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Editors Selection IGR 17-1

Examination methods: CCT

Comment by Peter Shah on:

11793 Relationship between central corneal thickness and retinal nerve fiber layer thickness in ocular hypertensive patients, Henderson PA; Medeiros FA; Zangwill LM et al., Ophthalmology, 2005; 112: 251-256

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This clinical observational cross-sectional study by Henderson et al. (30) examined the relationship between retinal nerve fibre layer (RNFL) measurements obtained by scanning laser polarimetry with variable corneal compensation (using the GDx VCC) and corneal thickness (CCT) measurements in ocular hypertensive (OHT) patients. This well-conducted study compared 44 OHT patients with 48 healthy subjects.

Higher GDx VCC parameter nerve fiber indicator (NFI) scores, indicative of thinner RNFL, were correlated significantly with thinner CCT measurements in the OHT patient group. The NFI values were not significantly different between OHT patients with thicker corneas and healthy subjects. The authors comment that these findings support the notion that RNFL defects as assessed by the GDx VCC may represent early glaucomatous damage in OHT eyes. It is important to remember that the study was not designed to assess this possibility as a primary outcome measure. When discussing the limitations of the study.

They do go on to comment that further longitudinal follow up is needed to assess the predictive value of these findings with respect to the future development of glaucoma. This study provides further interesting data on RNFL measurements. The study sample size is small and therefore one must be careful in drawing conclusions with respect to glaucoma pathogenesis too soon.

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