Synergic effect of corneal hysteresis and central corneal thickness in the risk of early‑stage primary open‑angle glaucoma progression

Purpose: To evaluate corneal hysteresis (CH), acquired with ocular response analyzer (ORA), as a risk factor for glaucoma progression in early-stage primary open-angle glaucoma (POAG). Methods: In a historical cohort study, patients diagnosed in 2011 with early-stage POAG according to the Hodapp, Pa...

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Bibliographic Details
Authors: Jiménez Santos, María A.; Sáenz Francés, Federico; Sánchez Jean, Rubén; Martínez De La Casa Fernández-Borrella, José María; García Feijoo, Julián; Jañez Escalada, Luis
Format: Article
Publication date:2021
Country:España
Institution:Universidad Complutense de Madrid (UCM)
Repository:Docta Complutense
Language:English
OAI Identifier:oai:docta.ucm.es:20.500.14352/8156
Online Access:https://hdl.handle.net/20.500.14352/8156
Access Level:Open access
Keyword:617.7‑007.681
612.841
Perimetry
Primary open-angle glaucoma
Progression
Corneal hysteresis
Risk factors
Oftalmología
3201.09 Oftalmología
Description
Summary:Purpose: To evaluate corneal hysteresis (CH), acquired with ocular response analyzer (ORA), as a risk factor for glaucoma progression in early-stage primary open-angle glaucoma (POAG). Methods: In a historical cohort study, patients diagnosed in 2011 with early-stage POAG according to the Hodapp, Parrish and Anderson classification modified for Octopus perimetry and followed up until glaucomatous progression development; otherwise, observations were censored in October 2018. Cox regression was used to obtain hazard ratios (HR) to evaluate baseline variables (CH, central corneal thickness, gender, age IOP and glaucoma family history) as risk factors for perimetric glaucoma progression. A likelihood ratio test for interaction was performed in order to assess the effect of the combination of CH and CCT on the risk of progression. Results: Of the cohort of 1573 patients, 11.38% developed early-stage POAG progression during the follow-up. The mean follow-up time was 3.28 ± 1.92 years. Patients without progression had a higher CH (11.35 ± 1.43 vs 9.07 ± 1.69 mmHg; p < 0.001) and CCT (570.75 ± 17.71 vs 554.51 ± 23.20; p < 0.001). In the multivariate analysis, each 1 mmHg of lower CH was associated with an increase of 2.13 times in the HR of progression (95% CI: 1.92–2.32; p < 0.001). CH hazard ratio was modified by CCT, with higher values of CCT and CH resulting in a higher HR of early glaucoma progression (p < 0.001). Conclusions: CH can be considered as a risk factor of progression in early-stage POAG. The risk associated with CH changed depending on CCT values, acting synergistically slowing the risk of glaucoma progression with higher values.