Yener Arif Ülkü, Özdemir Yıldız Zennure, Çöllüoğlu Hamurcu Zeliha, Balım Haluk
Department of Ophthalmology, Atatürk Sanatoryum Training and Research Hospital, Ankara, Türkiye.
Int Ophthalmol. 2025 Jul 22;45(1):306. doi: 10.1007/s10792-025-03683-3.
To determine the association of central corneal thickness with corneal epithelium, ocular A-scan parameters, anterior chamber angle, and optic nerve sheath diameter.
A total of 161 individuals with thick, thin or normal corneas, with average ages of 53.3, 56.8 and 52.9 years, respectively, were included in this study. During routine eye examination, the right and left eyes of those with corneas thicker than 600 µm or thinner than 500 µm were assessed by comparing them separately with the eyes of those with normal corneas and with each other. After the participants' corneal thicknesses were measured by a non-contact tonometry/pachymetry, anatomical structures such as anterior chamber depth, lens thickness, and axial length were calculated with the A-Scan mode of an ultrasound device, and optic nerve sheath diameter was measured by the B-Scan mode of the same analyzer. Measurements of anterior segment structures, including corneal epithelium, corneal pachymetry and anterior chamber angle were recorded with a spectral domain optical coherence tomography. The optic disc area was automatically measured with the same device and compared with the optic nerve sheath diameter and central corneal thickness.
Central corneal thickness was inversely correlated with age. Thicker central cornea was associated with smaller anterior chamber angle (for normal vs. thick 34.7 ± 5.7° and 29.4 ± 6.9°, P = 0.00, for normal vs. thin 34.7 ± 5.7° and 30.7 ± 7.3°, P = 0.00), whereas ocular A-scan parameters, including anterior chamber depth, lens thickness, and axial length did not show significant differences. Intraocular pressure measurements lower than 17.9 mmHg were significantly different between the groups, with the highest measurements obtained from the thick group (17.9 ± 3.2 mmHg, 15.3 ± 2.3 mmHg, and 16.7 ± 2.1 mmHg for thick, thin and normal corneas, respectively). Despite within normal limits in all groups, the optic nerve sheath diameter in the control group was significantly smaller than that in the thick and thin groups (4.23 ± 0.71 mm vs. 4.66 ± 0.54 mm for normal and thick, P = 0.00, 4.23 ± 0.71 mm vs. 4.58 ± 0.55 mm for normal and thin, P = 0.02). The epithelium at nine points in the thick corneas, was significantly thicker than the corresponding points of the other two groups (the central thickness of epithelium for the thick and thin 58.4 ± 3.9 µm vs. 52.8 ± 2.9 µm, P = 0.00, for the thick and normal 58.4 ± 3.9 µm vs. 53.4 ± 2.4 µm, P = 0.00). For the thick cornea group, optic nerve sheath diameter was significantly correlated with optic disc area (r = 0.86, P = 0.000) and central corneal thickness (P = 0.003, regression coefficients).
Thicker central cornea was associated with thicker corneal epithelium, smaller anterior chamber angle, greater optic nerve sheath diameter, and higher intraocular pressure readings.
确定中央角膜厚度与角膜上皮、眼部A超参数、前房角及视神经鞘直径之间的关联。
本研究纳入了总共161名角膜厚、薄或正常的个体，平均年龄分别为53.3岁、56.8岁和52.9岁。在常规眼科检查期间，将角膜厚度大于600 µm或小于500 µm者的左右眼分别与角膜正常者的眼睛进行比较，并相互比较。在通过非接触眼压计/角膜测厚仪测量参与者的角膜厚度后，使用超声设备的A超模式计算前房深度、晶状体厚度和眼轴长度等解剖结构，并通过同一分析仪的B超模式测量视神经鞘直径。使用光谱域光学相干断层扫描记录眼前节结构的测量值，包括角膜上皮、角膜测厚和前房角。使用同一设备自动测量视盘面积，并与视神经鞘直径和中央角膜厚度进行比较。
中央角膜厚度与年龄呈负相关。较厚的中央角膜与较小的前房角相关（正常角膜与厚角膜相比，分别为34.7±5.7°和29.4±6.9°，P = 0.00；正常角膜与薄角膜相比，分别为34.7±5.7°和30.7±7.3°，P = 0.00），而眼部A超参数，包括前房深度、晶状体厚度和眼轴长度未显示出显著差异。眼压测量值低于17.9 mmHg在各组之间存在显著差异，厚角膜组的测量值最高（厚、薄和正常角膜组分别为17.9±3.2 mmHg、15.3±2.3 mmHg和16.7±2.1 mmHg）。尽管所有组均在正常范围内，但对照组的视神经鞘直径显著小于厚角膜组和薄角膜组（正常与厚角膜组相比，分别为4.23±0.71 mm和4.66±0.54 mm，P = 0.00；正常与薄角膜组相比，分别为4.23±0.71 mm和4.58±0.55 mm，P = 0.02）。厚角膜组九个点处的上皮明显厚于其他两组的相应点（厚角膜组与薄角膜组的上皮中央厚度分别为58.4±3.9 µm和52.8±2.9 µm，P = 0.00；厚角膜组与正常角膜组的上皮中央厚度分别为58.4±3.9 µm和53.4±2.4 µm，P = 0.00）。对于厚角膜组，视神经鞘直径与视盘面积显著相关（r = 0.86，P = 0.000）和中央角膜厚度（P = 0.003，回归系数）。
较厚的中央角膜与较厚的角膜上皮、较小的前房角、较大的视神经鞘直径和较高的眼压读数相关。
