Central corneal thickness and its associations in a Russian population. The Ural eye and Medical Study

"Optic nerve of steel": A case of very high intraocular pressures with markedly little visual field progression over years

Purpose

We report a case of pseudoexfoliation glaucoma with exceedingly high intraocular pressures (IOP) but limited visual field progression despite poor adherence with treatment over a 7-year period.

Observation

A 67-year-old Eastern European female presented to the emergency room with an IOP of 52 mmHg OD and exam findings consistent with pseudoexfoliation glaucoma. Subsequent testing demonstrated superior and inferior arcuate deficits on Humphrey visual field (HVF) testing and corresponding thinning of optic nerve OD. The patient was very inconsistent with topical glaucoma medications, and after undergoing selective laser trabeculoplasty she was lost to follow-up without any additional treatment. She returned one year later with an IOP of 59 mmHg, but remarkably stable HVF. The patient refused to restart glaucoma drops and elected instead to proceed with a trabeculectomy OD, which was successfully performed, with the final visual acuity of 20/25 and IOP of 20 mmHg OD. The patient was again lost to follow-up for three years. Her IOP was 40 mmHg OD on return to clinic, but her glaucoma testing revealed very little progression. She decided to pursue placement of glaucoma drainage device (Baerveldt 350) OD, and her IOP was 18 mmHg OD after 6 months on no medications. The patient was lost to follow-up thereafter.

Conclusions

The limited visual field progression with chronically high IOP over years strongly argues in favor of IOP-independent mechanisms contributing to pathophysiology of glaucoma. This case also highlights the importance of longitudinal monitoring and tailoring glaucoma therapy holistically to individual patient circumstances.

Comparative analysis of central corneal thickness in ocular hypertension and healthy individuals

OBJECTIVE

This study aimed to compare the central corneal thickness (CCT) between patients with ocular hypertension (OHT) and healthy individuals, and to investigate the relationship between CCT and intraocular pressure (IOP), diopter, and corneal endothelium cell count (CECC).

METHODS

The CCT of 30 healthy subjects and 38 patients with OHT was measured using a non-contact specular microscope. IOP, diopter, and CECC were also assessed for all participants. Comparative analysis of CCT between the two groups was performed, along with correlation analysis between CCT and each parameter.

RESULTS

The average CCT for all participants was 527.57 ± 35.84 µm. The average CCT was 516.07 ± 34.76 µm for healthy subjects and 536.66 ± 34.46 µm for patients with ocular hypertension, showing a significant difference between the two groups (P ≤ 0.05). CCT was not correlated with age (Pearson r = -0.098, P = 0.426), diopter (spherical equivalent refraction) (Pearson r = -0.158, P = 0.197), or corneal endothelium cell count (Pearson r = 0.065, P = 0.598). However, a positive correlation was found between ocular hypertension and central corneal thickness (Pearson r = 0.278, P = 0.022).

CONCLUSION

Patients with ocular hypertension of members of the Chinese Han population exhibited greater CCT compared to healthy subjects in this study. CCT showed no association with age, diopter, or corneal endothelium cell count; however, a positive correlation was observed between intraocular pressure and CCT. With CCT as the abscissa and IOP as the ordinate, the linear regression equation is Y = 0.05+0.021X (F = 5.508, P = 0.022). The use of non-contact tonometers for measuring CCT may impact the accuracy of diagnosing and treating glaucoma and ocular hypertension.

Ocular parameters and anthropometry in Indo-Trinidadians

To assess ocular parameters and their association with anthropometric measurements in Indo-Trinidadians adults. This was a clinical, descriptive, cross-sectional study of ocular parameters and anthropometry in adults Trinidadians of South Asian descent (Indo-Trinidadian). Ocular parameters were measured using optical coherence tomography, intraocular lens master biometer, and an autorefractor. Weight, height, and body mass index (BMI) were measured by anthropometry. Univariable and multivariable linear regressions were used to determine the association between demographic variables, anthropometric and ocular parameters. A total of 149 participants (298 eyes) comprising of 90 females (60.6%) and 59 males (39.4%). Aged 18 to 67 participated in the study. Males were taller, heavier, and had longer axial lengths than females which were statistically significant (P < .05). Age was negatively correlated with central corneal thickness (CCT) (r = -0.353, P = .044) and retinal nerve fiber layer thickness (r = -0.348, P = .047) but positively correlated with lens thickness (R = 0.881, P < .001). Education level was positively associated with CCT (R = 0.408, P = .018) but negatively associated with lens thickness (r = -0.521, P = .002). Weight was negatively correlated with corneal topography (r = -0.427, P = .013). Height was negatively correlated with cup-to-disc ratio (r = -0.410, P = .018), CCT (r = -0.382, P = .028), and corneal topography (r = -0.453, P = .008). There was no correlation between BMI, ocular parameters and CCT. There was a significant difference in the ocular parameters between males and females of South Asian descent in Trinidad and Tobago. Weight was negatively associated with the corneal topography. Height was negatively associated with the cup-to-disc ratio, central corneal thickness, and corneal topography. BMI had no statistically significant association with the ocular parameters investigated.

Current social determinants of health and social risk factors in conditions of the cornea: a scoping review

PURPOSE OF REVIEW

To achieve health equity in eye health and vision care, social determinants of health (SDoH) and the associated social risk factors must be addressed. To address SDoH and social risk factors in ophthalmology, they must first be identified. The purpose of this review was to determine the SDoH and social risk factors in conditions of the cornea that have most recently been explored.

RECENT FINDINGS

This review identified social risk factors associated with all five domains of SDoH, as outlined by Healthy People 2030. The neighborhood and built environment was the domain identified the most for both exploration and observation. The social and community context domain was the least explored, and healthcare access and quality and social and community context domains were the least observed. The cornea condition explored the most in relation to SDoH was dry eye syndrome.

SUMMARY

The findings from this review can inform clinicians on the social risk factors that could be screened for in eye care facilities, so patients can be connected with services to minimize the impact of social risk factors on cornea conditions. Furthermore, the findings have identified cornea conditions and domains of SDoH that are understudied which can be an area for future studies by vision researchers.