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Glaukomrisiko und Hornhautdicke

The risk of glaucoma and corneal thickness

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Zusammenfassung

Der Augeninnendruck ist nach wie vor der wichtigste Risikofaktor für die Entstehung eines glaukomatösen Schadens. Neuere Studien weisen darauf hin, dass auch die Hornhautdicke ein Risikofaktor für die Entstehung einer glaukomatösen Schädigung darstellt. Eine mögliche Ursache hierfür könnte sein, dass die Hornhautdicke die Messung des Augeninnendruckes beeinflusst. Es konnte gezeigt werden, dass bei der Applanationstonometrie nach Goldmann die Messwerte mit der Hornhautdicke korrelieren. Dicke Hornhäute führen zu einer falsch hohen Messung des Augeninnendruckes und dünne zu einer falsch niedrigen. Ob es sich bei der Hornhautdicke als Risikofaktor für das Glaukom um einen reinen Messfehler oder einen Ausdruck biomechanischer Besonderheiten der Glaukomaugen handelt, ist nicht mit Sicherheit geklärt. Ein großer Teil des Hornhauteffektes beruht sicherlich auf dem Messfehler bei der Augeninnendruckmessung. Durch die Nichtberücksichtigung der Hornhautdicke können Messfehler entstehen, die zu Fehldiagnose und fehlerhafter Behandlung führen können. Aus diesem Grund sollte die Messung der Hornhautdicke bei Patienten mit einem Glaukom oder Glaukomverdacht nicht fehlen.

Abstract

Intraocular pressure is still the most important risk factor for the development of glaucomatous optic nerve damage. There is growing evidence that corneal thickness is a risk factor for the development of glaucoma. This might be caused by the effect of corneal thickness on intraocular pressure (IOP) measurements. Goldmann applanation tonometry measurements are correlated with corneal thickness. Thick corneas lead to false high readings whereas thin corneas lead to false low readings. If corneal thickness as a risk factor for glaucoma is only related to the dependency of IOP measurements on corneal thickness or is related to possible different biomechanical tissue properties in glaucomatous eyes is not known. However, a large proportion of the corneal thickness effect seems to be related to the effect on IOP readings by applanation tonometry. Neglecting corneal thickness can lead to false measurements of IOP with consequent misdiagnosis and false treatment. Therefore, measurements of corneal thickness should be performed in glaucoma patients and suspects.

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  1. Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Carl Gustav Carus, Dresden

    A. G. Böhm

  2. Universitäts-Augenklinik Dresden, Fetscherstraße 74, 01307 , Dresden

    A. G. Böhm

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Böhm, A.G. Glaukomrisiko und Hornhautdicke. Ophthalmologe 102, 909–918 (2005). https://doi.org/10.1007/s00347-005-1248-9

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