Hirasawa Kazunori, Matsuura Masato, Murata Hiroshi, Nakakura Shunsuke, Nakao Yoshitaka, Kiuchi Yoshiaki, Asaoka Ryo
Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Department of Orthoptics and Visual Science, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.
Transl Vis Sci Technol. 2017 Jun 14;6(3):18. doi: 10.1167/tvst.6.3.18. eCollection 2017 Jun.
To investigate the association between corneal biomechanical properties measured with the Ocular Response Analyzer (ORA) and also CorvisST (CST) tonometry, and glaucomatous visual field (VF) severity.
One hundred forty-six eyes of 91 patients with primary open-angle glaucoma who performed Humphrey Field Analyzer 30-2 or 24-2 SITA-Standard, ORA, and CST within 180 days were included in this multicentral, observational cross-sectional study. The association between ORA parameters (corneal hysteresis [CH] and corneal resistant factor [CRF]), CST parameters (A1 and A2 time, A1 and A2 length, A1 and A2 velocity, A1 and A2 deformation amplitude, highest deformation amplitude, highest concavity time, peak distance, and radius), and other basic parameters (age, intraocular pressure with Goldmann applanation tonometry, central corneal thickness, and axial length) against mean total deviation (mTD) were analyzed using a linear mixed-model and model selection with corrected Akaike Information Criterion (AICc).
The optimal model of VF severity included ORA's CH as well as a number of CST parameters, including A1 length, A2 time, radius, and highest concavity deformation amplitude (AICc: 971.7). The possibility this model describes visual field severity more accurately than the optimal model without CST parameters was 99.98%.
Glaucomatous VF severity was best described by both ORA and CST parameters. Eyes with corneas that experience sharp and deep indentation at the maximum deformation, wide indentation at the first applanation, and early second applanation in the CST measurement are more likely to show advanced VF severity.
CorvisST tonometry parameters are related to VF severity in glaucoma patients.
研究使用眼反应分析仪（ORA）以及CorvisST（CST）眼压计测量的角膜生物力学特性与青光眼视野（VF）严重程度之间的关联。
本多中心观察性横断面研究纳入了91例原发性开角型青光眼患者的146只眼，这些患者在180天内进行了Humphrey视野分析仪30-2或24-2 SITA标准检测、ORA检测和CST检测。使用线性混合模型和校正的赤池信息准则（AICc）进行模型选择，分析ORA参数（角膜滞后[CH]和角膜阻力因子[CRF]）、CST参数（A1和A2时间、A1和A2长度、A1和A2速度、A1和A2变形幅度、最大变形幅度、最大凹陷时间、峰值距离和半径）以及其他基本参数（年龄、Goldmann压平眼压计测量的眼压、中央角膜厚度和眼轴长度）与平均总偏差（mTD）之间的关联。
视野严重程度的最佳模型包括ORA的CH以及多个CST参数，包括A1长度、A2时间、半径和最大凹陷变形幅度（AICc：971.7）。该模型比无CST参数的最佳模型更准确描述视野严重程度的可能性为99.98%。
ORA和CST参数均能最好地描述青光眼视野严重程度。在CST测量中，角膜在最大变形时经历急剧而深度的压痕、首次压平时压痕较宽且第二次压平较早的眼睛更有可能表现出严重的视野严重程度。
CorvisST眼压计参数与青光眼患者的视野严重程度相关。
