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A Journal on Ophthalmology
Minerva Oftalmologica 2005 September-December;47(3-4):121-8
The relationship between corneal status and glaucoma
Sofianos C., Bricola G., Papadia M., Iester M., Traverso C. E.
Aim. Goldmann applanation tonometry is the most important method for measuring intraocular pressure. Recent studies showed that central corneal thickness is a significant variable for the measurement of intraocular pressure by applanation. When central corneal thickness is greater than average, then the intraocular pressure results overestimated. On the other hand, it is underestimated when the central corneal thickness is below average. This measurement error might conduct to a less than optimal management of the intraocular pressure in patients affected by glaucoma. The objective of this study was to verify whether a correlation exists between central corneal thickness and mean defect (MD) obtained by computerized Humphrey perimetry in subjects affected by primary open-angle glaucoma.
Methods. We included 86 eyes of 43 patients affected by primary open-angle glaucoma. All underwent ultrasonic contact pachimetry and computerized Humphrey perimetry program 30-2. We excluded patients with minimal perimetric defects, that is an MD value less than 3 dB.
Results. The results were statistically analyzed by t-test and linear regression analysis, which were performed each time by correlating 2 variables throughout the initial (N=86), the MD¾3dB group (N=48) and 3 groups (N=16 each) ranked in order of decreasing pachimetry. The information that comes out of our study is a statistically high correlation between central cornea thickness and MD value (P value Pachimetry vs MD = 0.00000674).
Conclusion. Our data support the hypothesis that the thinner the cornea, the greater the MD value. In patients with thinner cornea there could be a delayed glaucoma diagnosis due to the underestimation of the true intraocular pressure. We can also theorize that a thinner central corneal thickness may represent a risk factor for developing glaucoma, as a possible sign of weakness of the structures supporting the optic nerve.