Duke Eye Center and Department of Ophthalmology.
Department of Electrical and Computer Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina, USA.
Curr Opin Ophthalmol. 2022 May 1;33(3):243-249. doi: 10.1097/ICU.0000000000000842. Epub 2022 Feb 21.
This review summarizes recent findings on corneal hysteresis, a biomechanical property of the cornea. Corneal hysteresis measurements can be easily acquired clinically and may serve as surrogate markers for biomechanical properties of tissues in the back of the eye, like the lamina cribrosa and peripapillary sclera, which may be related to the susceptibility to glaucomatous damage.
Several studies have provided evidence of the associations between corneal hysteresis and clinically relevant outcomes in glaucoma. Corneal hysteresis has been shown to be predictive of glaucoma development in eyes suspected of having the disease. For eyes already diagnosed with glaucoma, lower corneal hysteresis has been associated with higher risk of progression and faster rates of visual field loss over time. Such associations appear to be stronger than those for corneal thickness, suggesting that corneal hysteresis may be a more important predictive factor. Recent evidence has also shown that cornealcorrected intraocular pressure measurements may present advantages compared to conventional Goldmann tonometry in predicting clinically relevant outcomes in glaucoma.
Given the evidence supporting corneal hysteresis as an important risk factor for glaucoma development and its progression, practitioners should consider measuring corneal hysteresis in all patients at risk for glaucoma, as well as in those already diagnosed with the disease.
本文总结了角膜滞后这一角膜生物力学特性的最新研究发现。临床检测角膜滞后值较为容易,它可能是眼球后部组织(如筛板和视乳头周围巩膜)生物力学特性的替代标志物,而这些组织的生物力学特性可能与青光眼损伤的易感性相关。
多项研究为角膜滞后与青光眼相关临床结局之间的关联提供了证据。研究表明,角膜滞后值可预测疑似青光眼患者的青光眼发展。对于已诊断为青光眼的患者,较低的角膜滞后值与进展风险增加和视野丧失速度加快有关。这些关联似乎比角膜厚度的关联更强烈,这表明角膜滞后值可能是一个更重要的预测因素。最近的证据还表明,与传统的 Goldmann 眼压测量相比,角膜校正眼压测量在预测青光眼相关临床结局方面可能具有优势。
鉴于支持角膜滞后值是青光眼发展和进展的重要危险因素的证据,临床医生应考虑在所有青光眼高危患者以及已诊断为该疾病的患者中测量角膜滞后值。