State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China (Y.X, Y.Y, Z.C, J.X, Y.Y, Y.F, P.L, K.Y, M.Y).
Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong (I.T.C, D.C.C.L).
Am J Ophthalmol. 2022 Oct;242:131-138. doi: 10.1016/j.ajo.2022.06.014. Epub 2022 Jun 25.
To assess and compare the corneal biomechanics of normal-tension glaucoma (NTG), high-tension glaucoma (HTG), and normal controls based on stiffness and modulus. The correlations among central corneal thickness (CCT), visual field, retinal nerve fiber layer (RNFL) thickness, and corneal biomechanics in glaucoma eyes were also evaluated.
A prospective, cross-sectional, comparative study.
This study included 334 eyes of 108 NTG patients, 113 HTG patients, and 113 control subjects at Zhongshan Ophthalmic Center, Sun Yat-Sen University. Corneal biomechanics were evaluated using a corneal indentation device (CID) and corneal visualization Scheimpflug technology (Corvis ST). Visual field and RNFL thickness were obtained using standard automated perimetry and spectral-domain optical coherence tomography. One-way analyses of variance with Bonferroni post hoc tests and a multivariable linear regression analysis with adjustment were conducted. Correlations among corneal biomechanical parameters, CCT, visual field, and RNFL thickness were analyzed.
The corneal stiffness of the NTG patients (71.0 ± 10.9 N/m) was significantly lower than that of the HTG patients (77.3 ± 15.6 N/m; P = .001) and the CCT- and IOP-matched normal controls (75.6 ± 11.0 N/m; P = .023). The patients in the NTG group had lower corneal stiffness than those in the control group (β = -4.88, 95% CI -9.002, -0.758; P = .020) after adjusting for confounders. Stiffness was positively correlated with CCT in the NTG group (P = .028) but not in the HTG group (P = .509). There was no significant correlation (P > .05) between corneal biomechanics, visual field, or RNFL thickness.
The corneas of NTG patients were softer than those of HTG patients and controls, as assessed by CID, which were associated with thinner CCT. These might suggest different ocular biomechanical properties in NTG and HTG.
基于硬度和模量评估并比较正常眼压青光眼（NTG）、高眼压青光眼（HTG）和正常对照者的角膜生物力学。还评估了青光眼眼中中央角膜厚度（CCT）、视野、视网膜神经纤维层（RNFL）厚度和角膜生物力学之间的相关性。
前瞻性、横断面、对照研究。
本研究纳入中山大学中山眼科中心的 108 例 NTG 患者、113 例 HTG 患者和 113 例对照者的 334 只眼。使用角膜压平装置（CID）和角膜可视化Scheimpflug 技术（Corvis ST）评估角膜生物力学。使用标准自动视野计和谱域光学相干断层扫描获得视野和 RNFL 厚度。采用单因素方差分析，Bonferroni 事后检验和多变量线性回归分析进行调整。分析角膜生物力学参数、CCT、视野和 RNFL 厚度之间的相关性。
NTG 患者（71.0 ± 10.9 N/m）的角膜硬度明显低于 HTG 患者（77.3 ± 15.6 N/m；P =.001）和 CCT 和IOP 匹配的正常对照者（75.6 ± 11.0 N/m；P =.023）。NTG 组患者的角膜硬度低于对照组（β = -4.88，95%CI-9.002，-0.758；P =.020），调整混杂因素后。在 NTG 组中，硬度与 CCT 呈正相关（P =.028），但在 HTG 组中无相关性（P =.509）。角膜生物力学、视野或 RNFL 厚度之间无显著相关性（P >.05）。
CID 评估结果显示，NTG 患者的角膜比 HTG 患者和对照组更软，这与 CCT 更薄有关。这些可能提示 NTG 和 HTG 之间存在不同的眼生物力学特性。
