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Synergic effect of corneal hysteresis and central corneal thickness in the risk of early-stage primary open-angle glaucoma progression

  • Glaucoma
  • Published:
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Abstract

Purpose

To evaluate corneal hysteresis (CH), acquired with ocular response analyzer (ORA), as a risk factor for glaucoma progression in early-stage primary open-angle glaucoma (POAG).

Methods

In a historical cohort study, patients diagnosed in 2011 with early-stage POAG according to the Hodapp, Parrish and Anderson classification modified for Octopus perimetry and followed up until glaucomatous progression development; otherwise, observations were censored in October 2018. Cox regression was used to obtain hazard ratios (HR) to evaluate baseline variables (CH, central corneal thickness, gender, age IOP and glaucoma family history) as risk factors for perimetric glaucoma progression. A likelihood ratio test for interaction was performed in order to assess the effect of the combination of CH and CCT on the risk of progression.

Results

Of the cohort of 1573 patients, 11.38% developed early-stage POAG progression during the follow-up. The mean follow-up time was 3.28 ± 1.92 years. Patients without progression had a higher CH (11.35 ± 1.43 vs 9.07 ± 1.69 mmHg; p < 0.001) and CCT (570.75 ± 17.71 vs 554.51 ± 23.20; p < 0.001). In the multivariate analysis, each 1 mmHg of lower CH was associated with an increase of 2.13 times in the HR of progression (95% CI: 1.92–2.32; p < 0.001). CH hazard ratio was modified by CCT, with higher values of CCT and CH resulting in a higher HR of early glaucoma progression (p < 0.001).

Conclusions

CH can be considered as a risk factor of progression in early-stage POAG. The risk associated with CH changed depending on CCT values, acting synergistically slowing the risk of glaucoma progression with higher values.

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Although we have not included it in our submission, the data is available for reviewers to check.

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Authors and Affiliations

  1. Ophthalmology Department, Hospital Clinico San Carlos, C/ Martín Lagos s/n, Madrid, Spain

    Maria A. Jiménez-Santos, Federico Saénz-Francés, Rubén Sánchez-Jean, José María Martinez-de-la Casa & Julian García-Feijoo

  2. Ophthalmology Department, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain

    José María Martinez-de-la Casa & Julian García-Feijoo

  3. Laboratorio de Vision, Instituro de Tecnología del Conocimiento, Facultad de Psicología, Universidad Complutense de Madrid, Madrid, Spain

    Luis Jañez-Escalada

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  1. Maria A. Jiménez-Santos
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Correspondence to Maria A. Jiménez-Santos.

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Ethics approval

A cohort study was approved by the Institutional Review Board at the Hospital Clínico San Carlos, and informed consent to access and publication of their clinical records and data selected from it were obtained from all patients. The research was carried out in accordance with the principles of the Helsinki Declaration for medical research involving human subjects.

Conflict of interest

Jimenez, M.: travel reimbursements and speaker fees by Allergan plc, Novartis. Sáenz-Francés, F.: travel reimbursements by Thea, Bausch and Lomb Inc, Allergan plc, consulting fees by Santen. Martínez-de-la-Casa, J.M.: travel reimbursements and speaker fees: Glaukos Corp, Allergan plc, Bausch and Lomb Inc, Zeiss AG, Esteve, Thea, consulting fees by Santen. García Feijóo, J.: travel reimbursements and speaker fees by Zeiss A.G., Heidelberg AG, Novartis AG, Glaukos Inc, Santen. Jáñez-Escalada, L. and Sánchez-Jean, R. declare no conflict of interest.

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Jiménez-Santos, M.A., Saénz-Francés, F., Sánchez-Jean, R. et al. Synergic effect of corneal hysteresis and central corneal thickness in the risk of early-stage primary open-angle glaucoma progression. Graefes Arch Clin Exp Ophthalmol 259, 2743–2751 (2021). https://doi.org/10.1007/s00417-021-05212-1

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