Corneal biomechanics measured with the ocular response analyser in patients with unilateral open-angle glaucoma (original) (raw)
Related papers
Journal of glaucoma, 2011
PURPOSE:: To assess the biomechanical properties of corneas in patients with normal tension glaucoma (NTG) and to compare them with those of patients with primary open-angle glaucoma (POAG), ocular hypertension (OHT), and normal controls (N). METHODS:: Corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann intraocular pressure (IOPg), and corneal compensated IOP (IOPcc) were obtained using an ocular response analyzer for 28 eyes in 14 patients with NTG, 75 eyes in 38 patients with chronic POAG, 53 eyes of 27 patients with OHT, and 44 eyes of 22 N controls. IOP using Goldmann applanation tonometry (IOPGA) and ultrasonic central corneal thickness (CCT) were also measured for each eye. Analysis of variance test was used for statistical analysis. RESULTS:: CH was significantly lower in the NTG group (9.88±2.02 mm Hg) compared with the N group (11.05±1.53 mm Hg; P<0.01). CRF was significantly lower in the NTG group (9.5±1.89 mm Hg) compared with the POAG group (11.15±2.35 ...
Investigative Ophthalmology & Visual Science, 2008
To assess the reproducibility of the ocular response analyzer (ORA) in nonoperated eyes and the impact of corneal biomechanical properties on intraocular pressure (IOP) measurements in normal and glaucomatous eyes. METHODS. In the reliability study, two independent examiners obtained repeated ORA measurements in 30 eyes. In the clinical study, the examiners analyzed ORA and IOP-Goldmann values from 220 normal and 42 glaucomatous eyes. In both studies, Goldmann-correlated IOP measurement (IOP-ORAg), corneal-compensated IOP (IOP-ORAc), corneal hysteresis (CH), and corneal resistance factor (CRF) were evaluated. IOP differences of 3 mm Hg or greater between the IOP-ORAc and IOP-ORAg were considered outcome significant. RESULTS. Intraexaminer intraclass correlation coefficients and interexaminer concordance correlation coefficients ranged from 0.78 to 0.93 and from 0.81 to 0.93, respectively, for all parameters. CH reproducibility was highest, and the IOP-ORAg readings were lowest. The median IOP was 16 mm Hg with the Goldmann tonometer, 14.5 mm Hg with IOP-ORAg (P Ͻ 0.001), and 15.7 mm Hg with IOP-ORAc (P Ͻ 0.001). Outcome-significant results were found in 77 eyes (29.38%). The IOP-ORAc, CH, and CRF were correlated with age (r ϭ 0.22, P ϭ 0.001; r ϭ Ϫ0.23, P ϭ 0.001; r ϭ Ϫ0.14, P ϭ 0.02, respectively), but not the IOP-ORAg or IOP-Goldmann. CONCLUSIONS. The ORA provides reproducible corneal biomechanical and IOP measurements in nonoperated eyes. Considering the effect of ORA, corneal biomechanical metrics produces an outcome-significant IOP adjustment in at least one quarter of glaucomatous and normal eyes undergoing noncontact tonometry. Corneal viscoelasticity (CH) and resistance (CRF) appear to decrease minimally with increasing age in healthy adults. (Invest Ophthalmol Vis Sci. 2008;49:968 -974)
American Journal of Ophthalmology
PURPOSE: To evaluate corneal biomechanical properties across the glaucoma spectrum and study the relationship between these measurements and intraocular pressure measured by Goldmann applanation tonometry (GAT-IOP) and central corneal thickness (CCT). • DESIGN: Prospective cross-sectional study. • METHODS: SETTING: Tertiary-care teaching institute. STUDY POPULATION: A total of 323 eyes of 323 participants (71 normal, 101 glaucoma suspect [GS], 38 ocular hypertension [OHT], 59 primary angle-closure disease [PACD], 36 primary open-angle glaucoma [POAG], and 18 normal-tension glaucoma [NTG]) who had received no ophthalmic treatment. OBSERVATION PROCEDURES: Corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated IOP (IOPcc), and Goldmann-correlated IOP (IOPg) measured by the Ocular Response Analyzer (ORA). GAT-IOP and CCT recorded in all subjects. MAIN OUTCOME MEASURES: Regression analysis used to determine the relationship between GAT-IOP, CCT, age, CRF, and CH. Bland-Altman plots used to assess agreement between IOP measured by GAT and the ORA (IOPg).
Journal of Clinical Medicine, 2021
Purpose: To evaluate and compare corneal hysteresis (CH), corneal resistance factor (CRF), and central corneal thickness (CCT), measurements were taken between a healthy population (controls), patients diagnosed with glaucoma (DG), and glaucoma suspect patients due to ocular hypertension (OHT), family history of glaucoma (FHG), or glaucoma-like optic discs (GLD). Additionally, Goldmann-correlated intraocular pressure (IOPg) and corneal-compensated IOP (IOPcc) were compared between the different groups of patients. Methods: In this prospective analytical-observational study, a total of 1065 patients (one eye of each) were recruited to undergo Ocular Response Analyzer (ORA) testing, ultrasound pachymetry, and clinical examination. Corneal biomechanical parameters (CH, CRF), CCT, IOPg, and IOPcc were measured in the control group (n = 574) and the other groups: DG (n = 147), FHG (n = 78), GLD (n = 90), and OHT (n = 176). We performed a variance analysis (ANOVA) for all the dependent va...
Evaluation of Corneal Biomechanical Properties with the Reichert Ocular Response Analyzer
European Journal of Ophthalmology, 2010
Purpose: To evaluate corneal biomechanical properties in eyes that had previously undergone penetrating keratoplasty (PK) using the ocular response analyzer (ORA). Methods: We recruited 26 patients who had received unilateral PK. Corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOPg), and cornea-compensated intraocular pressure (IOPcc) were measured with the ORA and were compared to the measurements from the contralateral eyes that did not undergo PK. Results: The CH was 8.95±2.59 mmHg in eyes that underwent PK and 9.78±1.45 mmHg in the contralateral eyes that did not undergo PK (p=0.077). The CRF was 10.26±2.64 mmHg in post-PK eyes and 9.75±1.45 mmHg in the contralateral eyes (p=0.509), and the CH-CRF was significantly smaller in post-PK eyes (-1.31±2.32 mmHg in post-PK eyes vs. 0.03±0.88 mmHg in fellow eyes, p=0.016). The IOPg and IOPcc were significantly higher in the PK group than they were in the control group. The IOPcc's were 20.81±7.81 mmHg and 16.27±2.49 mmHg in post-PK and control eyes, respectively (p=0.011); and the IOPg's were 19.22±7.34 mmHg and 15.07±3.03 mmHg in post-PK and control eyes, respectively (p=0.019). The IOPcc-g's were 1.59±2.81 mmHg and 1.21±1.30 mmHg in post-PK and control eyes, respectively (p=0.412), and the central corneal thickness (CCT)'s were 489.11±90.60 μm and 556.24±42.84 μm in post-PK and control eyes, respectively (p=0.068). Conclusions: Following PK, CH tended to decrease while CRF tended to increase, significantly decreasing CH-CRF. A significantly higher intraocular pressure and a thinner CCT following PK may have contributed to the observed changes in these corneal biomechanical parameters.
Association Between Corneal Biomechanical Properties and Glaucoma Severity
American Journal of Ophthalmology, 2012
To investigate the association between corneal biomechanical parameters using the Ocular Response Analyzer (ORA) and glaucoma severity. • DESIGN: Observational cross-sectional study. • METHODS: Two hundred ninety-nine eyes of 191 patients with confirmed or suspect glaucoma were recruited at the University of California, San Diego. Corneal hysteresis (CH) and corneal resistance factor (CRF) were obtained from all participants. Standard automated perimetry was done using the 24-2 Swedish Interactive Threshold Algorithm. Retinal nerve fiber layer (RNFL) thickness measurements were obtained using GDx ECC and spectral-domain optical coherence tomography (SD-OCT). The association between ORA parameters and disease severity was evaluated using univariable and multivariable regression models. • RESULTS: CH and CRF were both positively associated with mean defect (MD) (R 2 ؍ 0.03; P < .01 and R 2 ؍ 0.10; P < .01, respectively). In multivariable analysis, the association between CRF and MD remained significant while CH to MD did not (P < .01 and P ؍ .77). In the GDx ECC subgroup (204 eyes), there was a weak association between CH and CRF and average RNFL thickness (R 2 ؍ 0.07; P < .01 and R 2 ؍ 0.05; P < .01, respectively), which was not observed in the SD-OCT subgroup (146 eyes) (R 2 ؍ 0.01; P ؍ .30 and R 2 ؍ 0.01; P ؍ .21). After adjusting for central corneal thickness, age, and axial length, the relationship of CH and CRF to RNFL thickness no longer reached statistical significance. • CONCLUSIONS: The current study found only a weak relationship between corneal biomechanical parameters and measures of structural and functional damage in glaucoma.
Investigative Ophthalmology & Visual Science, 2014
PURPOSE. We examined the association of corneal hysteresis (CH) with Heidelberg retina tomograph (HRT)-and Glaucoma Detection with Variable Corneal Compensation scanning laser polarimeter (GDxVCC)-derived measures in a British population. METHODS. The EPIC-Norfolk Eye Study is nested within a multicenter cohort study-the European Prospective Investigation of Cancer. Ocular response analyzer (ORA), HRT3, and GDxVCC measurements were taken at the research clinic. Three ORA measurements were taken per eye, and the single best value used. Participants meeting predefined criteria were referred for a second examination, including Goldmann applanation tonometry (GAT) and central corneal thickness (CCT) measurement. Generalized estimating equation models were used to examine the associations of CH with HRT and GDxVCC parameters, adjusted for disc area. The GDxVCC analyses were adjusted further for typical scan score to handle atypical retardation. RESULTS. There were complete research clinic data from 5134 participants. Corneal hysteresis was associated positively with HRT rim area (P < 0.001), and GDxVCC retinal nerve fiber layer (RNFL) average thickness (P ¼ 0.006) and modulation (P ¼ 0.003), and associated negatively with HRT linear cup-to-disc ratio (LCDR, P < 0.001), after adjustment for Goldmann-correlated IOP and other possible confounders. In the 602 participants undergoing the second examination, CH was associated negatively with LCDR (P ¼ 0.008) after adjustment for GAT, CCT, and other possible confounders. CONCLUSIONS. Lower CH was associated with HRT and GDxVCC parameters in a direction that is seen in glaucoma and with ageing. Further research is required to establish if this is a causal relationship, or due to residual confounding by age, IOP, or CCT.
Anterior-segment morphology and corneal biomechanical characteristics in pigmentary glaucoma
Clinical Ophthalmology, 2013
The aim of the study reported here was to evaluate characteristics of the anteriorsegment via anterior-segment optical coherence tomography (AS-OCT) and corneal biomechanical properties using an ocular response analyzer and their changes by peripheral laser iridotomy (PI) in patients with pigmentary glaucoma (PG). Materials and methods: Seventeen eyes with PG were included consecutively. AS-OCT and ocular response analyzer measurements were taken before and 3 months after PI. Baseline morphology and change in morphology were analyzed by correlation and multiple linear regression analysis. The main parameters assessed were anterior-chamber (AC) angles and volume as well as corneal hysteresis (CH) and corneal resistance factor. Results: AC angles were found to have decreased significantly in each quadrant after PI (P,0.001), with the highest effect seen in the temporal quadrant, which decreased from 57.0°±9.6° to 44.1°±5.2° (± standard deviation). Mean AC volume decreased significantly from 213.1±36.4 to 187.0±23.4 mm 3 (P,0.001). CH and corneal resistance factor did not change after PI. CH was found to correlate with the preoperative superior and inferior angle width (Spearman's rho 0.553 and 0.615, respectively, P,0.05). Biomechanical parameters showed no predictive value on the change of AC angles or volume. Conclusion: PI in eyes with PG results in a highly significant reduction in the AC angles and volume as visualized by AS-OCT, with the largest effect seen in the temporal quadrant. CH is strongly positively correlated with the superior and inferior preoperative AC angles, emphasizing the importance of the biomechanical properties of the cornea for glaucoma pathogenesis in PG, but corneal biomechanical properties cannot predict PI-related AC changes.
Clinical ophthalmology (Auckland, N.Z.), 2018
To investigate the biomechanical response of the cornea, lamina cribrosa (LC), and prelaminar tissue (PT) to an acute intraocular pressure (IOP) increase in patients with markedly asymmetrical glaucoma and in healthy controls. A total of 24 eyes of 12 patients with markedly asymmetrical primary open-angle glaucoma (POAG) and 12 eyes of 12 healthy patients were examined with spectral-domain optical coherence tomography (SD-OCT) and ocular response analyzer (ORA) at baseline and during acute IOP elevation by means of an ophthalmodynamometer. The displacement of the LC and PT and the change in corneal hysteresis (CH) and corneal resistance factor (CRF) were evaluated. Following a mean IOP increase of 12.3±2.4 mmHg, eyes with severe glaucoma demonstrated an overall mean anterior displacement of the LC (-6.58±26.09 µm) as opposed to the posterior laminar displacement in eyes with mild glaucoma (29.08±19.28 µm) and in healthy eyes (30.3±10.9; ≤0.001 and =0.001, respectively). The PT displ...