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Abstract #79581 Published in IGR 20-2
Anterior Corneal Folds Correlate With Low Intraocular Pressure and May Serve as a Marker for Ocular Hypotony
Abualhasan H; Mimouni M; Safuri S; Blumenthal EZJournal of Glaucoma 2019; 28: 178-180
PURPOSE: Subtle folds can be seen in the anterior cornea in eyes with hypotony using fluorescein and blue light. We aim to assess their extent and grade with respect to the level of intraocular pressure (IOP). PATIENTS AND METHODS: Patients who presented to the department of ophthalmology at Rambam Health Care Campus with IOP<10 mm Hg during the period between July 2016 and June 2017. Corneal folds were evaluated after instilling an anesthetic drop and fluorescein staining. Outcome measures included: IOP, presence of anterior corneal folds, and the percentage of corneal surface containing folds. RESULTS: Overall, 100 eyes of 100 patients were included. The mean age±SD was 63.6±16.7 years (range, 19 to 96 y); 56% (n=56) were of male sex. Mean IOP was 5.3±2.7 mm Hg (range, 0 to 9 mm Hg). Subjects with and without anterior corneal folds were of similar age (P=0.25) and sex (P=0.69). Those with anterior corneal folds had a significantly lower IOP than the control group (4.0±2.4 vs. 7.4±1.7; P<0.001). Eyes with IOP of 0 to 2, 3 to 4, 5 to 6, 7 to 9 mm Hg demonstrated anterior corneal folds in 95%, 91%, 67%, and 18.4%, respectively. At an IOP≤5 mm Hg cut-off, the sensitivity and specificity of corneal folds as a predictor of hypotony was 89.8% and 70.6%, respectively. A significant inverse correlation between the relative area of the cornea covered by folds and the IOP was found (r=-0.7; P<0.001). CONCLUSIONS: Folds observed in the anterior corneal surface appear to be a robust sign of severe hypotony.
Department of Ophthalmology, Rambam Health Care Campus.
Full articleClassification:
2.2 Cornea (Part of: 2 Anatomical structures in glaucoma)