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OBJECTIVES: To investigate changes in optic nerve head topography and blood flow after therapeutic intraocular pressure reduction and to correlate them with central corneal thickness. METHODS: Sixteen patients with open-angle glaucoma and 16 patients with ocular hypertension underwent Heidelberg retina tomography and scanning laser Doppler flowmetry in 1 eye before and at least 2 months after a mean 35% sustained therapeutic reduction in intraocular pressure. Patients were assigned to a thin or thick group based on their median central corneal thickness. RESULTS: Compared with 16 patients with thick corneas (mean ± SD central corneal thickness, 587 ± 31 μm), the 16 patients with thin corneas (518 ± 32 μm) had greater reductions in mean (36 ± 32 vs 4 ± 36 μm, P = .003) and in maximum cup depth (73 ± 107 vs 4 ± 89 μm, P = .02). These changes were not statistically significantly different between the patients with open-angle glaucoma and those with ocular hypertension. Smaller mean ± SD improvements in neuroretinal rim blood flow were seen in patients with thinner corneas compared with those with thicker corneas (35 ± 80 vs 110 ± 111 arbitrary units, P = .04). CONCLUSION: Patients with open-angle glaucoma and ocular hypertension with thinner corneas show significantly greater shallowing of the cup, a surrogate marker for lamina cribrosa displacement (compliance), and smaller improvements of neuroretinal rim blood flow after intraocular pressure reduction.
Dr. M.R. Lesk, Department of Ophthalmology, University of Montreal, Montreal, Quebec, Canada. lesk@videotron.ca
2.2 Cornea (Part of: 2 Anatomical structures in glaucoma)
2.14 Optic disc (Part of: 2 Anatomical structures in glaucoma)
6.11 Bloodflow measurements (Part of: 6 Clinical examination methods)
6.9.1 Laser scanning (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis)