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      The thick and thin of the central corneal thickness in glaucoma

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      Eye
      Springer Nature

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          Abstract

          <p class="first" id="Par1">Central corneal thickness (CCT) is an important parameter in the assessment of any potential glaucoma patient. While it affects prognosis in ocular hypertension, its value in patients diagnosed with glaucoma is less certain. There are several biological factors and genetic components that may influence glaucoma progression, which have been associated with thinner CCT. The CCT itself can be affected by several factors including ethnicity, age, sex, glaucoma medications, genetics, and the subtype of glaucoma. Besides, there is variability in the measurement of CCT between difference types of devices. These factors need to be considered in the evaluation of glaucoma patients' CCT and its effect on interpretation of intraocular pressure levels and risk stratification. </p>

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          Most cited references42

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          Distribution of central corneal thickness and its association with intraocular pressure: The Rotterdam Study.

          To perform a cross-sectional study on the distribution of central corneal thickness and its association with intraocular pressure in an elderly population. We measured central corneal thickness and intraocular pressure in 395 subjects (352 control subjects, 13 patients with ocular hypertension, and 30 patients with primary open-angle glaucoma) aged 55 years or more. Mean central corneal thickness in the 352 control subjects was 537.4 microm (95% confidence interval [CI], 533.8 to 540.9 microm; range, 427 to 620 microm), with a maximal difference between eyes of 42 microm. There were no differences between sexes and no significant association with age. Linear regression analysis showed an increase of 0.19 mm Hg in intraocular pressure with each 10-microm increase in central corneal thickness (95% CI, 0.09 to 0.28 mm Hg). This association was similar in both eyes and in both sexes. The 13 patients with ocular hypertension had corneas a mean of 16.0 microm thicker (95% CI, -2.6 to +34.6 microm) compared with control subjects (P = .093); the 30 patients with primary open-angle glaucoma had corneas a mean of 21.5 microm thinner (95% CI, 8.8 to 34.1 microm) compared with control subjects (P = .001). Mean central corneal thickness was similar to that found in clinical studies, was slightly higher in patients with ocular hypertension, and was significantly lower in patients with primary open-angle glaucoma. Intraocular pressure was positively related with central corneal thickness. Central corneal thickness may influence the division between normal and increased intraocular pressure at a simple cutoff point of 21 mm Hg.
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            Repeatability and reproducibility of central corneal thickness measurement with Pentacam, Orbscan, and ultrasound.

            The purpose of this study was to compare central corneal thickness (CCT) measurements obtained with a novel rotating Scheimpflug camera (Pentacam; Oculus) with scanning slit topography (Orbscan; Bausch & Lomb), and with ultrasound pachymetry (SP-2000; Tomey). CCT in 30 healthy eyes was measured twice with each modality by 2 independent observers in random order. The results from scanning slit topography are given both with and without multiplication with the "acoustic correction factor" of 0.92. In addition, the displayed images from the rotating Scheimpflug camera and scanning slit topography were used to calculate the signal difference-to-noise ratios (SD/N) between cornea and background signal. The mean CCT values as determined with the different modalities (+/-standard deviation) were: 542+/-29 microm, 576+/-37 microm, 530+/-34 microm, and 552+/-32 microm for rotating Scheimpflug imaging, for uncorrected and for corrected scanning slit pachymetry, and for ultrasound, respectively. The differences between modalities (+/-95% limits of agreement) were -9.8+/-31 microm between rotating Scheimpflug and ultrasound, 24+/-31.2 microm between scanning slit and ultrasound, and 33+/-27 microm between scanning slit and rotating Scheimpflug imaging. The limits of agreement for within and between observer effects were within 4.2% of the absolute CCT values for scanning slit and ultrasound and within 2.2% for the rotating Scheimpflug imaging. The rotating Scheimpflug camera showed similar SD/N ratios but steeper edges of the corneal surfaces in the intensity profile plots. In the assessment of normal corneas, the Pentacam measured CCT values closer to ultrasound pachymetry and with less variability compared with Orbscan. The (interobserver) reproducibility with the Pentacam was highest of all 3 modalities.
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              Applanation tonometry and central corneal thickness.

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                Author and article information

                Journal
                Eye
                Eye
                Springer Nature
                0950-222X
                1476-5454
                February 15 2018
                :
                :
                Article
                10.1038/s41433-018-0033-3
                5944650
                29445115
                becd0f91-4f1b-4518-a8b1-ac38c5f4a8f3
                © 2018

                http://www.springer.com/tdm

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