Central Corneal Thickness in Children: Stability Over Time

doi:10.1016/j.ajo.2005.11.052

American Journal of Ophthalmology

Volume 141, Issue 5, May 2006, Pages 955-957

https://doi.org/10.1016/j.ajo.2005.11.052 Get rights and content

Purpose

To evaluate central corneal thickness (CCT) in children over time.

Design

Prospective observational case series.

Methods

CCT was measured by ultrasonic pachymetry in 69 eyes of 38 subjects age 3 to 14 years recruited from the Duke University Eye Center. Subjects included patients with and without glaucoma.

Results

For eyes on no glaucoma medication, the mean change in CCT was −1.9 ± 14 μm (n = 30; mean time between CCT measurements, 567 days). For eyes on stable glaucoma medication, the mean change in CCT was +8.1 ± 26 μm (n = 27; mean time between CCT measurements, 580 days). For eyes with a change in medical therapy between visits, the mean change in CCT was −3.8 ± 24 μm (n = 8, mean number of days between visits 723). Four eyes underwent trabeculectomy between measurements and experienced a mean change in CCT of −9.0 ± 6 μm with a mean of 1257 days between measurements. These CCT changes were not statistically significant.

Conclusions

CCT of children ages 3 to 14 years appears stable over a one- to two-year interval.

References (4)

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Central corneal thickness in the Ocular Hypertension Treatment Study (OHTS)
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Central corneal thicknesswill one measurement suffice?
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There are more references available in the full text version of this article.

Cited by (19)

Corneal thickness in children with growth hormone deficiency: The effect of GH treatment
2014, Growth Hormone and IGF Research
Citation Excerpt :
In normal children the average CCT was found to be ranging from 529 to 555 μm [24−26], with a close correlation with values reported for adults [26]. In addition, CCT values appear stable over time and show a positive correlation with IOP [27,28]. Most of the studies performed on patients with alterations of the GH-IGF-I axis were limited to assessing the differences in the ocular parameters between GH or IGF-I-treated patients, untreated ones, and controls, without a prospective evaluation during the follow-up of treatment.
The eye represents a target site for GH action, although few data are available in patients with GH deficiency (GHD). Our aim was to evaluate central corneal thickness (CCT) and intraocular pressure (IOP) values in GHD children to assess the role played by GHD or GH treatment on these parameters.
In 74 prepubertal GHD children (51 M, 23 F, aged 10.4 ± 2.4 years) we measured CCT and IOP before and after 12 months of treatment. A baseline evaluation was also made in 50 healthy children matched for age, gender and body mass index. The study outcome considered CCT and IOP during treatment and their correlations with biochemical and auxological data.
No difference in CCT and IOP between GHD children at baseline and controls was found (all p > 0.005). GHD children after 12 months of therapy showed greater CCT (564.7 ± 13.1 μm) than both baseline values (535.7 ± 17 μm; p < 0.001) and control subjects (536.2 ± 12.5 μm; p < 0.001), with a concomitantly higher corrected mean IOP (15.6 ± 0.7 mm Hg; p < 0.001) than both baseline (12.5 ± 0.8 mm Hg; p < 0.001) and controls (12.3 ± 0.5 mm Hg; p < 0.001), without correlation with auxological and biochemical parameters.
12 months of GH treatment in children with GHD, regardless of auxological and biochemical data, affect CCT and IOP. Our findings suggest careful ocular evaluation in these patients to prevent undesirable side effects during the follow-up.
Acquired central corneal thickness increase following removal of childhood cataracts
2011, American Journal of Ophthalmology
Citation Excerpt :
While we did not confirm the same relationship in the present study, our current data were collected longitudinally and therefore compared CCT in each eye over a follow-up interval, while the previous small study used age as a surrogate for time since cataract removal. In addition, we had previously reported on the stability of CCT measurements in children aged 3 to 14 years over a 1- to 2-year period.14 On the other hand, the present study did find mean CCT in the aphakic and pseudophakic eyes with glaucoma to be significantly higher than mean CCT in the eyes without glaucoma, at both the initial and final measurements, suggesting that glaucoma accentuates the CCT elevation after cataract removal.
To evaluate central corneal thickness (CCT) in children with congenital/developmental cataracts before and after cataract removal, to correlate CCT with corneal diameters before cataract surgery in this same group, and to evaluate CCT over time in a separate group of children who were already aphakic or pseudophakic at study entry.
Longitudinal study.
Children with cataract (Group 1, with pre-cataract-removal CCT) and aphakia/pseudophakia (Group 2, presenting after cataract removal) were included. CCT measurements were performed using ultrasound pachymetry. Normal fellow eyes of unilaterally affected cases served as controls. In bilateral cases, right eyes were used for analyses.
Group 1 comprised 66 children. Before cataract surgery, unilateral cases (n = 31) showed similar CCT and strong association between the affected and fellow eyes (552.0 ± 32.9 μm vs 550.9 ± 40.4 μm, respectively; r² = 0.71, P = .0001). After cataract surgery, affected eyes (n = 13) showed mean CCT increase of 29.7 ± 43.1 μm (P = .03) while fellow eyes remained unchanged. Similarly, before cataract surgery, bilateral cases (n = 35) showed similar CCT between the right and left eyes. After cataract surgery, mean CCT increase was 27.4 ± 39.4 μm for first operated eyes of bilateral cases (n = 17, P = .01). Group 2 comprised 50 aphakic/pseudophakic children lacking pre-cataract-removal CCT. CCT was higher in eyes with glaucoma vs those without, at both first and last measurements (ΔCCT 58.9 ± 27.0 μm at first examination, P = .034, and 56.4 ± 27.1 μm at last examination, P = .043, respectively). There was no statistically significant CCT change over the study interval (median 28 months) for either Group 2 eyes with or those without glaucoma.
CCT in children with cataracts increases after cataract surgery while the fellow eye remains stable. This increase seems to occur early after surgery, likely remaining stable thereafter, though glaucoma can accentuate the increase.
Developmental and childhood glaucoma
2009, Becker-Shaffer's Diagnosis and Therapy of the Glaucomas: Eighth Edition
Central corneal thickness and endothelial cell density in congenital glaucoma
2008, Journal Francais d'Ophtalmologie
S. Guigou, R. Coste, D. Denis.
The aim of this study was to compare endothelial cell density and central corneal thickness between eyes with congenital glaucoma and normal eyes.
We conducted a prospective study of pediatric patients between 3 and 18 years of age. Group A comprised 401 normal eyes and group B 69 glaucoma eyes, categorized into three subgroups: 3-4, 5-9, and 10 or more years of age. Measurements were taken using the Topcon SP 2000 specular microscope.
The mean pachymetry in group B (519±34 µm) was significantly thinner than in group A (529±32 µm) (p<0.05). There was a significant positive correlation with age in the two groups (p<0.05 ANOVA) until the 5- to 9-year-old subgroup. The mean endothelial cell density in group B (2,922±553 cells/mm²) was lower than in group A (3,470±357 cells/mm²) (p<0.01). There was a significant negative correlation with age in group A (p<0.01 ANOVA).
Corneal distension attributable to intraocular hypertony may explain the thinner pachymetry. In congenital glaucoma, a thinner cornea may tend to lower tonometrically recorded intraocular pressure. Glaucoma seems to be the main factor of the endothelial cell loss.
Central corneal thickness and endothelial cell density should be taken into account when managing congenital glaucoma to avoid undertreatment and to measure endothelial damage.
Le but de cette étude est de comparer la densité cellulaire endothéliale et la pachymétrie cornéenne centrale dans le glaucome congénital par rapport à une population saine.
Nous avons mené une étude prospective sur des enfants âgés de 3 à 18 ans, répartis en un groupe A (401 yeux sains) et un groupe B (69 yeux glaucomateux) selon trois classes d’âge 3-4, 5-9 et plus de 10 ans. Les mesures ont été effectuées grâce au microscope optique Topcon SP 2000.
La pachymétrie moyenne dans le groupe B (519 ± 34 µm) était plus faible que dans le groupe A (529 ± 32 µm) (p < 0,05). Il existait une corrélation positive significative statistiquement dans les deux groupes entre la pachymétrie moyenne et l’âge jusqu’à la tranche d’âge 5-9 ans (p < 0,05 ANOVA). La densité cellulaire endothéliale dans le groupe B (2 922 ± 553 cellules/mm²) était inférieure à celle du groupe A (3 470 ± 357 cellules/mm²) (p < 0,01). Elle était corrélée de façon négative avec l’âge dans le groupe A seulement (p < 0,01 ANOVA).
La pachymétrie plus fine des enfants glaucomateux s’expliquerait par l’hypertonie fragilisant et étirant la cornée. En raison du principe de mesure de la pression intra-oculaire à l’aplanation, il pourrait être dangereux de la sous-estimer chez ces jeunes patients. En cas de glaucome, il existe une perte cellulaire endothéliale dépendant de l’hypertonie intra-oculaire ou d’une chirurgie filtrante plus que de l’âge.
Dans les glaucomes congénitaux, la pachymétrie et le comptage cellulaire doivent être pris en compte pour corriger la pression intra-oculaire à la hausse et pour évaluer la répercussion endothéliale des dommages.
Central corneal thickness in children-does it help or hinder our evaluation of eyes at risk for glaucoma?
2008, Journal of AAPOS
Central Corneal Thickness: Congenital Cataracts and Aphakia
2007, American Journal of Ophthalmology
Citation Excerpt :
Therefore, it is possible that the preponderance of White subjects in the cataract group established bias toward finding a difference in mean CCT between the cataract and normal control groups, and we found no difference. We previously reported that the CCT of unoperated pediatric eyes with and without glaucoma seems to be stable over time.19 The large difference in the CCT of aphakic and pseudophakic eyes vs normal eyes and phakic eyes with cataracts suggests that the increase in CCT (and therefore probably also in overall corneal thickness) likely occurs after surgery.
To evaluate central corneal thickness (CCT) in normal children (controls) and in those with cataracts, pseudophakia, and aphakia.
Prospective, observational case series.
CCT was measured in 369 eyes of 223 children. Subjects with glaucoma, anterior segment abnormalities, or intraocular pressure of more than 30 mm Hg were excluded. Group means were compared for controls and for eyes with pediatric cataracts, pseudophakia, and aphakia.
The mean CCT of eyes with cataracts was more than that of controls (574 ± 54 μm [n = 46] and 552 ± 38 μm [n = 230], respectively; P = .001). After excluding from the cataract group those eyes with aniridia, Down syndrome, Marfan syndrome, or glaucoma surgery, the mean CCT (564 ± 34 μm [n = 36]) was no longer greater than that of controls (P = .07). The mean CCT of pseudophakic eyes (598 ± 56 μm [n = 29]) was greater than the mean CCT of controls (P < .001) and was similar to the mean CCT of eyes with cataracts (P = .06). The mean CCT of aphakic eyes (642 ± 88 μm [n = 64]) was greater than the mean CCT of controls (P < .001), eyes with cataracts (P < .001), and eyes with pseudophakia (P = .003).
In the absence of factors known to affect CCT (Down syndrome, Marfan syndrome, and aniridia), CCT is similar in eyes with pediatric cataracts and normal controls and increases after cataract surgery.

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Brief reportCentral Corneal Thickness in Children: Stability Over Time