Gil Pedro, Pires Joana, Matos Rita, Cardoso Mariana S, Lopes Nádia, Matias João, Mariano Manuel
Centro Hospitalar Baixo Vouga, Aveiro, Portugal.
J Glaucoma. 2017 Feb;26(2):e41-e45. doi: 10.1097/IJG.0000000000000535.
The purpose of the study was to describe and compare anterior and posterior topographic elevation maps in primary open angle glaucoma patients with functional damage staging and in healthy controls.
A total of 217 subjects were consecutively recruited, including 111 primary open angle glaucoma patients (patients), and 106 healthy individuals (controls). All patients performed Pentacam HR corneal topography. Mean anterior keratometry and anterior and posterior topographic elevation maps were compared in the central 3, 5, and 7 mm. Humphrey automated perimetry results from the patient group were classified according to the Glaucoma Staging System.
Age (patients: 72.32±8.09; controls: 70.82±8.36; P=0.18) and central corneal pachymetry (patients: 541.13±36.98; controls: 548.67±34.56; P=0.12) were similar in both groups. Maximum elevation readings in the central 5 mm were significantly (P<0.05) higher in the anterior (patients: 8.21±8.63; controls: 5.79±3.62) and posterior (patients: 16.17±8.72; controls: 13.92±6.03) corneal topography of the glaucomatous patients, as well as in the anterior (patients: 17.32±20.78; controls: 9.61±5.64) and posterior (patients: 38.81±19.78; controls: 26.38±12.73) central 7 mm. There was a weak but significant correlation between the Glaucoma Staging System stage and both the anterior 5 mm (r=0.397) and 7 mm (r=0.304) maximum, as well as the posterior 5 mm (r=0.233) and 7 mm (r=0.241) maximum.
In patients with primary open angle glaucoma, there is a forward shifting of the posterior and anterior corneal surfaces. This appears to be correlated with more advanced stages of functional damage, pointing to a possible link between corneal structural changes and duration and intensity of elevated intraocular pressure. Further studies may ascertain the potential for this biological marker to be used in monitoring primary open angle glaucoma patients.
本研究旨在描述并比较原发性开角型青光眼患者功能性损害分期的前后表面地形高度图与健康对照者的该图。
连续招募了217名受试者，包括111名原发性开角型青光眼患者（患者组）和106名健康个体（对照组）。所有患者均进行了Pentacam HR角膜地形图检查。比较了中央3mm、5mm和7mm区域的平均前角膜曲率以及前后表面地形高度图。患者组的Humphrey自动视野计检查结果根据青光眼分期系统进行分类。
两组的年龄（患者组：72.32±8.09；对照组：70.82±8.36；P = 0.18）和中央角膜厚度（患者组：541.13±36.98；对照组：548.67±34.56；P = 0.12）相似。青光眼患者中央5mm区域的前表面（患者组：8.21±8.63；对照组：5.79±3.62）和后表面（患者组：16.17±8.72；对照组：13.92±6.03）地形高度的最大读数显著更高（P<0.05），中央7mm区域的前表面（患者组：17.32±20.78；对照组：9.61±5.64）和后表面（患者组：38.81±19.78；对照组：26.38±12.73）也是如此。青光眼分期系统的分期与前表面5mm（r = 0.397）和7mm（r = 0.304）的最大高度以及后表面5mm（r = 0.233）和7mm（r = 0.241）的最大高度之间存在微弱但显著的相关性。
在原发性开角型青光眼患者中，角膜前后表面向前移位。这似乎与更晚期的功能性损害相关，表明角膜结构变化与眼内压升高的持续时间和强度之间可能存在联系。进一步的研究可能会确定这种生物标志物用于监测原发性开角型青光眼患者的潜力。
