Evaluation of Corneal biomechanics in primary open angle glaucoma

Document Type : Original Article

Authors

1 Ophthalmology department_benisuif University

2 Ophthalmology department, Beni-Suef university

Abstract

Background:
Elevated intraocular pressure (IOP) is one of the most important factors for diagnosis and monitoring of glaucoma. IOP is currently the only modifiable risk factor for glaucoma, cornea is the transparent tissue covering the front of the eye. It is a powerful refracting surface, providing 2/3 of the eye's focusing power. The adult cornea is only about 1/2 millimeter thick and is comprised of 6 layers: epithelium, Bowman's membrane, stroma, Dua's layer, Descemet's membrance and endothelium.

Objectives:
correlation of Corneal Biomechanics (ORA) with perimetry, IOP and OCT optic nerve results in eyes with primary open angle glaucoma and glaucoma suspect patients.

Patients and Methods:
This study is a prospective cross-sectional study, ocular response analyzer (ORA) parameters were measured in 40 patients with correlation to their Intraocular pressure (IOP), Perimetry and ocular coherence tomography (OCT) retinal nerve fiber layer thickness (RNFL) on 80 eyes, Patients ages range between 45-65 years old. The study was prepared on patients seeking treatment in ophthalmology polyclinic in The Memorial Institute of Ophthalmic Researches in Giza , they were screened to identify those with primary open angle glaucoma and glaucoma suspect patients.

Results:
Our study revealed that the corneal biomechanics Parameters are significantly lower in patients with advanced primary open angle glaucoma (POAG).

Conclusion:
Studying corneal biomechanics is essential for early diagnosis of glaucoma suspect and follow up of primary open angle glaucoma patients.

Keywords


  1. Dascalescu, D., Corbu, C., Constantin, M., Cristea, M., Ionescu, C., Cioboata, M., & Voinea, L. (2015). Correlations between Corneal Biomechanics and Glaucoma Severity in Patients with Primary Open Angle Glaucoma. Maedica, 10(4), 33.
  2. Gupta, D. (2005). Glaucoma diagnosis and management. Lippincott Williams & Wilkins
  3. De Moraes, C. G. V., Prata, T. S., Liebmann, J., & Ritch, R. (2008). Modalities of tonometry and their accuracy with respect to corneal thickness and irregularities. Journal of optometry, 1(2), 43-49.
  4. Girard, M. J., Dupps, W. J., Baskaran, M., Scarcelli, G., Yun, S. H., Quigley, H. A.,... & Strouthidis, N. G. (2015). Translating ocular biomechanics into clinical practice: current state and future prospects. Current eye research, 40(1), 1-18.
  5. Vinciguerra, R., Rehman, S., Vallabh, N. A., Batterbury, M., Czanner, G., Choudhary, A.,... & Willoughby, C. E. (2019). Corneal biomechanics and biomechanically corrected intraocular pressure in primary open-angle glaucoma, ocular hypertension and controls. British Journal of Ophthalmology, bjophthalmol-2018
  6. Gaspar, R., Pinto, L. A., & Sousa, D. C. (2017). Corneal properties and glaucoma: a review of the literature and meta-analysis. Arquivos brasileiros de oftalmologia, 80(3), 202-206
  7. Ang, G. S., Bochmann, F., Townend, J., & Azuara-Blanco, A. (2008). Corneal biomechanical properties in primary open angle glaucoma and normal tension glaucoma. Journal of glaucoma, 17(4), P259-262
  8. Chen, M., Kueny, L., & Schwartz, A. L. (2018). The role of corneal hysteresis during the evaluation of patients with possible normal-tension glaucoma. Clinical ophthalmology (Auckland, NZ), 12, 555
  9. Ruberti, J. W., & Zieske, J. D. (2008). Prelude to corneal tissue engineering–gaining control of collagen organization. Progress in retinal and eye research, 27(5), 549-577.
  10. Gkika, M., Labiris, G., Giarmoukakis, A., Koutsogianni, A., & Kozobolis, V. (2012). Evaluation of corneal hysteresis and corneal resistance factor after corneal cross-linking for keratoconus. Graefe's Archive for Clinical and Experimental Ophthalmology, 250(4), 565-573.
  11. Shin, J. Y., Choi, J. S., Oh, J. Y., Kim, M. K., Lee, J. H., & Wee, W. R. (2010). Evaluation of corneal biomechanical properties following penetrating keratoplasty using the ocular response analyzer. Korean Journal of Ophthalmology, 24(3), 139-142.
  12. Lawrence, W. (1854). A Treatise on the Diseases of the Eye. Blanchard and Lea.
  13. Flammer, J., & Orgül, S. (1998). Optic nerve blood-flow abnormalities in glaucoma. Progress in retinal and eye research, 17(2), 267-289.
  14. Mansouri, K., Leite, M. T., Weinreb, R. N., Tafreshi, A., Zangwill, L. M., & Medeiros, F.A. (2012). Association between corneal biomechanical properties and glaucoma severity. American journal of ophthalmology, 153(3), 419-427.
  15. El-Malah, M. A. (2013). Evaluation of corneal biomechanics using ocular response analyzer for normal and primary open angle glaucoma eyes. Journal of the Egyptian Ophthalmological Society, 106(4),P 249.‏
  16. Vinciguerra, R., Rehman, S., Vallabh, N. A., Batterbury, M., Czanner, G., Choudhary, A.,... & Willoughby, C. E. (2019). Corneal biomechanics and biomechanically corrected intraocular pressure in primary open-angle glaucoma, ocular hypertension and controls. British Journal of Ophthalmology, bjophthalmol-2018.
  17. Hussnain, S. A., Kovacs, K. D., Warren, J. L., & Teng, C. C. (2018). Corneal hysteresis and anterior segment optical coherence tomography anatomical parameters in primary angle closure suspects. Clinical & experimental ophthalmology, 46(5), 468-472
  18. Congdon, N. G., Broman, A.T., Bandeen-Roche, K., Grover, D., & Quigley, H.A. (2006). Central corneal thickness and corneal hysteresis associated with glaucoma damage. American journal of ophthalmology, 141(5), 868-875.
  19. Chen, M., Kueny, L., & Schwartz, A. L. (2018). The role of corneal hysteresis during the evaluation of patients with possible normal-tension glaucoma. Clinical ophthalmology (Auckland, NZ), 12, 555.‏
  20. Hirneiß, C., Neubauer, A. S., Yu, A., Kampik, A., & Kernt, M. (2011). Corneal biomechanics measured with the ocular response analyser in patients with unilateral open-angle glaucoma. Acta ophthalmologica, 89(2), P189-192.‏
  21. Grise-Dulac, A., Saad, A., Abitbol, O., Febbraro, J. L., Azan, E., Moulin-Tyrode, C., & Gatinel, D. (2012). Assessment of corneal biomechanical properties in normal tension glaucoma and comparison with open-angle glaucoma, ocular hypertension, and normal eyes. Journal of glaucoma, 21(7), P486-489.‏
  22. Board, D (2002). IPCC Abstract deadline: May 1st 2002 Travel Awards available for IPCC: deadline May 15th 2002.
  23. Brandt, J. D., Beiser, J. A., Kass, M. A., Gordon, M. O., & Ocular Hypertension Treatment Study (OHTS) Group. (2001). Central corneal thickness in the ocular hypertension treatment study (OHTS). Ophthalmology, 108(10), 1779-1788.
  24. Saif M, Saif A, Saif P, Abdel Khalek M, Mahran W. Dry Eye Changes After Phacoemulsification And Manual Small Incision Cataract Surgery (MSICS). . Int J Ophthalmol Eye Res.2016; 4(2), 184-191
  25. Saif A, Saif P, Dabous O. Fundus changes in thalassemia in Egyptian patients. Delta Journal of Ophthalmology. 2017;18(1):20.
  26. Saif ATS, Saif PS , El Deeb A. Role of amniotic membrane transplantation in symblepharon. Guoji Yanke Zazhi(Int Eye Sci) 2017;17(5):819-824
  27. Saif AT, Saif P. Achieving Target IOP. Glokom-Katarakt/Journal of Glaucoma-Cataract. 2017 Mar;12(1):60–9.
  28. Nassar M, Saif M, Saif A, Saif P. Sensitivity and specificity of nassar color test in early detection of diabetic macular edema. Journal of Retina-Vitreous. 2016;24:109-113.‏
  29. Abdelraof, A., Anwar, M., El bahrawe, R. Assessment of the knowledge towards Cancer Cervix among Nurse Staff in Health Care Facilities in Beni-Suef City, Egypt. Egyptian Journal of Medical Research, 2020; 1(1): 7-15. doi: 10.21608/ejmr.2020.89057
  30. Sheir, R., Salem, M., Mamdouh, M., AbdelKarem, R. The Relation between Microvascular Complications of Type II Diabetes with Levels of Serum Progranulin.. Egyptian Journal of Medical Research, 2020; 1(1): 29-42. doi: 10.21608/ejmr.2020.89039
  31. Sheir, R., Salem, M., Mamdouh, M., AbdelKarem, R. The Relation between Microvascular Complications of Type II Diabetes with Levels of Serum Progranulin.. Egyptian Journal of Medical Research, 2020; 1(1): 29-42. doi: 10.21608/ejmr.2020.89039