Assessment of corneal hysteresis measured by the ocular response analyzer as a screening tool in patients with glaucoma

摘要

Background: Corneal hysteresis (CH) is used to determine the level of risk of patients developing glaucoma, categorized as suspect, mild, moderate and severe. Methods: This is a retrospective review of 126 consecutive eyes presenting, for the first time, at a glaucoma subspecialty clinic. All eyes at initial examination underwent measurement of CH and intraocular pressure using the Goldmann applanation tonometry (IOPgat). Eyes were classified as CH10 (n=51) or CH≥10 (n=75) and categorized into glaucoma suspect, mild, moderate, or severe glaucoma based on 24-2 Humphrey visual field testing. Additional data included number of topical glaucoma medications. Results: Of the eyes classified as a CH10, 45.5% had moderate or severe glaucoma, and 11.8% of eyes with a CH≥10 had moderate or severe glaucoma. In the CH≥10 group, the mean IOPgat was 19.5 mmHg ± 4.72 mmHg ( P 0.01) on 1 ± 1.26 ( P 0.01) medications in the moderate/severe glaucoma group and 20.13 mmHg ± 4.95 mmHg ( P 0.01) on 0.60 ± 0.95 ( P 0.01) medications in the glaucoma suspect/mild glaucoma group. In the CH10 group, mean IOPgat was 20.47?mmHg ± 7.56 mmHg ( P 0.01) on 1.79 ± 1.17 ( P 0.01) medications in the moderate/severe glaucoma group. Mean IOPgat was 17.54 mmHg ± 5.48 mmHg ( P 0.01) on 0.63 ± 0.83 ( P 0.01) medications in the glaucoma suspect/mild glaucoma group. Conclusion: Moderate to severe glaucoma is 2.9 ( P 0.01) times more likely to occur in eyes that measure a CH10 compared to eyes that measure a CH≥10. Although not statistically significant, suspect or mild glaucoma is more common in eyes that measure a CH≥10. Eyes in the CH10 moderate/severe glaucoma group had statistically significant higher IOPgat ( P 0.01) compared to the CH10 suspect/mild glaucoma group. Measuring CH at initial presentation can help predict the severity of glaucoma.