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Abstract #21202 Published in IGR 10-2
The importance of central corneal thickness measurements and decision making in general ophthalmology clinics: A masked observational study
Patwardhan AA; Khan M; Mollan SP; Haigh PBMC Ophthalmology 2008; 8: 1
BACKGROUND: To assess the impact of knowing central corneal thickness (CCT) on glaucoma management in a United Kingdom district general hospital. METHODS: A masked observational non-interventional study included 304 eyes of 152 consecutive glaucoma cases attending general clinic. CCT was measured using a hand-held pachymeter. IOP, as measured by the Goldmann applanation tonometer (GAT), was adjusted for CCT using a normogram. Two identical study sheets were retrospectively constructed from each subject's case notes: one included the CCT and adjusted IOP information, the other excluded. Study sheets were randomly presented to a single masked observer to decide glaucoma management. The difference in management decision was noted. RESULTS: The mean ± standard deviation CCT was 561.5 ± 35.7 microm, 538.9 ± 41.4 microm, 538.3 ± 40.3 μm for ocular hypertension (OHT), primary open-angle glaucoma (POAG) and normal-pressure glaucoma (NPG) subjects respectively. IOP adjustment was greater than ± 2 mmHg in 33.9% (103/304) of eyes. CCT and adjusted IOP information led to different treatment option in 37% (55/152). Of the most important changes 20.4% (31/152) cases would have been commenced on additional IOP-lowering medication, 2.0% (3/152) would have been counselled for trabeculectomy surgery and 3.3% (5/152) of the cohort would have been observed rather than treated. CONCLUSION: CCT and adjusted IOP measurement can influence glaucoma management in a clinical context. It helps attribute risk and hence aids patient management decisions.
Dr. A.A. Patwardhan, Department of Ophthalmology, Shrewsbury and Telford Hospitals NHS Trust, Shrewsbury, UK. apatwa@hotmail.com
Classification:
6.1.3 Factors affecting IOP (Part of: 6 Clinical examination methods > 6.1 Intraocular pressure measurement; factors affecting IOP)
2.2 Cornea (Part of: 2 Anatomical structures in glaucoma)
