Park Keunheung, Shin Jonghoon, Lee Jiwoong
Department of Ophthalmology, Pusan National University School of Medicine, #179 Gudeok-ro, Seo-gu, Busan, 602-739, South Korea.
Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.
BMC Ophthalmol. 2018 Jan 15;18(1):7. doi: 10.1186/s12886-018-0673-x.
We evaluated the relationships between corneal biomechanical properties and structural parameters in patients with newly diagnosed, untreated normal-tension glaucoma (NTG).
All subjects were evaluated using an Ocular Response Analyzer (ORA) measuring corneal hysteresis (CH) and the corneal resistance factor (CRF). Central corneal thickness (CCT), Goldmann applanation tonometric (GAT) data, axial length, and the spherical equivalent (SE), were also measured. Confocal scanning laser ophthalmoscopy was performed with the aid of a Heidelberg retina tomograph (HRT III). We sought correlations between HRT parameters and different variables including CCT, CH, and the CRF. Multiple linear regression analysis was performed to identify significant associations between corneal biomechanical properties and optic nerve head parameters.
We enrolled 95 eyes of 95 NTG patients and 93 eyes of 93 normal subjects. CH and the CRF were significantly lower in more advanced glaucomatous eyes (P = 0.001, P = 0.008, respectively). The rim area, rim volume, linear cup-to-disc ratio (LCDR), and mean retinal nerve fiber layer (RNFL) thickness were significantly worse in more advanced glaucomatous eyes (P < 0.001, P < 0.001, P < 0.001, and P = 0.001). CH was directly associated with rim area, rim volume, and mean RNFL thickness (P = 0.012, P = 0.028, and P = 0.043) and inversely associated with LCDR (P = 0.015), after adjusting for age, axial length, CCT, disc area, GAT data, and SE. However, in normal subjects, there were no significant associations between corneal biomechanical properties and HRT parameters.
A lower CH is significantly associated with a smaller rim area and volume, a thinner RNFL, and a larger LCDR, independent of disc size, corneal thickness, intraocular pressure, and age.
我们评估了新诊断的未经治疗的正常眼压性青光眼（NTG）患者角膜生物力学特性与结构参数之间的关系。
所有受试者均使用眼反应分析仪（ORA）进行评估，测量角膜滞后（CH）和角膜阻力因子（CRF）。还测量了中央角膜厚度（CCT）、Goldmann压平眼压计（GAT）数据、眼轴长度和等效球镜度（SE）。借助海德堡视网膜断层扫描仪（HRT III）进行共焦扫描激光眼科检查。我们寻找HRT参数与包括CCT、CH和CRF在内的不同变量之间的相关性。进行多元线性回归分析以确定角膜生物力学特性与视神经乳头参数之间的显著关联。
我们纳入了95例NTG患者的95只眼和93例正常受试者的93只眼。在病情更严重的青光眼眼中，CH和CRF显著降低（分别为P = 0.001，P = 0.008）。在病情更严重的青光眼眼中，视盘边缘面积、视盘边缘体积、线性杯盘比（LCDR）和平均视网膜神经纤维层（RNFL）厚度明显更差（P < 0.001，P < 0.001，P < 0.001，P = 0.001）。在调整年龄、眼轴长度、CCT、视盘面积、GAT数据和SE后，CH与视盘边缘面积、视盘边缘体积和平均RNFL厚度直接相关（P = 0.012，P = 0.028，P = 0.043），与LCDR呈负相关（P = 0.015）。然而，在正常受试者中，角膜生物力学特性与HRT参数之间无显著关联。
较低的CH与较小的视盘边缘面积和体积、较薄RNFL以及较大的LCDR显著相关，与视盘大小、角膜厚度、眼压和年龄无关。
