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Editors Selection IGR 22-4

Prognostic factors: Corneal Hysteresis as a Risk Factor for Progression

Gábor Holló

Comment by Gábor Holló on:

99092 A Prospective Longitudinal Study to Investigate Corneal Hysteresis as a Risk Factor of Central Visual Field Progression in Glaucoma, Kamalipour A; Moghimi S; Eslani M et al., American Journal of Ophthalmology, 2022; 240: 159-169


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Low corneal hysteresis (CH) has been considered as one of the several known risk factors of glaucoma progression. It has been associated with both structural and visual field progression measures.1,2 In their prospective cohort study, Kamalipour et al. investigated if low CH represents a special risk factor for central visual field progression.3. The impetus for the investigation is the special importance of the central visual field for everyday life activities and quality of life. Trend and event

While central visual field progression was 0.07 dB/year faster per 1 mmHg lower CH (p < 0.001), the relationship did not prove to be significant for the total 24-degree visual field. Descent and Glaucoma

They found a moderately increased rate of progression in the central (10 degree) visual field for lower CH, which was consistent with both types of statistical analyses. While central visual field progression was 0.07 dB/year faster per 1 mmHg lower CH (p < 0.001), the relationship did not prove to be significant for the total 24-degree visual field. Further, the central visual field effect was maintained when the early glaucoma eyes (baseline MD ≥ -6.0 dB) were separately investigated. These results are of clinical importance since they call attention to the role of low CH in assessing the risk for central visual field damage in glaucoma eyes. Although the pathophysiological mechanisms behind the this relationship are not yet clear, and most patients were under various topical medications in the study period which can influence CH, clinicians may want to consider intensification of IOP lowering treatment when the central visual field is involved and CH is low.

Clinicians may want to consider intensification of IOP lowering treatment when the central visual field is involved and CH is low

References

  1. Medeiros FA, Meira-Freitas D, Lisboa R, et al. Corneal hysteresis as a risk factor for glaucoma progression: a prospective longitudinal study. Ophthalmology. 2013;120:1533-1540.
  2. Susanna CN, Diniz-Filho A, Daga FB, et al. A Prospective Longitudinal Study to Investigate Corneal Hysteresis as a Risk Factor for Predicting Development of Glaucoma. Am J Ophthalmol.2018;187:148-152.
  3. Kamalipour A, Moghimi S, Eslani M, et al. A Prospective Longitudinal Study to Investigate Corneal Hysteresis as a Risk Factor of Central Visual Field Progression in Glaucoma. Am J Ophth. 2022; published online first http://dx.doi.org/10.1016/j. ajo.2022.02.025


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