J Korean Ophthalmol Soc.  2012 Jul;53(7):1002-1010. 10.3341/jkos.2012.53.7.1002.

Correlation Between Central Corneal Thickness and Glaucomatous Damage

• Kim YJ
• Na JH
• Lee Y
• Sung KR

• KMID: 2215860
• DOI: http://doi.org/10.3341/jkos.2012.53.7.1002

Abstract

PURPOSE
To evaluate the correlations between central corneal thickness (CCT) and optic disc and retinal nerve fiber layer (RNFL) parameters determined by spectral domain optical coherence tomography (SD OCT) and visual field (VF) global indices.
METHODS
The present study included 151 eyes diagnosed with open-angle glaucoma (OAG) and 135 glaucoma suspect (GS) eyes. The CCT, RNFL thickness, optic disc parameters, and VF global indices were measured. The relationships between CCT and RNFL thickness, optic disc parameters, and VF global indices were assessed by linear regression analysis.
RESULTS
Intraocular pressure (IOP, p < 0.001) and VF mean deviation (p = 0.005) in all participants, age (p = 0.017) and IOP (p = 0.003) in the GS group, and IOP (p = 0.002) and inferior RNFL thickness (p = 0.017) in the OAG group were significantly associated with CCT. Among the optic disc parameters, rim area, average cup/disc ratio, and vertical cup/disc ratio were significantly associated with CCT in all participants in the univariate but not multivariate analysis.
CONCLUSIONS
Optic disc parameters obtained by SD OCT were not correlated with CCT in the OAG or GS group, while RNFL thickness and VF mean deviation showed associations.

Keyword

Central corneal thickness; Optic disc parameters; Retinal nerve fiber layer thickness; Spectral domain optical coherence tomography; Visual field indices

MeSH Terms

Eye
Glaucoma
Glaucoma, Open-Angle
Intraocular Pressure
Linear Models
Nerve Fibers
Retinaldehyde
Tomography, Optical Coherence
Visual Fields
Retinaldehyde

Figure

• 

  Figure 1 Correlation between (A) central corneal thickness and intraocular pressure and (B) central corneal thickness and mean deviation in open angle glaucoma and glaucoma suspect subjects. (A) R2 = 0.068, p < 0.001. (B) R2 = 0.037, p = 0.001.

• 

  Figure 2 Correlation between (A) central corneal thickness and age and (B) central corneal thickness and intraocular pressure in glaucoma suspect subjects. (A) R2 = 0.047, p = 0.011. (B) R2 = 0.064, p = 0.003.

• 

  Figure 3 Correlation between (A) central corneal thickness and intraocular pressure and (B) central corneal thickness and inferior retinal nerve fiber layer thickness in open angle glaucoma. (A) R2 = 0.064, p = 0.002. (B) R2 = 0.019, p = 0.091.

Reference

1. Burgoyne CF, Downs JC. Premise and prediction-how optic nerve head biomechanics underlies the susceptibility and clinical behavior of the aged optic nerve head. J Glaucoma. 2008. 17:318–328.

2. Chauhan BC. Endothelin and its potential role in glaucoma. Can J Ophthalmol. 2008. 43:356–360.

3. Allingham R, Damji KF, Freedman S, et al. Allingham RR, Damji KF, Freedman S, editors. Optic nerve, retina, and choroid. Shields' Textbook of Glaucoma. 2011. 6th ed. Philadelphia: Lippincott Williams & Wilkins;chap. 4.

4. Burgoyne CF, Quigley HA, Thompson HW, et al. Early changes in optic disc compliance and surface position in experimental glaucoma. Ophthalmology. 1995. 102:1800–1809.

5. Burgoyne CF, Morrison JC. The anatomy and pathophysiology of the optic nerve head in glaucoma. J Glaucoma. 2001. 10:5 Suppl 1. S16–S18.

6. Quigley HA, Brown A, Dorman-Pease ME. Alterations in elastin of the optic nerve head in human and experimental glaucoma. Br J Ophthalmol. 1991. 75:552–557.

7. Quigley HA, Guy J, Anderson DR. Blockade of rapid axonal transport. Effect of intraocular pressure elevation in primate optic nerve. Arch Ophthalmol. 1979. 97:525–531.

8. Gordon MO, Beiser JA, Brandt JD, et al. The Ocular Hypertension Treatment Study: baseline factors that predict the onset of primary open-angle glaucoma. Arch Ophthalmol. 2002. 120:714–720. discussion 829-30.

9. Burgoyne CF, Downs JC, Bellezza AJ, et al. The optic nerve head as a biomechanical structure: a new paradigm for understanding the role of IOP-related stress and strain in the pathophysiology of glaucomatous optic nerve head damage. Prog Retin Eye Res. 2005. 24:39–73.

10. Bayraktar S, Bayraktar Z. Central corneal thickness and intraocular pressure relationship in eyes with and without previous LASIK: comparison of Goldmann applanation tonometer with pneumatonometer. Eur J Ophthalmol. 2005. 15:81–88.

11. Doughty MJ, Zaman ML. Human corneal thickness and its impact on intraocular pressure measures: a review and meta-analysis approach. Surv Ophthalmol. 2000. 44:367–408.

12. Allingham R, Damji KF, Freedman S, et al. Allingham R, Damji KF, Freedman S, editors. Intraocular pressure and tonometry. Shields' Textbook of Glaucoma. 2011. 6th ed. Philadelphia: Lippincott Williams & Wilkins Wilkins;chap. 2.

13. Wolfs RC, Klaver CC, Vingerling JR, et al. Distribution of central corneal thickness and its association with intraocular pressure: The Rotterdam Study. Am J Ophthalmol. 1997. 123:767–772.

14. Herndon LW, Weizer JS, Stinnett SS. Central corneal thickness as a risk factor for advanced glaucoma damage. Arch Ophthalmol. 2004. 122:17–21.

15. Medeiros FA, Sample PA, Weinreb RN. Corneal thickness measurements and frequency doubling technology perimetry abnormalities in ocular hypertensive eyes. Ophthalmology. 2003. 110:1903–1908.

16. Medeiros FA, Sample PA, Weinreb RN. Corneal thickness measurements and visual function abnormalities in ocular hypertensive patients. Am J Ophthalmol. 2003. 135:131–137.

17. Xu L, Zhang H, Wang YX, Jonas JB. Central corneal thickness and glaucoma in adult Chinese: the Beijing Eye Study. J Glaucoma. 2008. 17:647–653.

18. Kaushik S, Gyatsho J, Jain R, et al. Correlation between retinal nerve fiber layer thickness and central corneal thickness in patients with ocular hypertension: an optical coherence tomography study. Am J Ophthalmol. 2006. 141:884–890.

19. Henderson PA, Medeiros FA, Zangwill LM, Weinreb RN. Relationship between central corneal thickness and retinal nerve fiber layer thickness in ocular hypertensive patients. Ophthalmology. 2005. 112:251–256.

20. Mumcuoglu T, Townsend KA, Wollstein G, et al. Assessing the relationship between central corneal thickness and retinal nerve fiber layer thickness in healthy subjects. Am J Ophthalmol. 2008. 146:561–566.

21. Pakravan M, Parsa A, Sanagou M, Parsa CF. Central corneal thickness and correlation to optic disc size: a potential link for susceptibility to glaucoma. Br J Ophthalmol. 2007. 91:26–28.

22. Kourkoutas D, Georgopoulos G, Maragos A, et al. New nonlinear multivariable model shows the relationship between central corneal thickness and HRTII topographic parameters in glaucoma patients. Clin Ophthalmol. 2009. 3:313–323.

23. Abe H, Shirakashi M, Tsutsumi T, et al. Laser scanning tomography of optic discs of the normal Japanese population in a population-based setting. Ophthalmology. 2009. 116:223–230.

24. Wu RY, Zheng YF, Wong TY, et al. Relationship of central corneal thickness with optic disc parameters: the Singapore Malay Eye Study. Invest Ophthalmol Vis Sci. 2011. 52:1320–1324.

25. Mesiwala NK, Pekmezci M, Porco TC, Lin SC. Optic disc parameters from optovue optical coherence tomography: comparison of manual versus automated disc rim determination. J Glaucoma. 2011. 04. 25. [Epub ahead of print].

26. Wollstein G, Kagemann L, Bilonick RA, et al. Retinal nerve fibre layer and visual function loss in glaucoma: the tipping point. Br J Ophthalmol. 2012. 96:47–52.

27. Savini G, Carbonelli M, Parisi V, Barboni P. Repeatability of optic nerve head parameters measured by spectral-domain OCT in healthy eyes. Ophthalmic Surg Lasers Imaging. 2011. 42:209–215.

28. Sharma A, Oakley JD, Schiffman JC, et al. Comparison of automated analysis of Cirrus HD OCT spectral-domain optical coherence tomography with stereo photographs of the optic disc. Ophthalmology. 2011. 118:1348–1357.

29. Abràmoff MD, Lee K, Niemeijer M, et al. Automated segmentation of the cup and rim from spectral domain OCT of the optic nerve head. Invest Ophthalmol Vis Sci. 2009. 50:5778–5784.

30. Sung KR, Kim JS, Wollstein G, et al. Imaging of the retinal nerve fibre layer with spectral domain optical coherence tomography for glaucoma diagnosis. Br J Ophthalmol. 2011. 95:909–914.

31. Leske MC, Heijl A, Hyman L, et al. Predictors of long-term progression in the early manifest glaucoma trial. Ophthalmology. 2007. 114:1965–1972.

32. Sung KR, Kim DY, Nam YP. Relationship between central corneal thickness and retinal nerve fiber layer thickness in glaucomatous subject. J Korean Ophthalmol Soc. 2009. 50:418–423.

33. Schuman JS. Spectral domain optical coherence tomography for glaucoma (an AOS thesis). Trans Am Ophthalmol Soc. 2008. 106:426–458.

34. Leung CK, Cheung CY, Weinreb RN, et al. Retinal nerve fiber layer imaging with spectral-domain optical coherence tomography: a variability and diagnostic performance study. Ophthalmology. 2009. 116:1257–1263. 1263.e1–1263.e2.

35. Gramer E, Althaus G, Leydhecker W. [Site and depth of glaucomatous visual field defects in relation to the size of the neuroretinal edge zone of the optic disk in glaucoma without hypertension, simple glaucoma, pigmentary glaucoma. A clinical study with the Octopus perimeter 201 and the optic nerve head analyzer]. Klin Monbl Augenheilkd. 1986. 189:190–198.

36. Girkin CA, Liebmann J, Fingeret M, et al. The effects of race, optic disc area, age, and disease severity on the diagnostic performance of spectral-domain optical coherence tomography. Invest Ophthalmol Vis Sci. 2011. 52:6148–6153.

37. Oddone F, Centofanti M, Tanga L, et al. Influence of disc size on optic nerve head versus retinal nerve fiber layer assessment for diagnosing glaucoma. Ophthalmology. 2011. 118:1340–1347.

38. Sung KR, Na JH, Lee Y, et al. Glaucoma diagnostic capabilities of optic nerve head parameters as determined by cirrus HD optical coherence tomography. J Glaucoma. 2011. 06. 01. [Epub ahead of print].

39. Qiu KL, Zhang MZ, Leung CK, et al. Diagnostic classification of retinal nerve fiber layer measurement in myopic eyes: a comparison between time-domain and spectral-domain optical coherence tomography. Am J Ophthalmol. 2011. 152:646–653.

40. Shak AA , Malakhanova MK, Ogorodnikova SN. [Evaluation of stereometric parameters of optic disc and nerve fiber layer using HRT II. Report 3: measurement error of spectral-domain optical coherence tomography compared with Heidelberg retinal tomograph III]. Vestn Oftalmol. 2011. 127:46–49.

41. Gunvant P, Porsia L, Watkins RJ, et al. Relationships between central corneal thickness and optic disc topography in eyes with glaucoma, suspicion of glaucoma, or ocular hypertension. Clin Ophthalmol. 2008. 2:591–599.

42. Jonas JB, Holbach L. Central corneal thickness and thickness of the lamina cribrosa in human eyes. Invest Ophthalmol Vis Sci. 2005. 46:1275–1279.

43. Ren R, Li B, Gao F, et al. Central corneal thickness, lamina cribrosa and peripapillary scleral histomorphometry in non-glaucomatous Chinese eyes. Graefes Arch Clin Exp Ophthalmol. 2010. 248:1579–1585.

44. Ha SG, Kim YY. Relationship between central corneal thickness and scleral thickness in Korean glaucomatous patients. J Korean Ophthalmol Soc. 2010. 51:1485–1490.

45. Kim JM, Park KH, Kim SH, et al. The relationship between the cornea and the optic disc. Eye (Lond). 2010. 24:1653–1657.