Sng Chelvin C A, Ang Marcus, Barton Keith
aGlaucoma Service, Moorfields Eye Hospital, London, UK bDepartment of Ophthalmology, National University Health System cSingapore Eye Research Institute dSingapore National Eye Centre, Singapore, Singapore eNational Institute for Health Research, Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital fDepartment of Epidemiology and Genetics, Institute of Ophthalmology, University College, London, UK.
Curr Opin Ophthalmol. 2017 Mar;28(2):120-126. doi: 10.1097/ICU.0000000000000335.
The purpose of this review is to summarize the role of central corneal thickness (CCT) in the clinical management of a glaucoma patient.
The prognostic value of CCT is well recognized in patients with ocular hypertension. However, its predictive value in other glaucoma suspects and patients with established glaucoma is less certain. Tonometry artefacts can result from variations in CCT. However, an adequately validated correction algorithm for Goldmann applanation tonometry measurements does not exist. Newer methods of tonometry are potentially less influenced by CCT but are limited in their clinical use. There may also be biological and genetic associations between corneal thickness and glaucoma. Demographics, environmental factors, glaucoma treatment and the measurement device used have a significant influence on CCT, and should be considered when interpreting the effect of cornea thickness in patients with glaucoma. New measurements of the biomechanical properties of the cornea are likely to be better approximations of the globe biomechanics than CCT, but these require further evaluation.
The clinical significance of CCT is well recognized in the context of glaucoma diagnosis and management, though the extent of its importance remains debatable. Corneal biomechanical properties may be more significantly associated with glaucoma than CCT.
本综述旨在总结中央角膜厚度(CCT)在青光眼患者临床管理中的作用。
CCT的预后价值在高眼压症患者中已得到充分认可。然而,其在其他青光眼可疑患者和已确诊青光眼患者中的预测价值尚不确定。眼压测量假象可由CCT的变化引起。然而,目前尚无经过充分验证的用于校正Goldmann压平眼压测量值的算法。新型眼压测量方法可能受CCT的影响较小,但在临床应用中存在局限性。角膜厚度与青光眼之间可能还存在生物学和遗传学关联。人口统计学、环境因素、青光眼治疗以及所使用的测量设备对CCT有显著影响,在解释角膜厚度对青光眼患者的影响时应予以考虑。角膜生物力学特性的新测量方法可能比CCT更能准确反映眼球生物力学,但这些方法需要进一步评估。
尽管CCT重要性的程度仍存在争议,但在青光眼诊断和管理中其临床意义已得到充分认可。角膜生物力学特性可能比CCT与青光眼的关联更为显著。