Thinner Central Corneal Thickness Research Articles

Associations between corneal curvature and other anterior segment biometrics in young myopic adults

To investigate the associations between corneal curvature (CC) and other anterior segment biometrics in young myopic adults. In this retrospective multi-center study, 7893 young myopic adults were included. CC and other anterior segment biometrics were measured by Scheimpflug imaging (Pentacam). CC was defined as SimK at central 3 mm area, and other anterior segment biometrics included white-to-white corneal diameter (WTW), central corneal thickness (CCT), corneal volume (CV) at 3 mm, 5 mm, and 7 mm area, anterior corneal astigmatism (ACA), posterior corneal astigmatism (PCA), anterior corneal eccentricity (ACE) and asphericity (ACAP), posterior corneal eccentricity (PCE) and asphericity (PCAP), anterior chamber depth (ACD), and anterior chamber volume (ACV). Univariate regression analyses were used to assess the associations between CC and other anterior segment biometrics, and multivariate regression analyses were further performed to adjusted for age, gender and spherical equivalent. CC was higher in patients of female gender and higher myopia (all P < 0.05). Eyes in higher CC quartiles had lower WTW, thinner CCT, lower CV at 3 mm and 5 mm, lower ACD, and lower ACV (all P < 0.001), but had larger ACA, larger PCA, less PCE and less PCAP (all P < 0.001), compared to eyes in lower CC quartiles. The trends of CV at 7 mm, ACE and ACAP were inconsistent in different CC quartiles. After adjusting for age, gender and spherical equivalent with multivariate linear regression, CC was positively correlated to CV at 7 mm (βs = 0.069), ACA (βs = 0.194), PCA (βs = 0.187), ACE (βs = 0.072), PCAP (βs = 0.087), and ACD (βs = 0.027) (all P < 0.05), but was negatively correlated to WTW (βs = − 0.432), CCT (βs = − 0.087), CV-3 mm (βs = − 0.066), ACAP (βs = − 0.043), PCE (βs = − 0.062), and ACV (βs = − 0.188) (all P < 0.05). CC was associated with most of the other anterior segment biometrics in young myopic adults. These associations are important for better understanding of the interactions between different anterior segment structures in young myopic patients, and are also useful for the exploration of the pathogenesis of myopia.

Efficacy and safety of first-line or second-line selective laser trabeculoplasty for normal-tension glaucoma: a multicentre cohort study

Background/aimsThis study aimed to investigate and compare the efficacy and safety of first-line and second-line selective laser trabeculoplasty (SLT) in Japanese patients with normal-tension glaucoma (NTG).Methods100 patients with NTG were...

Association Between Endothelial Cell Density and Corneal Thickness in Medium, Short, and Long Eyes of Han Chinese Cataract Patients

To evaluate the association between the endothelial cell density (ECD) and central corneal thickness (CCT) in medium, short, and long eyes of preoperative Han Chinese cataract patients. Retrospective cross-sectional study. We consecutively enrolled 410 eyes, namely, 50 short eyes (axial length [AL]<22.0 mm), 150 medium eyes (22.0≤AL<24.0 mm), 120 medium-long eyes (24.0≤AL<26.0 mm), and 90 long eyes (AL≥26.0 mm), of 410 adult patients scheduled for cataract surgery. The ECD and CCT were determined preoperatively with a noncontact specular microscope. The association between the CCT and ECD was identified by using a multivariable regression analysis. A thin cornea was defined as having a CCT less than 500 µm. After adjusting for age, the presence of arterial hypertension, the presence of diabetes mellitus, intraocular pressure, and AL, a positive association between the CCT and ECD was identified in short eyes (linear regression coefficient [B]=3.40; standardized B [β]=0.52; P = .03), medium eyes (B = 2.33; β=0.28; P = .002), medium-long eyes (B = 1.84; β=0.25; P = .02), and long eyes (B = 2.69; β=0.41; P = .04). In the total group, the multivariable logistic analysis showed a significant link between the presence of a thin cornea and a lower ECD (odds ratio [OR]=0.80 per 100 cells/mm2 increase; P = .001). For cataract patients of Han ethnicity, a significant association between a thin CCT and a lower ECD was shown across the AL spectrum and was most prominent in short eyes. Eyes with a thin cornea are more likely to have a lower ECD.

Risk factors and macular microvascular changes in open angle glaucoma progression: A longitudinal study using OCT‐A

Aims/Purpose: To investigate prospectively macular microvascular changes in patients with glaucoma and identify common characteristics among the progressive eyes.Methods: A 12‐month prospective longitudinal study was performed with 124 open‐angle‐glaucoma‐eyes (GE). Glaucomatous progression was defined as a decrease of ≥5 μm in average or ≥7 μm in a sector of RNFL thickness. OMAG OCT microangiography (Angioplex, HD OCT, Cirrus 5000, Zeiss) was used to analyse the macular region. The statistical analysis was performed using the SPSS version 23.0 statistical package (SPSS Inc., IL).Results: Among the GE group, 22.36% of eyes showed progression, being the decrease of the Complete Region Macular Vessel Density (MVD) and Macular Capillary Perfusion Density (MPD) greater (−1.14 mm/mm2 and −3.18%) compared to non‐progressive eyes (−0.42 mm/mm2 and −1.02%) [p = 0.123 and 0.057], being the temporal and superior sectors for both MVD and MPD, the ones that showed greater differences (−1.44 mm/mm2, −1.11 mm/mm2, −3.6% and −2.95% respectively) [p &gt; 0.05 for all]. Characteristics as elevated intraocular pressure (IOP) (17.29 vs 14.87 mmHg), thinner central corneal thickness (CCT) (521.53 vs 538.65 μm) and lower ocular perfusion pressure (OPP) (45.88 vs 49.21 mmHg) were significantly different in those progressive GE [p &lt; 0′05 for all]. Nevertheless, increased vertical cup to disc ratio (CDV) (0.64 vs 0.63) and minimum ganglion cell layer thickness (GCLM) (58,82 vs 56.51 μm) were not significantly different in progressive GE [p = 0.768 and 0.249].Conclusions: Data showed that when glaucomatous progression took place, stronger vascular changes occurred in the macular area, as greater decrease of MVD and MPD specially in the temporal and superior sectors. In addition, common characteristics as elevated intraocular pressure, thinner central corneal thickness and lower ocular perfusion pressure were identified in progressive GE. Nevertheless, further research with larger population and larger follow‐up is needed to obtain stronger results.

Relationship between central corneal thickness and inter‐eye disease severity in primary angle closure glaucoma

Aims/Purpose: To determine whether subjects with asymmetric primary angle closure glaucoma (PACG) demonstrate greater central corneal thickness (CCT) asymmetry compared to those with symmetrical disease severity.Methods: The following clinical data were retrospectively extracted from the case records of 281 PACG subjects: presenting intraocular pressure (IOP), visual field mean deviation (MD) at presentation, CCT, anterior chamber depth (ACD), and axial length (AL). The eye with the worse visual field MD was considered the worse eye. Asymmetric PACG was defined as the inter‐eye visual field MD difference of greater than 5 dB; and symmetrical PACG disease as an inter‐eye difference of less than 5 dB. Subjects with previous acute primary angle closure were excluded.Results: Based on the definitions, a total of 160 out of 281 PACG subjects (56.9%) presented with asymmetrical disease and 121 (43.1%) with symmetrical disease. Subjects with asymmetric disease had a significantly thinner CCT in the worse eye (529.2 ± 35.2 μm) compared to the fellow eye (535.3 ± 37.2 μm) (p &lt; 0.001), and higher presenting IOP (28.8 ± 12.0 vs 20.1 ± 8.4 mmHg, p &lt; 0.001), but no inter‐eye differences were observed for measurements of AL (p = 0.71) and ACD (p = 0.51) respectively. For patients with symmetric disease, no significant inter‐eye differences were observed for CCT (531.7 ± 31.2 vs 532.9 ± 32.4 μm, p = 0.38), AL (p = 0.30) and ACD (p = 0.31), but the worse eye had significantly higher IOP (22.7 ± 7.9 vs 20.6 ± 6.9 mmHg, p &lt; 0.001). In the asymmetric disease group, 30.6% of subjects had a thinner CCT (≥ 10 μm) in the worse eye compared to 16% of subjects in the symmetric group. There was no correlation between inter‐eye CCT difference and inter‐eye difference of visual field MD (p = 0.17).Conclusions: In PACG subjects with asymmetric disease at presentation, eyes with more severe disease have a thinner CCT and higher presenting IOP. Whether CCT is an independent risk factor for PACG through mechanisms beyond its influence on IOP measurements remains to be established.

Factors contributing to the development of choroidal microvasculature dropout in glaucoma suspects and patients with glaucoma

Aims/Purpose: We aimed to characterize and compare the occurrence of MvD between glaucoma suspects and patients with glaucoma. In addition, the factors related to the development of parapapillary MvD in glaucoma suspects and patients with glaucoma were investigated.Methods: Total 150 eyes, 68 eyes of glaucoma suspects and 82 eyes of glaucoma patients were analysed in this study. Disc photography, VF, OCT, HRT, OCTA examinations were performed every year. Student's t‐test and the χ2 test were used to compare continuous and categorical variables, respectively. Slope of OCT, HRT, and VF parameters were calculated as change per year using linear regression. Univariate and multivariate logistic regression analyses were used to identify factors associated with MvD development.Results: Comparison between group who developed MvD and group without MvD, there was a significant difference in the slope of cup volume by OCT, central VF progression, and ONH surface depression measured by HRT. Thinner baseline GCIPL thickness, central VF progression, and the slope of cup shape measures by HRT were found to be significant associated factors to MvD development in multivariate analysis in total subjects. In the regression analysis of glaucoma suspect group, greater axial length and baseline cup volume among the baseline factors and the slope of GCIPL thickness and central VF progression among follow‐up factors were significantly associated with the MvD development. In the glaucoma group, central VF progression and ONH depression among follow‐up elements were observed as significant factors and the baseline factor had little relationship.Conclusions: MvD appears not only as a result of the progression of axonal loss of RGC in glaucoma but may also be developed by structural changes and mechanical susceptibility of the ONH associated with baseline characteristics, including myopia, thin central corneal thickness, and higher baseline IOP. Analysing the structural susceptibility of the ONH can predict the occurrence of MvD, which is can be helpful in predicting the progression of glaucoma.

Klinik olarak Tek Taraflı Psödoeksfoliasyon Sendromu Olanların Ön Segment Parametrelerinin Schempflug Görüntüleme Tekniği ile değerlendirilmesi

Objective: We aimed to compare the intraocular pressure (IOP), keratometry values (K), and anterior segment parameters of patients with clinically unilateral pseudoexfoliation syndrome (PEX) with the other eyes without PEX and the control group. Material and Method: Fifty four patients with unilateral PEX findings and 40 participants without PEX findings in both eyes were included in the study as a control group. IOP was measured by Goldmann applanation tonometry. K values and anterior segment parameters [central corneal thickness (CCT), anterior chamber depth (ACD), iridocorneal angle (ICA), and anterior chamber volume (ACV)] were measured using Scheimpflug imaging technique. Results: The mean age of PEX patients was 67.9±9.2 years, while the mean age of the control group was 58.9±5.7 years. The IOP values of the eyes with PEX were significantly higher than the other eyes (p=0.02), and there was no significant difference between them and the control group (p=0.59). In terms of K values and anterior segment parameters, the measurements of eyes with PEX and the other eyes, and eyes with PEX and control group were similar (p&amp;gt;0.05). Conclusion: In our study, eyes with PEX had higher IOP values than the fellow eyes and control group. In addition, thinner CCT, narrower ACD, and ICA values were found in eyes with PEX than in the other eyes. However, these values were not statistically significant.

Corneal remodeling after SMILE for moderate and high myopia: short-term assessment of spatial changes in corneal volume and thickness

PurposeTo evaluate the early corneal remodeling and its influencing factors after Small incision lenticule extraction (SMILE) for moderate and high myopia.MethodsThis was a retrospective study. Pre- and post-operative (1 week and 1, 3, 6 months) corneal volume (CV), mean keratometry (Km), and corneal thickness (CT) were measured by Scheimpflug tomography. CT at the central, thinnest point, and on concentric circles of 2, 4, and 6 mm diameter was recorded to assess corneal thickness spatial profile (CTSP) and percentage of thickness increase (PTI) in the moderate and high myopia groups, and to explore possible influencing factors.ResultsAfter SMILE, the peripheral CT decreased in the moderate myopia group and central corneal thickness (CCT) increased in the high myopia group at 1 month compared to 1 week (all P < 0.05). The CV, Km and CT were significantly increased at 3 months compared to 1 month (all P < 0.05), but there was no significant change at 6 months compared to 3 months for both groups (all P > 0.05). Patients with high myopia showed greater corneal thickness changes (△CT) and higher PTI than moderate myopia (all P < 0.05). Regression analysis revealed that in addition to refraction, peripheral PTI was negatively correlated with CCT in the moderate myopia group (4 mm: β = -0.023, P = 0.001; 6 mm: β = -0.050, P < 0.001), as well as in the high myopia group (4 mm: β = -0.038, P < 0.001; 6 mm: β = -0.094, P < 0.001). Moreover, peripheral PTI in the moderate myopia group was negatively correlated with age (4 mm: β = -0.071, P = 0.003; 6 mm: β = -0.162, P < 0.001).ConclusionsAfter SMILE, the CV, Km, and CTSP showed dynamic changes in the early stage, which stabilized after 3 months. Compared to the moderate myopia group, the high myopia group experienced slower corneal stabilization. The change in PTI at 6 months after SMILE may be related to higher preoperative refraction, thinner CCT and younger age.

Differences in Axial Length and Anterior Chamber Depth among Keratoconic, Myopic and Emmetropic Eyes

Purpose: To report variation of the axial length (AL) and anterior chamber depth (ACD) among keratoconic (KC) eyes compared to myopic and emmetropic eyes in an African population sample. Study Design: Cross sectional observational. Place and Duration of Study: Al-Faisal Eye Hospital at Khartoum state of Sudanfrom January 2022 to September 2022. Methods: One-hundred and twenty-four eyes of 62 patients were divided into KC group (n =17, eyes=34), myopic group (n=28, eyes=56), and an age/gender matched emmetropic group (n=17, eyes =34). Central corneal thickness (CCT) was measured using ultrasonic pachymeter, AL, ACD and keratometry readings (K-reading) were recorded for each patient using non-contact partial coherence interferometry with an IOL Master. Results: Mean age of the sample population was 22.27± 6.05 (range; 10 – 40 years). KC patients had the highest spherical equivalent of refraction (SER) (-6.19±3.91 dioptres), highest k-reading (48.98±5.68 dioptres) and the thinnest CCT. Myopic participants had a longer AL compared to other refractive error groups (AL=24.99±2.39, p&lt;0.001). KC patients exhibited a larger ACD in comparison to emmetropes and myopes (ACD=3.6?9±0.26, p&lt;0.001). Among all participants, SER exhibited the highest correlation with AL (r=-0.71, p&lt;0.001) followed by a weaker correlation with ACD (r=-0.26, p=0.003). However, among KC patients, SER exhibited a weaker correlation with AL compared to myopes (r=-0.55, p=0.001), and a higher correlation with ACD compared to myopes (r=-0.38, p=0.03). Conclusion: ACD and corneal curvature were the most significantly detrimental parameters in KC. KC participants demonstrated a lower correlation between SER and AL and higher correlation between SER and ACD.

Hypocalcemic cataract secondary to idiopathic hypoparathyroidism in an adolescent.

Idiopathic hypoparathyroidism is a rare endocrine disorder characterized by hypocalcemia secondary to inadequate parathyroid hormone secretion. Hypocalcemia-related cataract is most often observed in patients with postoperative hypoparathyroidism, whereas primary hypoparathyroidism-related cataract is rare and displays slow progression. Cataract usually occurs in people aged 18 to 50 years. Here, we describe a 17-year-old boy with bilateral cataract and a history of hypocalcemic tetany who was diagnosed with idiopathic hypoparathyroidism. Phacoemulsification with implantation of a monofocal aspherical intraocular lens was performed in the right eye; 6 months later, it was performed in the left eye. Elevated phosphorus and diminished calcium were observed in blood and aqueous humor. A deep anterior chamber, relatively thin central corneal thickness, large white-to-white distance, and thin lens were also observed. During follow-up, neither eye displayed intraocular lens decentration; best-corrected visual acuity was 20/20 in both eyes. These findings suggest that ophthalmologists should be vigilant when hypocalcemic tetany and cataract are present, especially in adolescents and young adults.

Real-world agreement of same-visit Tono-Pen vs Goldmann applanation intraocular pressure measurements using electronic health records

PurposeTo compare intraocular pressure (IOP) obtained with Tono-Pen (TP) and Goldmann applanation (GAT) using large-scale electronic health records (EHR). DesignRetrospective cohort study. MethodsA single pair of eligible TP/GAT IOP readings was randomly selected from the EHR for each ophthalmology patient at an academic ophthalmology center (2013–2022), yielding 4550 eligible measurements. We used Bland-Altman analysis to describe agreement between TP/GAT IOP differences and mean IOP measurements. We also used multivariable logistic regression to identify factors associated with different IOP readings in the same eye, including demographics, glaucoma diagnosis, and central corneal thickness (CCT). Primary outcome metrics were discrepant measurements between TP and GAT as defined by two methods: Outcome A (normal TP despite elevated GAT measurements), and Outcome B (TP and GAT IOP differences ≥6 mmHg). ResultThe mean TP/GAT IOP difference was 0.15 mmHg ( ± 5.49 mmHg 95% CI). There was high correlation between the measurements (r = 0.790, p < 0.001). We found that TP overestimated pressures at IOP <16.5 mmHg and underestimated at IOP >16.5 mmHg (Fig. 4). Discrepant measurements accounted for 2.6% (N = 116) and 5.2% (N = 238) for outcomes A and B respectively. Patients with thinner CCT had higher odds of discrepant IOP (OR 0.88 per 25 μm increase, CI [0.84–0.92], p < 0.0001; OR 0.88 per 25 μm increase, CI [0.84–0.92], p < 0.0001 for outcomes A and B respectively). ConclusionIn a real-world academic practice setting, TP and GAT IOP measurements demonstrated close agreement, although 2.6% of measurements showed elevated GAT IOP despite normal TP measurements, and 5.2% of measurements were ≥6 mmHg apart.

Rate of Retinal Nerve Fiber Layer Thinning in Glaucomatous Eyes with Optic Disc and Parapapillary Deep-Layer Microvasculature Loss.

Microvasculature dropout in the parapapillary choroidal layer was a more important biomarker of glaucomatous nerve fiber layer thinning when it presented with deep-layer microvasculature of the optic disc rather than when it presents by itself. To characterize open-angle glaucoma (OAG) eyes with optic nerve head (ONH) deep-layer microvasculature dropout (MvD-D) and parapapillary choroidal layer microvasculature dropout (MvD-P) and compare their retinal nerve fiber layer (RNFL) thinning rate. This study included 122 OAG eyes that underwent ≥5 serial spectral-domain optical coherence tomography (OCT) scans during a mean follow-up of 5.4 years. Swept-source OCT angiography (SS-OCTA) was used to evaluate MvD-P and MvD-D. Subjects were classified into three groups according to the presence of MvD-P and MvD-D: (1) no dropout (n=37); (2) solely MvD-P (n=40), and (3) both MvD-P and MvD-D (n=45). The RNFL thinning rate was compared among the three groups, and the associated factors were assessed by Cox proportional hazard analysis. RNFL thinning rates were highest in the group with both MvD-P and MvD-D, followed by the group with solely MvD-P and finally by the no dropout group (-0.24 vs. -0.65 vs. -1.20μm/year, P<0.001). Thinner central corneal thickness (hazard ratio [HR]=0.990, P=0.003), presence of disc hemorrhage (HR=1.802, P=0.035), and coexistence of MvD-P and MvD-D (HR=2.941, P<0.001) were the factors associated with RNFL thinning. The coexistence of MvD-P and MvD-D was associated with faster RNFL thinning than MvD-P alone or no dropout, which suggested that observing the optic disc deep microvasculature along with parapapillary choroidal layer using SS-OCTA may be clinically relevant in monitoring glaucoma progression.

Comparison of Contrast Sensitivity and Central Corneal Thickness in Primary Open Angle Glaucoma Suspects and Visually Normal Participants

Introduction: Glaucoma causes a reduction of contrast sensitivity (CS) while thinner central corneal thickness is (CCT) associated with the risk of glaucoma. Thus, in glaucoma suspect patients, CS and CCT measurements may better evaluate and monitor the disease. The purpose of this study was to compare CS and CCT between a Primary Open Angle Glaucoma (POAG) suspect group and a normal group of similar age. Methods: CS was measured with the Pelli-Robson CS chart, while CCT was measured with a hand-held pachymeter. In total, 115 glaucoma suspects and 102 normal participants were included. Results: There was a significant effect of the clinical condition on CS [F(1,209)=5.409, p=0.02]. The effect of age on CS was also significant [F(3,209)=20.419, p&lt;0.001]. The interaction between age and clinical condition was not statistically significant [F(3,209)=0.815, p=0.49]. CS of POAG suspects was significantly lower than that of the normal group for the younger age groups (40 to 59 years old) but not for the older age groups (50 to 80 years old). There was no significant effect of clinical condition on CCT [F(3,209)=0.754, p=0.39]. However, there was a significant effect of age on CCT [F(3,209)=3.789, p=0.01]. Conclusion: Contrast sensitivity measurement is potentially useful to be integrated with routine investigations for POAG suspect patients, especially those who are younger than 60 years old. Measurements of central corneal thickness alone may not be able to differentiate between POAG suspects and visually normal individuals.

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

Thin Central Corneal Thickness May Be a Risk Factor for Myopia Progression in Children.

This study investigated the correlation between corneal biomechanical parameters and the speed of myopia progression. This is a retrospective, multicenter study. Both Chinese and Caucasian children were involved. The follow-up time was at least 12 months. Ocular biometry data including the central corneal thickness (CCT), axial length (AL), corneal keratometry (K), anterior chamber depth (ACD), white-to-white (WTW) distance, and pupil size (PS) were measured. The age of onset, speed of progression of spherical equivalent (SE), and speed of AL elongation were calculated. Data were analyzed using the R programming language. This study comprised 306 eyes of 153 myopic children. 122 children were Chinese, and 31 children were Caucasian. The myopia progression was faster in Chinese children than that in the Caucasian group in both SE progression speed and AL elongation speed. The CCT was negatively correlated with the SE speed of progression (correlation coefficient, R = -0.65, and p=7.25 × 10-38) and AL speed (R = -0.47 and p=1.62 × 10-18). CCT was positively correlated with the age of onset (R = 0.35 and p=4.53 × 10-10). No significant correlation (R > 0.3 and p < 0.01) was found between other ocular biometries (K, ACD, WTW, and PS) and the onset and speed of the progression of myopia. The same trends were found in both Chinese and Caucasian children and in both the right eye and left eye. CCT was negatively correlated with myopia (SE) progression speed and AL elongation speed. Thin CCT may be associated with faster myopia progression.

Comparison of Central Corneal Thickness Measurement using Optical and Ultrasound Pachymetry in Primary Open Angle Glaucoma Patients

Introduction: A thinner Central Corneal Thickness (CCT) is an important criterion in determining the probability of progression from Ocular Hypertension (OHT) to Primary Open Angle Glaucoma (POAG). The most common devices for measuring CCT are ultrasound and optical pachymeters. Ultrasound pachymetry is a quick and precise approach to quantify corneal thickness that is also portable and inexpensive. The advantages of optical method include operator independency and noninvasiveness. Aim: To compare central corneal thickness using optical and ultrasound pachymetry in patients with POAG. Materials and Methods: This cross-sectional study was conducted at the Department Ophthalmology, ESI Post Graduate Institute of Medical Sciences and Research, Basaidarapur, Delhi, India, from October 2020 to April 2022. There were 105 POAG patients (210 eyes), divided into three subgroups of 35 subjects each (70 eyes each), based on the number of anti-glaucoma medications being instilled, topically (one/two/three drugs), and 35 healthy antiglaucoma controls (70 eyes). Central corneal thickness measurements were taken by Ultrasonic Pachymeter (USP) TOMEY SP-100, and by CEM-530 Non Contact Specular Microscope (NCSM) (optical). Statistical analysis was performed by the Statistical Package for Social Sciences (SPSS) program for Windows, version 17.0 (SPSS, Chicago, Illinois). Results: The mean CCT taken with NCSM and USP was 540.83±35.51 µm and 538.74±36.22 µm, respectively, in Right Eyes (RE) of 35 glaucoma patients on one drug, (p-value=0.80). Similarly, Left Eyes (LE), mean CCT with NCSM was 544.17±33.98 µm, and with USP was 541.69±36.6 µm (p-value=0.76). Mean CCT taken with NCSM and USP was 539.83±30,85 µm and 537.66±30.5 µm, respectively in RT eyes of 35 glaucoma patients on two drugs (p-value=0.76). Left eyes, mean CCT was 541.91±29.79 µm with NCSM as compared to USP which was 540.11±29.89 µm (p-value=0.80). On comparing the mean CCT values of RE in glaucoma subjects who were controlled on three antiglaucoma drugs it was found to be 528.37±26.44 µm using NCSM and 527.09±26.17 µm using USP (p-value=0.84). The meanvalues of CCT for LE was 521.94±26.53 µm with NCSM and with USP was 520±26.52 µm, respectively (p-value=0.81). Comparison of mean CCT measurements using NCSM and USP in 35 age-matched controls RE eye was found to be 517.83±21.27 µm and 515.97±20.91 µm, respectively (p-value=0.71). Similarly, for LE mean CCT values were 518.8±24.21 µm and 516.8±24.37 µm, respectively (p-value=0.73). Conclusion: The CCT measured using NCSM was found to be higher than that measured using USP in POAG subgroups patients as well as healthy age-matched controls, however the difference was not statistically significant. There was highly significant linear correlation between the CCT measured using NCSM and USP in all POAG subgroups as well as healthy controls. This suggests that the devices could be used interchangeably in glaucoma patients as well as healthy subjects of similar age group.

Ocular biometry measures and their correlation with refractive error in Aboriginal and Torres Strait Islander children

ABSTRACT Clinical relevance The ocular biometry measures of the eye determine the refractive status, and while most refractive error develops during childhood, the ocular biometry measures of Aboriginal and Torres Strait Islander children have not previously been reported. Background To investigate the ocular biometry of Aboriginal and Torres Strait Islander children, including measures important in determining refractive error and those which relate to the risk of ocular disease. Methods Participants included 252 primary and secondary school children (Aboriginal and Torres Strait Islander: 101; non-Indigenous: 151), aged between 4 and 18 years. Habitual monocular distance visual acuity, cycloplegic autorefraction, and ocular optical biometry were measured in all participants and intraocular pressure measured in secondary school children using rebound tonometry. Results The mean (±SD) spherical equivalent refractive error of Aboriginal and Torres Strait Islander children was significantly less hyperopic than non-Indigenous children (Aboriginal and Torres Strait Islander: +0.52 ± 0.80 D; non-Indigenous: +0.86 D ±0.58 D; p < 0.001). There were no differences in axial length or axial length/corneal radius ratio between the two groups, however the mean lens power of Aboriginal and Torres Strait Islander children was significantly greater than that of non-Indigenous children (Aboriginal and Torres Strait Islander: 23.62 D; non-Indigenous: 22.51 D; p < 0.001). Aboriginal and Torres Strait Islander children had a thinner central corneal thickness (Aboriginal and Torres Strait Islander: 534 ± 37 µm; non-Indigenous: 543 ± 35 µm; p = 0.04), and lower intraocular pressure compared with non-Indigenous children (Aboriginal and Torres Strait Islander: 14.7 ± 3.8 mmHg; non-Indigenous: 16.0 ± 3.7; p = 0.02). Conclusion Differences exist in the refractive error, lens power, central corneal thickness, and intraocular pressure of Aboriginal and Torres Strait Islander children compared to non-Indigenous Australian children which have potential implications for the development of refractive error and ocular disease later in life.

Discordance between Anterior Segment Anatomy and Axial Length in Cataract Surgery Candidates in France

Introduction: The aims of this study were to study ocular biometric data and their association with age and sex in a population of cataract surgery candidates and to assess the proportion of inhomogeneous eyes and the ratio anterior segment (AS) to axial length (AL). Multicentric cross-sectional analysis was conducted between April 2008 and May 2021 in public and private ophthalmic institutions in Montpellier, France. Individuals ≥40 years old who underwent ocular biometry before cataract surgery were included. Methods: Right phakic eyes were included. Ocular biometrics were measured by using the Lenstar LS900 device. We defined AS as anterior chamber depth (ACD) plus lens thickness (LT) and calculated the ratio of AS to AL. We defined inhomogeneous eyes as those with deep AS (≥4th quartile) and short AL (≤1st quartile) (AS+) or with short AS and high AL (AL+). Results: We included 11,650 individuals (11,650 eyes) (mean [SD] age 71.64 [10.50] years; 54.51% women). Older age was associated with shorter AL (p < 0.01), shallower ACD (p < 0.01), thinner central corneal thickness (p < 0.01), and larger LT (p < 0.001). Women had shorter AL, shallower ACD, and thinner central corneal thickness than men (p < 0.001). In total, 778 (6.68%) eyes were inhomogeneous (3.22% AS+ and 3.46% AL+), for a mean (SD) AS/AL ratio of 0.36 (0.01) and 0.28 (0.01), respectively, as compared with 0.32 (0.02) for homogeneous eyes (p < 0.001). Conclusion: The AS/AL ratio could be useful to screen inhomogeneous eyes before cataract surgery and justify the use of new generation formulas in these eyes to avoid the risk of refractive error.

Macular and peripapillary microvascular changes in open angle glaucoma and ocular hypertension: A longitudinal study using optical coherence tomography angiography (OCT‐A)

AbstractPurpose: To investigate prospectively macular and peripapillary microvascular changes in patients with glaucoma and ocular hypertension.Methods: A 12‐month prospective longitudinal study was performed with 124 open‐angle‐glaucoma‐eyes (GE), 111 ocular‐hypertension‐eyes (OHE) and 98 gender and age matched control‐eyes (CE). Glaucomatous progression was defined as a decrease of ≥5 μm in average or ≥7 μm in a sector of RNFL thickness. OMAG OCT microangiography (Angioplex, HD OCT, Cirrus 5000, Zeiss) was used to analyse optic disc and macular regions. The statistical analysis was performed using Mann–Whitney‐Test with the SPSS version 23.0 statistical package (SPSS Inc., IL).Results: Among OHE and GE groups, 21.7% of eyes showed progression, being the decrease of Peripapillary Flux Index (PFI), Macular Vessel Density (MVD) and Macular Capillary Perfusion Density (MPD) greater (−0.0067; −0.696 mm/mm2 and −1.56%) compared to non‐progressive eyes (+0.0038; 0.527 mm/mm2 and 1.55%) being the nasal and inferior sectors for PFI, and the superior and temporal sectors for both MVD and MPD, the ones that showed greater differences [p = 0.015 and p &lt; 0.001 for the last two]. Furthermore, Peripapillary Perfusion Density (PPD) showed non‐significant greater decrease (−0.347) compared to non‐progressive eyes (−0.324) [p = 0.775]. Characteristics as increased vertical cup to disc ratio (CDV) (0.64 vs. 0.57), elevated intraocular pressure (IOP) (18.25 vs. 15.40 mmHg), thinner central corneal thickness (CCT) (520.18 vs. 541.67 μm) and lower ocular perfusion pressure (OPP) (47.81 vs. 48.95 mmHg) were significantly different in those progressive OHE and GE [p &lt; 0.05 for all]. Nevertheless, minimum ganglion cell layer thickness (GCLM) was only significantly lower in progressive GE (58.51 vs. 73.98 μm) [p = 0.036].Conclusions: Data showed that when glaucomatous progression took place, stronger microvascular changes occurred in the macular and peripapillary areas, as greater decrease of MVD, MPD and PFI, especially in superior and temporal sectors for the macular area, and in nasal and inferior sectors for the peripapillary area. Nevertheless, further research with larger population and larger follow‐up is needed to obtain stronger results.