depth (VCD) were 22.35 ± 0.69 mm, 43.35 ± 1.58 D, 7.80 ± 0.28 mm, 2.87 ± 0.08, 533.31 ± 32.51 μm, 2.70 ± 0.28 mm, 3.91 ± 0.27 mm, and 15.20 ± 0.68 mm, respectively. With increasing age, AL, CR, AL/CR ratio, CCT, ACD, LT, and VCD also increased. Regardless of age, males consistently exhibited longer AL, flatter corneal curvature, shallower ACD, thicker CCT, thinner LT, and longer VCD compared to females. AL, K, CR, LT, and VCD all showed significant linear relationships with SE (all P < 0.001) in univariate linear regression analysis after adjusting for gender and age.ConclusionThe prevalence of myopia among preschool children aged 3–6 in Chengdu is relatively low. Ocular biometric parameters affecting refractive errors include AL, K, CR, LT, and VCD. The preschool period serves as a critical phase for myopia prevention and control.

Clinical Characteristics and Surgical Outcomes of Turkish Patients With Pediatric Glaucoma Who Underwent Glaucoma Surgery in a University Hospital.

To describe the clinical characteristics and outcomes of a pediatric cohort surgically treated for primary or secondary pediatric glaucoma (PPG/SPG). A retrospective chart review was conducted of all patients with pediatric glaucoma who had surgery between 2013 and 2021. Relevant demographic and clinical data were cumulated and analyzed. Forty-two eyes of 29 patients (18 girls and 11 boys) were included: 22 (52.4%) primary congenital glaucoma (PCG), 7 (16.7%) juvenile open-angle glaucoma, and 13 (30.9%) SPG. Mean ages at presentation were 2.57 ± 2.87, 131.96 ± 27.71, and 62.09 ± 65.12 months, respectively. In this study, eyes with PCG presented the earliest, with the highest intraocular pressure (IOP) and thickest central corneal thickness (CCT). The mean number of glaucoma surgeries was 1.48 ± 0.71, with 38.1% of the eyes needing two or more glaucoma surgeries; trabeculectomy was the most frequent glaucoma surgery in this cohort. After surgical intervention, the overall mean IOP dropped from 32.25 ± 12.97 to 18.10 ± 9.23 mm Hg (P < .001). Moreover, the percentage using antiglaucoma medications decreased from 100% to 35.7% at the final visit, as did the number of medications prescribed per eye (2.69 ± 0.92 vs 1.05 ± 1.46, P ≤ .001). Mean best corrected visual acuity (BCVA), in patients who could have their BCVA measured, improved from 0.61 ± 0.61 to 0.53 ± 0.51 logMAR at final follow-up. Surgical intervention was shown to provide a well-controlled IOP, decrease dependance on glaucoma medications, and improve BCVA in both PPG and SPG. Multiple surgical interventions may be necessary in the treatment of some pediatric patients with glaucoma. Prognostically, thicker CCT was significantly associated with worse IOP control, more glaucoma surgeries, and more antiglaucoma medications at the final visit. Initial BCVA correlated significantly with BCVA at the final visit. [J Pediatr Ophthalmol Strabismus. 2024;61(3):188-197.].

Comparison of risk factors for OBL in FS-LASIK and SMILE correction for myopia and myopia astigmatism.

To find out the incidence and risk factors of opaque bubble layer (OBL) in eyes with myopia and myopic astigmatism following femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE). A total of 1076 eyes from 569 patients who had FS-LASIK or SMILE were included in the retrospective research. For each kind of surgery, eyes were separated into two groups: "OBL" groups and "no OBL" groups. In the FS-LASIK group, eyes that developed OBL were split into "hard OBL" and "soft OBL" groups. The incidence and size of OBL were analyzed after watching the surgical procedure videotaped during the operation and taking screenshots. Surgical parameters, including sphere, cylinder, keratometry, corneal thickness, flap thickness, cap thickness, lenticule thickness, and visual acuity, were compared. In the FS-LASIK surgery, the incidence of OBL was 63.2% (347 eyes). A thicker central corneal thickness (CCT) was the only independent risk factor affecting the OBL area (β = 0.126, P = 0.019). One hundred and thirty of these eyes had hard OBL, and the flap thickness of these eyes was thinner than that of those with soft OBL (P = 0.027). In the SMILE group, 26.6% (140 eyes) developed OBL. A higher flat keratometry (K) and a thicker residual stromal thickness (RST) were risk factors affecting the OBL area (β = 0.195, P = 0.024; β = 0.281, P = 0.001). The incidence of OBL differs between the FS-LASIK surgery and the SMILE surgery. There are differences in the factors influencing OBL between the two surgeries.

Agreement of intraocular pressure measurement with Corvis ST, non-contact tonometer, and Goldmann applanation tonometer in children with ocular hypertension and related factors.

To access the agreement of intraocular pressure (IOP) values obtained from biomechanically corrected tonometer [Corvis ST (CST)], non-contact tonometer (NCT), and Goldmann applanation tonometer (GAT) in children with NCT measured-IOP (NCT-IOP) values of 22 mm Hg or more, and related factors. A total of 51 eyes with NCT-IOP≥22 mm Hg in children aged 7 to 14y were examined and IOP was measured by CST, NCT, and GAT. Based on GAT measured IOP (GAT-IOP), ocular hypertension (OHT) group (≥22 mm Hg, 24 eyes) and the non-OHT group (<22 mm Hg, 27 eyes) were defined. We compared the agreement of the three measurements, i.e., CST measured IOP (CST-IOP), GAT-IOP, and NCT-IOP, and further analyzed the correlation between the differences in tonometry readings, central corneal thickness (CCT), axial length (AL), optic disc rim volume, and age. Compared with the OHT group, thicker CCT, larger rim volume, and higher differences between NCT-IOP and GAT-IOP, were found in the non-OHT group. The differences between CST-IOP and GAT-IOP were lower than the differences between NCT-IOP and GAT-IOP in both groups. The mean differences in CST-IOP and GAT-IOP were 1.26 mm Hg (95% limit of agreement ranged from 0.1 to 2.41 mm Hg, OHT group) and 1.20 mm Hg (95% limit of agreement ranged from -0.5 to 3.00 mm Hg, non-OHT group), and the mean differences in NCT and GAT were 3.90 mm Hg (95% limit of agreement ranged from -0.19 to 9.70 mm Hg, OHT group) and 6.00 mm Hg (95% limit of agreement ranged from 1.50 to 10.50 mm Hg, non-OHT group). The differences between CST-IOP and GAT-IOP were not related to CCT, age, and AL in both groups; while the differences between NCT-IOP and GAT-IOP were related to CCT in the OHT group (r=0.93, P<0.001) and to CCT and AL in the non-OHT group (r=0.66, P<0.001, r=-0.81, P<0.001). The accuracy of NCT in the diagnosis of pediatric OHT is low. The agreement of CST-IOP and GAT-IOP was significantly higher in children with and without OHT than in those with NCT-IOP and GAT-IOP. Therefore, CST can be used as a good alternative for IOP measurement in children. The impacts of CCT and AL on NCT measurement need to be fully considered when managing childhood IOP.

Study on Related Factors of the Treatment Zone After Wearing Paragon CRT and Euclid Orthokeratology Lenses.

To explore the influence factors of the treatment zone diameter (TZD) and its relationship with axial length growth (ALG) after wearing Paragon CRT and Euclid orthokeratology lenses. The right eye data of myopic patients wearing Paragon CRT and Euclid orthokeratology in the ophthalmology department of The First Affiliated Hospital of Soochow University were retrospectively reviewed from April 2019 to October 2022. The TZD and ALG were compared between the Paragon CRT and Euclid groups. The correlation factors of TZD after wearing lens for 1 month and the relationship between the overlapping treatment zone-to-pupil area ratio and the ALG after wearing lens for 1 year were analyzed between the two groups. There were 160 patients (160 eyes) in the Paragon CRT group and 155 patients (155 eyes) in the Euclid group. After wearing lens for 1 month, the TZD in the Paragon CRT group (3.72±0.37 mm) was larger than that in the Euclid group (3.26±0.37 mm) ( P <0.001). The stepwise multivariate linear regression analysis showed that the eccentricity at the flattest meridians (Em) and the central corneal thickness were correlated with the TZD in both groups ( P <0.05). After wearing lens for 1 year, the ALG in the Paragon CRT group (0.32±0.20 mm) was larger than that in the Euclid group (0.25±0.20 mm) ( P =0.001). The stepwise multivariate linear regression analysis showed that the initial wearing age and the overlapping treatment zone area-to-pupil area ratio were correlated with the ALG in both groups ( P <0.05). For both the Paragon CRT and Euclid orthokeratology, the wearers with thicker central corneal thickness and smaller Em usually had a smaller TZD. In both groups, the overlapping treatment zone area-to-pupil area ratio was correlated with the ALG.

Association of Blood Pressure With Rates of Macular Ganglion Cell Complex Thinning in Patients With Glaucoma

There are scarce data on the association of blood pressure measures with subsequent macular structural rates of change in patients with glaucoma. To investigate the association of baseline blood pressure measures with rates of change of the macular ganglion cell complex in patients with central or moderate to advanced glaucoma damage at baseline. This prospective cohort study, conducted from August 2021 to August 2022, used data from patients in the Advanced Glaucoma Progression Study at the University of California, Los Angeles. Participants were between 39 and 80 years of age and had more than 4 macular imaging tests and 2 or more years of follow-up. A diagnosis of glaucoma with either central damage or a visual field mean deviation worse than -6 dB. The main outcome was the association of blood pressure measures with ganglion cell complex rates of change. Macular ganglion cell complex thickness rates of change were estimated with a bayesian hierarchical model. This model included relevant demographic and clinical factors. Blood pressure measures, intraocular pressure, and their interactions were added to the model to assess the association of baseline blood pressure measures with global ganglion cell complex rates of change. The cohort included 105 eyes from 105 participants. The mean (SD) age, 10-2 visual field mean deviation, and follow-up time were 66.9 (8.5) years, -8.3 (5.3) dB, and 3.6 (0.4) years, respectively, and 67 patients (63.8%) were female. The racial and ethnic makeup of the cohort was 15 African American (14.3%), 23 Asian (21.9%), 12 Hispanic (11.4%), and 55 White (52.4%) individuals based on patient self-report. In multivariable analyses, female sex, history of taking blood pressure medications, higher intraocular pressure, thicker central corneal thickness, shorter axial length, higher contrast sensitivity at 12 cycles per degree, and higher baseline 10-2 visual field mean deviation were associated with faster ganglion cell complex thinning. Lower diastolic blood pressure was associated with faster rates of ganglion cell complex thinning at higher intraocular pressures. For intraocular pressures of 8 and of 16 mm Hg (10% and 90% quantiles, respectively), every 10 mm Hg-lower increment of diastolic blood pressure was associated with 0.011 μm/y slower and -0.130 μm/y faster rates of ganglion cell complex thinning, respectively. In this cohort study, a combination of lower diastolic blood pressure and higher intraocular pressure at baseline was associated with faster rates of ganglion cell complex thinning. These findings support consideration of evaluating and addressing diastolic blood pressure as a therapeutic measure in patients with glaucoma if supported by appropriate clinical trials.

Central corneal thickness associations with systemic factors: The Colombian glaucoma study

Abstract Objective: To establish Central Corneal Thickness associations with systemic factors in six cities of Colombia. Methods: A cross-sectional study was conducted in Colombia among hypertensive and diabetic patients. Two thousand sixty-seven subjects older than 50 diagnosed with SH and DM were included. Participants underwent a complete ophthalmic examination, including intraocular pressure (IOP) measurement by Goldmann tonometry, Central Corneal Thickness (CCT), and Blood pressure. The glaucoma diagnosis was confirmed by structural and functional evidence. Results: In multiple regression analysis, a trend of thinner corneal thicknesses was observed, with increasing decades of life, 60 - 69 years (-7.14 microns (μm) p: 0.58), 70- 79 years (-2.05 μm p: 0.38), &gt; 80 years (-7.3 p &lt;0.056) being almost statistically significant only in patients older than 80 years. Female patients had thinner CCT (- 5.04 μm) than male patients. African- Colombian patients had thinner corneas (-9.6 μm) than mestizo patients (P= 0.002). Patients with migraine had thicker CCT (6.83 μm p &lt;0.024) compared with no- migraine patients. Diabetic patients had thicker CCT (3.91 μm) than non-diabetic patients (P= 0.039). Finally, a 0.66 μm increase per mm hg of the systolic pressure (P=0.024) and a 0.99 μm decrease per mm hg of Systolic Perfusion Pressure (P=0.038) was observed, but no association was found between CCT and Systemic Hypertension. Conclusion: Our study highlights the relationship between systemic factors such as age, sex, race, DM, systolic blood pressure, migraine, and systolic perfusion pressure with an ocular biomarker such as CCT

Central corneal thickness associations with systemic factors: The Colombian glaucoma study

Abstract Objective: To establish Central Corneal Thickness associations with systemic factors in six cities of Colombia. Methods: A cross-sectional study was conducted in Colombia among hypertensive and diabetic patients. Two thousand sixty-seven subjects older than 50 diagnosed with SH and DM were included. Participants underwent a complete ophthalmic examination, including intraocular pressure (IOP) measurement by Goldmann tonometry, Central Corneal Thickness (CCT), and Blood pressure. The glaucoma diagnosis was confirmed by structural and functional evidence. Results: In multiple regression analysis, a trend of thinner corneal thicknesses was observed, with increasing decades of life, 60 - 69 years (-7.14 microns (μm) p: 0.58), 70- 79 years (-2.05 μm p: 0.38), &gt; 80 years (-7.3 p &lt;0.056) being almost statistically significant only in patients older than 80 years. Female patients had thinner CCT (- 5.04 μm) than male patients. African- Colombian patients had thinner corneas (-9.6 μm) than mestizo patients (P= 0.002). Patients with migraine had thicker CCT (6.83 μm p &lt;0.024) compared with no- migraine patients. Diabetic patients had thicker CCT (3.91 μm) than non-diabetic patients (P= 0.039). Finally, a 0.66 μm increase per mm hg of the systolic pressure (P=0.024) and a 0.99 μm decrease per mm hg of Systolic Perfusion Pressure (P=0.038) was observed, but no association was found between CCT and Systemic Hypertension. Conclusion: Our study highlights the relationship between systemic factors such as age, sex, race, DM, systolic blood pressure, migraine, and systolic perfusion pressure with an ocular biomarker such as CCT

Flap-making patterns and corneal characteristics influence opaque bubble layer occurrence in femtosecond laser-assisted laser in situ keratomileusis

BackgroundOpaque bubble layer (OBL), which generates from photo-disruptive procedures on the cornea, has been a common phenomenon during femtosecond laser-assisted refractive surgeries and it would potentially impact eye tracking and flap lifting. And we have observed that an updated flap-making pattern could form less OBL clinically than the traditional pattern, which needed further approval. Thus, the purpose of this study is to prove our observation and investigate the possible risk factors related to the occurrence and type of OBL in laser in situ keratomileusis (LASIK) flaps using the Visumax laser system.MethodsThis prospective study included 167 eyes of 86 patients (mean age: 27.5 ± 6.1 years) undergoing bilateral femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) for myopia/myopic astigmatism by the same surgeon from April 2020 to August 2020. Preoperative data on refraction, central corneal thickness (CCT), and keratometry as well as intraoperative data were included for analysis. A new flap-making pattern creating an offset between flap-cut and side-cut was adopted to compare with the traditional pattern. The operation video of flap formation was analyzed to identify the existence and type of OBL. The area covered by OBL and the ratio of OBL to flap were calculated using Image J software.ResultsAmong 167 eyes, 54 eyes (32.3%) developed OBLs, consisting of 31 as hard OBL coexisting with soft OBL, and 23 as soft OBL alone. The OBL incidence was significantly reduced in eyes with the new flap-making pattern compared with the traditional pattern (13.8% vs. 52.5%, P < 0.001). Hard OBLs had larger area ratios than soft OBLs (14.3 ± 8.3% vs. 1.1 ± 1.8%, P < 0.001). Univariate analyses revealed that eyes with more myopia, thicker CCT, and traditional flap-making patterns were more likely to develop OBLs. Multivariate analysis further confirmed that more myopia, thicker CCT, and traditional flap-making pattern were risk factors for OBLs. A Larger corneal diameter was associated with a higher incidence of hard OBL when applying the traditional flap-making process.ConclusionMore myopia, thicker CCT, and larger corneal diameter were risk factors for OBL development during flap creation, whereas a flap-making pattern with an offset between flap-cut and side-cut could reduce the incidence of OBL.

Comparison of Non-contact Tonometry and Goldmann Applanation Tonometry Measurements in Non-pathologic High Myopia.

PurposeTo compare intraocular pressure (IOP) values obtained using Goldmann applanation tonometry (IOPGAT) and non-contact tonometry (IOPNCT) in a non-pathologic high myopia population.MethodsA total of 720 eyes from 720 Chinese adults with non-pathologic high myopia were enrolled in this cross-sectional study. Demographic and ocular characteristics, including axial length, refractive error, central corneal thickness (CCT), and corneal curvature (CC) were recorded. Each patient was successively treated with IOPNCT and IOPGAT. Univariate and multivariable linear regression analyses were conducted to detect factors associated with IOPNCT and IOPGAT, as well as the measurement difference between the two devices (IOPNCT−GAT).ResultsIn this non-pathologic high myopia population, the mean IOPNCT and IOPGAT values were 17.60 ± 2.76 mmHg and 13.85 ± 2.43 mmHg, respectively. The IOP measurements of the two devices were significantly correlated (r = 0.681, P < 0.001), however, IOPNCT overestimated IOPGAT with a mean difference of 3.75 mmHg (95% confidence interval: 3.60–3.91 mmHg). In multivariate regression, IOPNCT was significantly associated with body mass index (standardized β = 0.075, p = 0.033), systolic blood pressure (SBP) (standardized β = 0.170, p < 0.001), and CCT (standardized β = 0.526, p < 0.001). As for IOPGAT, only SBP (standardized β = 0.162, p < 0.001), CCT (standardized β = 0.259, p < 0.001), and CC (standardized β = 0.156, p < 0.001) were significantly correlated. The mean IOPNCT−GAT difference increased with younger age (standardized β = −0.134, p < 0.001), higher body mass index (standardized β = 0.091, p = 0.009), higher SBP (standardized β = 0.074, p = 0.027), thicker CCT (standardized β = 0.506, p < 0.001), and lower IOPGAT (standardized β = −0.409, p < 0.001).ConclusionIn the non-pathologic high myopia population, IOPNCT overestimated IOPGAT at 3.75 ± 2.10 mmHg. This study suggests that the difference between the values obtained by the two devices, and their respective influencing factors, should be considered in the clinical evaluation and management of highly myopic populations.

Intraocular pressure and diurnal fluctuation of open-angle glaucoma and ocular hypertension: a baseline report from the LiGHT China trial cohort

AimsTo report the baseline intraocular pressure (IOP) characteristics and its diurnal fluctuation in the Laser in Glaucoma and Ocular Hypertension China cohort.Methods622 primary open-angle glaucoma (POAG) patients and 149 ocular...

The Inferior, Superior, Temporal Rim Width Pattern (IST Rule) Detects Glaucoma in a Japanese Population.

Précis:The inferior>superior>temporal rim width rate (IST pattern) rather than inferior≥superior≥nasal≥temporal (ISNT) pattern was suited for screening glaucoma in Japanese subjects. Failure of the IST pattern was associated with several important risk factors for glaucoma.Purpose:The purpose of this study was to find a rim width rate pattern to yield the highest positive likelihood ratio (LR+) in detecting glaucoma eyes and to identify risk factors for glaucoma correlating with its failure in a population-based setting.Methods:Disc stereophotographs of 2474 eyes of 2474 normal subjects and 237 eyes of 237 glaucoma subjects found in the Kumejima Study were analyzed using computer-assisted planimetry. Among all combinations of the inferior (I), superior (S), nasal (N) and/or temporal (T) rim width rate, a pattern showing the highest LR+ was selected and risk factors for glaucoma correlating with its failure were determined using multiple logistic regression analysis.Results:The average I, S, N, and T rim widths (SD) were 0.45 (0.10), 0.39 (0.09), 0.47 (0.11), and 0.27 (0.07) mm. Among all combinations, the I>S>T rim width rate pattern (IST pattern) disregarding the N rim width showed the highest LR+ of 2.002 (95% confidence interval, 1.778–2.253). Failure of the IST pattern in normal eyes correlated with a smaller disc area (P<0.001) and disc ovality (P=0.005) and larger β-peripapillary area (P<0.001) and compliance with in glaucoma eyes with a smaller β-PPA area (P=0.027), thicker central corneal thickness (P=0.017), lower intraocular pressure (P=0.019), and higher body mass index (P=0.037).Conclusion:Among all combinations, the I>S>T rim width pattern, the IST pattern, yielded the highest LR+ in detecting glaucoma in Japanese glaucoma eyes and its failure of or compliance with the pattern significantly correlated with several known risk factors for glaucoma.

Crystalline lens thickness change is associated with axial length elongation and myopia progression in orthokeratology

AimsConsidering individual variability in regards to the effects of orthokeratology (ortho-k) on myopia progression and controversies regarding the precise underlying mechanism, the aim of this study was to investigate several ocular measurements associated with axial length (AL) growth in children wearing ortho-k lenses. MethodsIn this retrospective chart review, medical records of 53 Chinese children who wore ortho-k lenses over the course of 12 months were reviewed. Baseline variables included age at initiation of ortho-k wear, refractive error (spherical equivalent, SE), central corneal thickness (CCT), and flat and steep keratometry of corneal principal meridians. The change of anterior chamber depth (ACD) and the change of crystalline lens thickness (CLT) between baseline and the 12-month follow-up were also analyzed. The contributions of all analyzed variables to AL change were assessed using univariate and multivariate regression analyses. ResultsInitially, the results of paired t-test showed that CLT and AL were significantly increased after 12 months of ortho-k wear compared with that at baseline (P = 0.001 and < 0.001). The ACD did not change significantly after 12 months compared with that at baseline (P = 0.491). Subsequently, univariate analyses showed that a reduced rate of AL elongation was found in children who were older age at initiation of ortho-k wear (P = 0.028), had greater SE (higher degree of myopia) at baseline (p = 0.006), had thicker CCT at baseline (P = 0.04), and had greater increase of CLT (P = 0.001) in 12 months. At last, only greater SE (higher degree of myopia) and greater increase of CLT were associated with smaller increases of AL in multivariable analyses, (P = 0.003 and 0.001). ConclusionsBoth CLT and AL were significantly increased in children with overnight ortho-k wear after 12 months of follow-up. Greater baseline SE and greater increase of CLT were associated with less increase in AL during ortho-k wear in children with myopia.

Corneal Biometric Parameters and Refractive Properties in Microcornea With Normal Axial Length.

The purpose of this study was to evaluate the features of and relationships among corneal diameter, central corneal thickness (CCT), endothelial cell density (ECD), and corneal refractive properties in cases of microcornea (MC) with normal axial length. We included 22 patients (35 eyes) with MC and cataracts and 41 patients (48 eyes) with isolated cataracts as age-matched controls. They were divided into patients with MC younger than 18 years (MC-child), patients with MC 18 years or older (MC-adult), children with congenital cataracts (CCs), and adults with senile cataracts (SCs). Corneal diameter, axial and anterior chamber length, and keratometry were measured; central corneal endothelial cell imaging was performed. The mean horizontal corneal diameter was 7.71 ± 1.51 and 8.78 ± 0.52 mm in MC-child and MC-adult groups, respectively, and 11.89 ± 0.59 and 11.52 ± 2.42 mm in child and adult controls, respectively. The mean CCT was 641.26 ± 63.37 (MC-child) and 617.38 ± 45.40 mm (MC-adult), and 554.92 ± 34.64 (CC) and 551.58 ± 28.47 mm (SC). The mean ECD was 2898.47 ± 443.90 (MC-child) and 2825.81 ± 484.65 cells/mm 2 (MC-adult), and 3155.13 ± 372.67 (CC) and 2749.33 ± 399.63 cells/mm 2 (SC). The average keratometry was 44.22 ± 3.14 D (MC-child) and 43.86 ± 2.59 D (MC-adult), and 44.19 ± 1.44 D (CC) and 43.94 ± 1.34 D (SC). Patients with MC and normal axial length possess specific parameters, including significantly smaller corneal diameter and thicker CCT than the patients in the control groups. There were no significant differences in ECD and average keratometry. These parameters should be taken into account in the follow-up and treatment.

Intraocular Pressure, Age, and Central Corneal Thickness in a Healthy Chinese Children Population: The Handan Offspring Myopia Study

ABSTRACT Purpose To assess the distribution and factors related to intraocular pressure (IOP) in a Chinese children population in Northern China. Methods 1,238 offspring aged 6 to 18 years, residing in six villages, were recruited for this current study, the Handan Offspring Myopia Study. Participants underwent an interviewer-administered questionnaire and a complete ocular examination, including standardized measurement of IOP with Perkins applanation tonometry. Results 1,648 eyes of 828 children were included in the analysis. The mean IOP was 13.9 ± 1.6 mmHg. The mean IOP for the study population increased from 13.0 ± 1.5 mmHg for those 6 to 7 years of age to 14.2 ± 1.4 mmHg for those 15 years of age or older (P < .001). The mean central corneal thickness (CCT) was 548.7 ± 32.1 μm, and had no difference among different age groups and gender. In univariate regression analysis, age (0.12 mmHg per 1 year old), height (0.09 mmHg per 5 cm), weight (0.02 mmHg per kg), body mass index (0.07 mmHg per 1 m/kg2), systolic blood pressure (0.06 mmHg per 5 mmHg), CCT (0.06 mmHg per 5 μm), and SE (−0.11 mmHg per 1 D) were correlated with IOP. In multivariate regression analysis, higher IOP was only associated with older ages (p = .002) and thicker CCT (p = .001). Conclusion The mean IOP in healthy rural Chinese children aged 6–18 years is about 14 mmHg, which is lower than in adults in the same locality. The mean IOP is slightly increasing with age during childhood, which is opposite to the result among adults. Age and CCT are the major independent factors associated with IOP.

Lens thickness and associated ocular biometric factors among cataract patients in Shanghai

BackgroundTo evaluate the distribution of lens thickness (LT) and its associations with other ocular biometric factors among cataract patients in Shanghai.MethodsTwenty-four thousand thirteen eyes from 24,013 cataract patients were retrospectively included. Ocular biometric factors including LT, central corneal thickness (CCT), anterior chamber depth (ACD), white-to-white (WTW) distance, anterior corneal curvature, and axial length (AL) were obtained using the IOLMaster700. The associations between LT and general or ocular factors were assessed.ResultsThe mean age was 62.5 ± 13.6 years and 56.1% were female. The mean LT was 4.51 ± 0.46 mm. The LT was greater in older patients (P < 0.001). LT was positively correlated with CCT, while negatively correlated with ACD, WTW, and anterior corneal curvature (P < 0.001). Multivariate analysis revealed that increased LT was associated with older age, male gender, thicker CCT, shallower ACD, larger WTW, and flatter anterior corneal curvature (P < 0.001). LT changed with a variable behavior according to AL. In short eyes LT increased as AL increased, then decreased with longer AL in normal eyes and moderate myopic eyes, but increased again as AL increased in highly myopic eyes. Thickest LT was found in the 20.01–22 mm AL group. The correlation between LT and other biometric factors remained significant when stratified by ALs.ConclusionsIn a large Chinese cataractous population, we found that the thicker lens may be associated with older age, male gender, thicker CCT, shallower ACD, larger WTW, and flatter anterior corneal curvature. As AL increased, the change of LT was nonlinear, with the thickest lens seen in the 20–22 mm AL group.

The effects of type 2 diabetes mellitus on the corneal endothelium and central corneal thickness

Aim of this study is to evaluate the differences in corneal endothelial cell morphology and corneal thickness in patients with and without type 2 diabetes related to age, disease duration, and HbA1c percentage. This retrospective cross-sectional study included 511 (1022 eyes) type 2 diabetes patients and 900 (1799 eyes) non-diabetic patients. The endothelial cell density (ECD), variation in endothelial cell size (CV), percentage of hexagonal cells, and central corneal thickness (CCT) were analyzed using a noncontact specular microscope and a Pentacam Scheimpflug camera. We also examined the correlation between the corneal parameters and the duration of diabetes. For total ages, the subjects with type 2 diabetes showed significantly lower ECD, hexagonality, higher CV, and thicker CCT than the control group. This difference was more pronounced in patients with long-standing DM (≥ 10 years) and high HbA1c (≥ 7%). When stratified by age group, from the 60 s group, corneal endothelial cell parameters showed a statistically significant difference between DM and control groups. The duration of diabetes was inversely correlated with ECD (r = − 0.167; p = 0.000). These findings suggest that diabetes affects corneal endothelial cell in older age and those with long-standing DM and higher HbA1c. Regular corneal endothelial examinations are required in diabetic patients.

Distribution and analysis of intraocular pressure and its possible association with glaucoma in children.

To analyze intraocular pressure (IOP) and glaucoma-associated factors in children. A total of 4438 children aged 7-16years (2321 boys and 2117 girls) were included in this study. Various ophthalmologic [IOP, central corneal thickness (CCT), etc.] and demographic (body mass index, etc.) parameters were evaluated. IOP increased between the ages of 7 and 9years, peaking at 9years. IOP increased after reaching a trough at 11years and subsequently stabilized after 14years. Girls exhibited thinner CCT (534.28 ± 30.84µm vs. 537.04 ± 31.33µm, P = 0.003), thicker lens thickness (3.56 ± 0.21mm vs. 3.54 ± 0.20mm, P = 0.001), shorter axial length (22.91 ± 0.93mm vs. 23.32 ± 0.89mm, P < 0.001), shallower anterior chamber depth (2.92 ± 0.27mm vs. 3.00 ± 0.26mm, P < 0.001), higher refraction (- 0.57 ± 1.48 D vs. 0.16 ± 1.35 D, P < 0.001), and higher mean corneal curvature (43.77 ± 1.39 vs. 43.03 ± 1.35, P < 0.001). Multivariable analysis assessed the following IOP-associated factors: thicker CCT [standardized correlation coefficient (SRC) = 0.201, P < 0.001), deeper anterior chamber depth (SRC = 0.059, P = 0.009), shorter axial length (SRC = - 0.086, P = 0.036), lower mean corneal curvature (SRC = - 0.123, P < 0.001), higher refraction (SRC = - 0.090, P < 0.001). IOP fluctuated in children, and a trend toward a higher mean IOP between the ages of 9 and 11years, which stabilized after 14years, was observed. IOP was associated with CCT, anterior chamber depth, axial length, lens thickness, mean corneal curvature, spherical equivalent, and systolic blood pressure.

Central Corneal Thickness in Ocular Hypertension Patients in Sanglah General Hospital Bali

Ocular hypertension (OH) is a risk factor in glaucoma and modifiable in its early stages. Goldmann applanation tonometer (GAT) is still the gold standard in measuring intraocular pressure (IOP) which is an important parameter in diagnosing and managing glaucoma. Several factors can affect the accuracy of the GAT, one of them is the thickness of the central cornea. This descriptive study was intended to describe the central corneal thickness (CCT) characteristics of the OH patients. The study was conducted at Eye Clinic - Sanglah General Hospital Denpasar which involved 32 patients with 46 eyes diagnosed with HO in 2018. The mean age of subjects was 43.98 (± 17.92), men had a larger proportion (68.1 %). Sixty-six per cent of patients were diagnosed with bilateral OH. In this study, the mean central corneal thickness in HO subjects was 573.81 ± 33.46 μm. The patients' median vertical cup to disc ratio at the time of diagnosis was 0.33, with a mean visual acuity of 0.85. The median value of IOP at the first time of examination was 24.47 mmHg.Central corneal thickness is known to have a positive correlation with IOP, thus affecting the accuracy of IOP measurements. The thicker central corneal thickness will lead to overestimation of the IOP and the thinner one will cause underestimation.