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Corneal biomechanics, thickness and optic disc morphology in children with optic disc tilt
  1. Laurence Shen Lim (llimshen{at}gmail.com),
  2. Gus Gazzard (gusgazzard{at}googlemail.com),
  3. Yiong-Huak Chan (medcyh{at}nus.edu.sg),
  4. Allan Fong (afcy_sg{at}yahoo.com.sg),
  5. Aachal Kotecha (aachalkotecha{at}googlemail.com),
  6. Eeling Sim (scorm{at}nus.edu.sg),
  7. Donald Tan (snecdt{at}pacific.net.sg),
  8. Louis Tong (louistong{at}hotmail.com),
  9. Seang-Mei Saw (cofsawsm{at}nus.edu.sg)
  1. Singapore National Eye Centre
  2. Glaucoma Research Unit, Moorfields Eye Hospital, London, UK
  3. Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore
  4. Singapore National Eye Centre
  5. Glaucoma Research Unit, Moorfields Eye Hospital, London, UK
  6. Singapore Eye Research Institute
  7. Singapore Eye Research Institute
  8. Singapore National Eye Centre
  9. National University of Singapore

    Abstract

    Aims: To determine the associations between corneal biomechanical parameters as measured by the Reichert Ocular Response Analyzer (ORA) and disc morphology and retinal nerve fiber layer thickness (RNFL) measured by the Heidelberg Retinal Tomograph (HRT) II in Singaporean children.

    Methods: This is a cross-sectional study conducted on a subset of children enrolled in the Singapore Cohort Study of the Risk Factors of Myopia (SCORM). Corneal hysteresis (CH), corneal resistance factor (CRF) and central corneal thickness (CCT) were measured with the ORA. Optic disc morphology and RNFL thickness were assessed by the HRT II. Cycloplegic refraction and ultrasound A-scans were also performed and disc tilt was assayed from stereo photographs.

    Results: 102 subjects (mean age 12.01± 0.57 years; range 11 - 14yrs) were included in the study. The mean CH was 12.00 ± 1.40mmHg, the mean CRF was 11.99 ± 1.65mmHg and the mean CCT was 581.12 ± 33.53μm. Eyes with tilted discs had significantly longer axial lengths and more myopic refraction than eyes without tilted discs. There were no significant correlations between CH, CRF or CCT and the HRT II parameters, after the application of the Bonferroni correction. When stratified for disc tilt however, the global disc area was significantly correlated with CCT (r = -0.49, p = 0.001).

    Conclusion: Corneal biomechanical properties as measured with the ORA do not vary with optic disc parameters or RNFL. Central corneal thickness is correlated with disc area in Singaporean schoolchildren with tilted discs. This relationship may influence glaucoma risk in myopic subjects.

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