Lopez Juan P, Freedman Sharon F, Muir Kelly, Duncan Lois, Stephens Derek, Atenafu Eshetu, Levin Alex V
Departments of Ophthalmology and Vision Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
J Pediatr Ophthalmol Strabismus. 2011 Mar-Apr;48(2):108-16. doi: 10.3928/01913913-20100518-03. Epub 2010 May 21.
To investigate central corneal thickness (CCT) in children with glaucoma and at risk for glaucoma.
The study included 139 children with glaucoma: 66 at risk for glaucoma (ie, aphakia, aniridia, or uveitis) and 66 normal children. CCT was measured by ultrasound pachymetry and intraocular pressure (IOP) by applanation. Analysis of variance was used to compare CCT between groups. Correlation analysis assessed associations between CCT and ocular factors including spherical equivalent, cup-to-disc ratio, glaucoma medications, and number of intraocular surgeries.
CCT was significantly higher for 141 eyes with glaucoma (mean: 0.598 mm, P < .001) and 76 eyes at risk for glaucoma (mean: 0.604 mm, P = .001) than for 66 normal eyes (mean: 0.558 mm). No significant difference was observed between at-risk (P = .989) and glaucoma eyes. Eyes with aphakia (0.653 mm) and aniridia (0.639 mm) had the thickest CCT values. Thinnest CCT was found in anterior segment dysgenesis and uveitis (mean: 0.541 mm). A significant positive correlation between CCT and spherical equivalent was found for glaucoma (r = 0.413; P < .001) and at-risk (r = 0.412; P < .0003) eyes, and between CCT and intraocular surgery for at-risk eyes (P = .0066). A significant negative correlation was found between CCT and cup-to-disc ratio for glaucoma eyes (r = -0.223; P = .01).
This is the largest series of CCT in pediatric glaucoma and related disorders. The data suggest caution in application of standard formulas for IOP-to-CCT correction when evaluating children with glaucoma because their mean CCT values extend far beyond values reported for normal eyes.
研究青光眼患儿及青光眼高危患儿的中央角膜厚度（CCT）。
该研究纳入了139例青光眼患儿：66例青光眼高危患儿（即无晶状体、无虹膜或葡萄膜炎）以及66例正常儿童。采用超声测厚法测量CCT，应用压平眼压计测量眼压（IOP）。采用方差分析比较各组间的CCT。相关性分析评估CCT与包括等效球镜度、杯盘比、青光眼用药及眼内手术次数等眼部因素之间的关联。
141只青光眼患眼（平均：0.598mm，P <.001）和76只青光眼高危患眼（平均：0.604mm，P =.001）的CCT显著高于66只正常眼（平均：0.558mm）。高危患眼与青光眼患眼之间未观察到显著差异（P =.989）。无晶状体眼（0.653mm）和无虹膜眼（0.639mm）的CCT值最厚。在前段发育异常和葡萄膜炎患眼中发现最薄的CCT（平均：0.541mm）。在青光眼患眼（r = 0.413；P <.001）和高危患眼（r = 0.412；P <.0003）中，CCT与等效球镜度之间存在显著正相关，在高危患眼中CCT与眼内手术之间存在显著正相关（P =.0066）。在青光眼患眼中，CCT与杯盘比之间存在显著负相关（r = -0.223；P =.01）。
这是关于小儿青光眼及相关疾病中CCT的最大系列研究。数据表明，在评估青光眼患儿时，应用标准公式进行眼压至CCT校正时应谨慎，因为他们的平均CCT值远远超出正常眼所报告的值。
