Shimmyo Mitsugu, Ross Anna J, Moy Anna, Mostafavi Ramin
Department of Clinical Ophthalmology, New York Medical College, New York, New York, USA.
Am J Ophthalmol. 2003 Oct;136(4):603-13. doi: 10.1016/s0002-9394(03)00424-0.
This is to investigate whether there are differences in Goldmann applanation tonometry (GAT), central corneal thickness, and corneal curvature among four racial groups. If differences are present, they may alter GAT reading, diagnosis, and management of glaucoma in the population.
Observational retrospective cross-sectional study.
Charts of patients who have had keratorefractive surgery were examined. Central corneal thickness, corneal curvature, refractive power, and GAT were measured in 1482 Caucasian, 172 Asian, 204 Hispanic, and 118 African-American eyes (total 1976 eyes). Refractive components and GAT were compared. We compared intraocular pressure (IOP) adjusted by GAT, central corneal thickness, and corneal curvature among the four groups.
There was a statistically significant difference between the mean (+/- standard deviation) central corneal thickness of African American (535.46 +/- 33.39) and Caucasian (552.59 +/- 34.48) eyes. Mean central corneal thickness was near 550 microm in Caucasians, Asians, and Hispanics. No significant difference was noted in corneal curvature in the four groups. There was a significant correlation between central corneal thickness and corneal curvature, and GAT was similar among the four groups. When IOP was adjusted for central corneal thickness, it was significantly greater in African Americans (16.12 +/- 3.27) than in Caucasians (14.32 +/- 2.93). Corneas of women were significantly thinner than corneas of men.
African Americans had significantly thinner central corneal thickness than Caucasians, Asians, or Hispanics, causing the underreading of true IOP. Significant correlation between central corneal thickness and corneal curvature was demonstrated. Uncorrected GAT underreading of African Americans may lead to delay in diagnosis, inadequate treatment target setting, and higher morbidity. Goldmann applanation tonometry needs to be corrected by central corneal thickness and corneal curvature for proper diagnosis and management of glaucoma.
本研究旨在调查四个种族群体在Goldmann压平眼压测量法（GAT）、中央角膜厚度和角膜曲率方面是否存在差异。如果存在差异，可能会改变人群中青光眼的GAT读数、诊断和治疗。
观察性回顾性横断面研究。
检查接受过角膜屈光手术患者的病历。测量了1482只白种人眼睛、172只亚洲人眼睛、204只西班牙裔眼睛和118只非裔美国人眼睛（共1976只眼睛）的中央角膜厚度、角膜曲率、屈光力和GAT。比较了屈光成分和GAT。我们比较了四组中经GAT校正的眼压（IOP）、中央角膜厚度和角膜曲率。
非裔美国人（535.46±33.39）和白种人（552.59±34.48）眼睛的平均（±标准差）中央角膜厚度之间存在统计学显著差异。白种人、亚洲人和西班牙裔的平均中央角膜厚度接近550微米。四组的角膜曲率无显著差异。中央角膜厚度与角膜曲率之间存在显著相关性，四组的GAT相似。当根据中央角膜厚度校正IOP时，非裔美国人（16.12±3.27）显著高于白种人（14.32±2.93）。女性的角膜明显比男性的角膜薄。
非裔美国人的中央角膜厚度明显低于白种人、亚洲人或西班牙裔，导致对真实眼压的读数偏低。中央角膜厚度与角膜曲率之间存在显著相关性。非裔美国人未经校正的GAT读数偏低可能导致诊断延迟、治疗目标设定不足和更高的发病率。Goldmann压平眼压测量法需要根据中央角膜厚度和角膜曲率进行校正，以正确诊断和管理青光眼。
