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Abstract #99245 Published in IGR 22-4
Corneal Hysteresis and Rates of Neuroretinal Rim Change in Glaucoma
Jammal AA; Medeiros FAOphthalmology. Glaucoma 2022; 5: 483-489
PURPOSE: To evaluate the impact of corneal hysteresis (CH) as a risk factor for progressive neuroretinal rim loss in glaucoma, as measured by spectral-domain optical coherence tomography (SDOCT) Bruch's membrane opening minimum rim width (MRW). DESIGN: Prospective observational cohort study. PARTICIPANTS: The study group included 118 eyes of 70 glaucoma subjects. Average follow-up time for the cohort was 3.9 ± 1.3 years with an average of 6.4 ± 2.0 SDOCT tests, ranging from 4 to 12. METHODS: CH measurements were acquired at baseline using the Ocular Response Analyzer (Reichert Instruments, Depew, NY, USA). Linear mixed models were used to investigate the relationship between rates of MRW loss and baseline CH. Multivariable analyses adjusted for other putative predictive factors for progression, including mean intraocular pressure (IOP), central corneal thickness (CCT), age, race, and baseline disease severity. MAIN OUTCOME MEASURES: Effects of CH on rates of MRW change over time. RESULTS: CH had a significant effect on rates of MRW progression over time. Each 1mmHg lower CH was associated with -0.38μm/year faster MRW loss (95% CI: -0.70 to -0.06; P=0.019), after adjustment for other predictive factors. Mean IOP was also significantly associated with progression, with -0.35μm/year (95% CI: -0.47 to -0.23) faster MRW change for each 1mmHg higher pressure (P<0.001). In the analysis of predictive strength, mean IOP was the strongest predictive factor (R = 23%), followed by CH (R = 14%) and baseline disease severity (R = 6%). CCT explained only 3% of the variability in slopes of change in global MRW. CONCLUSION: Lower CH measurements were associated with faster loss of neuroretinal rim in glaucoma as measured by MRW. The predictive ability of CH was superior to that of CCT. These findings suggest that CH is an important parameter to be considered in assessing risk of glaucoma progression.
Vision, Imaging and Performance Laboratory (VIP), Duke Eye Center and Department of Ophthalmology, Duke University, Durham, NC.
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