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Central corneal thickness and progression of the visual field and optic disc in glaucoma
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  1. B C Chauhan1,2,
  2. D M Hutchison1,
  3. R P LeBlanc1,
  4. P H Artes1,
  5. M T Nicolela1
  1. 1Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, NS, Canada
  2. 2Department of Physiology and Biophysics, Dalhousie University, Halifax, NS, Canada
  1. Correspondence to: Balwantray C Chauhan Department of Ophthalmology and Visual Sciences, Dalhousie University, 2nd Floor Centennial Building, Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada B3H 2Y9; baldal.ca

Abstract

Aims: To determine whether central corneal thickness (CCT) is a significant predictor of visual field and optic disc progression in open angle glaucoma.

Methods: Data were obtained from a prospective study of glaucoma patients tested with static automated perimetry and confocal scanning laser tomography every 6 months. Progression was determined using a trend based approach called evidence of change (EOC) analysis in which sectoral ordinal scores based on the significance of regression coefficients of visual field pattern deviation and neuroretinal rim area over time are summed. Visual field progression was also determined using the event based glaucoma change probability (GCP) analysis using both total and pattern deviation.

Results: The sample contained 101 eyes of 54 patients (mean (SD) age 56.5 (9.8) years) with a mean follow up of 9.2 (0.7) years and 20.7 (2.3) sets of examinations every 6 months. Lower CCT was associated with worse baseline visual fields and lower mean IOP in the follow up. In the longitudinal analysis CCT was not correlated with the EOC scores for visual field or optic disc change. In the GCP analyses, there was a tendency for groups classified as progressing to have lower CCT compared to non-progressing groups. In a multivariate analyses accounting for IOP, the opposite was found, whereby higher CCT was associated with visual field progression. None of the independent factors were predictive of optic disc progression.

Conclusions: In this cohort of patients with established glaucoma, CCT was not a useful index in the risk assessment of visual field and optic disc progression.

  • CCT, central corneal thickness
  • EOC, evidence of change
  • GCP, glaucoma change probability
  • MD, mean deviation
  • OHTS, Ocular Hypertension Treatment Study
  • PSD, pattern standard deviation
  • RA, rim area
  • visual field
  • optic disc
  • glaucoma
  • progression
  • central corneal thickness
  • CCT, central corneal thickness
  • EOC, evidence of change
  • GCP, glaucoma change probability
  • MD, mean deviation
  • OHTS, Ocular Hypertension Treatment Study
  • PSD, pattern standard deviation
  • RA, rim area
  • visual field
  • optic disc
  • glaucoma
  • progression
  • central corneal thickness

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Footnotes

  • Ethical approval: The study was approved by the Queen Elizabeth II Health Science Centre Research Ethics Committee. All patients gave written informed consent.

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