Abstract #84612 Published in IGR 21-1

Relationship of Corneal Hysteresis and Anterior Lamina Cribrosa Displacement in Glaucoma

Wong BJ; Moghimi S; Zangwill LM; Christopher M; Belghith A; Ekici E; Bowd C; Fazio MA; Girkin CA; Weinreb RN
American Journal of Ophthalmology 2020; 212: 134-143

See also comment(s) by Crawford DownsJulian Garcia Feijoo & Frances SaenzTony Realini

PURPOSE: To investigate the relationship between corneal hysteresis (CH) and anterior lamina cribrosa surface (ALCS) displacement over time in a cohort of patients with glaucoma. DESIGN: Prospective observational case series. METHODS: In this study, 147 eyes from 96 glaucoma or glaucoma suspect patients were followed for a mean of 3.5 years and 7.9 visits. Baseline CH measurements were obtained using the Ocular Response Analyzer (ORA; Reichert Ophthalmic Instruments Inc, Depew, New York, USA). The mean anterior lamina cribrosa surface depth (ALCSD) and choroidal thickness were by automated segmentation of spectral-domain optical coherence tomography (SD-OCT) scans. The rate of change of ALCSD was calculated using linear mixed effects models. Relationship between baseline CH and follow-up ALCSD rate of change was adjusted for confounding factors, including age, intraocular pressure (IOP), and choroidal thickness. RESULTS: The mean baseline CH was 9.4 mm Hg (95% confidence interval [CI] 9.1-9.7). Overall, the ALCS was displaced posteriorly at a rate of 0.78 μm/y (95% CI -1.82, 0.26). Seventeen eyes (11.5%) showed a significant posterior displacement of ALCS, whereas 22 eyes (15.0%) showed a significant anterior displacement of ALCS. The choroidal thickness thinned at a rate of -1.09 μm/y during the follow-up (P = .001). Multivariable mixed modeling showed that choroidal thinning, lower IOP change, and lower corneal hysteresis were significantly associated with posterior ALCS displacement over time (P = .034, P = .037, and P = .048). Each 1 mm lower CH was associated with 0.66 μm/y posterior displacement of the ALCS. CONCLUSIONS: Lower corneal hysteresis was significantly associated with posterior displacement of the anterior lamina cribrosa over time. These data provide additional support for lower corneal hysteresis being a risk factor for glaucoma progression.

Shiley Eye Institute, Hamilton Glaucoma Center, University of California San Diego, La Jolla, California, USA; USC Roski Eye institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.

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2.2 Cornea (Part of: 2 Anatomical structures in glaucoma)
2.14 Optic disc (Part of: 2 Anatomical structures in glaucoma)
2.3 Sclera (Part of: 2 Anatomical structures in glaucoma)

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