What is our current knowledge on the clinical significance of central corneal thickness (CCT)? This important question was issued and addressed in the review article by Dueker et al. (835) The authors selected 81 published reports to their review, which were classified as level I (randomised clinical trials or quality validated cohort studies), level II (well-designed case-control studies and exploratory cohort studies or nonrandomised clinical studies) and level III (poorly designed case-control studies and case series).
Although CCT is important, further research is needed to clarify the role of CCT in glaucoma screening and during glaucoma treatmentAfter presenting the biomechanical and clinical data on the relationship of CCT to IOP and IOP measurement, the reports were analysed to answer the three most important clinical questions: is CCT a risk factor for 1) progression from OHT to glaucoma; 2) for the presence of glaucomatous optic neuropathy; 3) for progression of damage in POAG?
Strong and consistent evidence was found that CCT is a reliable indicator for progression of OHT to glaucoma. In addition, it was found that low CCT is frequently associated with the initial diagnosis of glaucoma when patients already on treatment are reviewed. In contrast, in screening the significance of CCT is questioned. Importantly, the authors found that CCT is not helpful in predicting the risk of glaucoma progression. These results clearly show the reader that recording CCT is important, but further research is needed to clarify the role of CCT in glaucoma screening and during glaucoma treatment, as well as to understand the relationship between CCT and corneal compliance or CCT and ageing.