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Comparison Between Central Corneal Thickness and Intraocular Pressure in Patients with Macrodiscs with Physiologic Macro-excavation and Normal-sized Vital Discs
Viestenz A., Wakili N., Jünemann A., Horn F. K., Mardin C. Y.,
Friedrich-Alexander-Universität, Augenklinik (Erlangen)
Purpose: Macrodisks with physiological macrocups and elevated intraocular pressure (IOP) are frequently suspecious for glaucoma. In case of an IOD of more than 21 mmHg, these patients were often treated antiglaucomatous. We investigated a possible relationship between macrodisks, IOP and central corneal thickness.
Method: Using the Erlangen Glaucoma-Registry, 246 out of 1096 consecutive patients with unremarkable and repeated visual field (Octopus 500, G1-3, MD<2.1) were selected retrospectively. The following data were collected: corneal pachymetry (Tomey), IOP-profile, visual acuity, keratometry. The morphometric analysis was performed by planimetry. Optic nerve heads larger than 3.1 mm2 were defined to be macrodiscs.
Results: The following groups were subdevided: A) macrodisk, IOD<22mmHg (87 patients). B) macrodisks, IOD>21 mmHg (66 patients). C) normal sized vital disks, IOP<22mmHg (93 patients). The mean corneal thickness was: A) 575 ± 36mm, B) 596 ± 37mm, C) 557 ± 31mm (p=0.003). The mean keratometric equivalent measured: A) 41.7 ± 1.3 Dpt, B) 42.4 ± 1.3 Dpt, C) 43.0 ± 1.2 Dpt (p<0.05). The maximum of IOP was in: A) 17.6 ± 3.1, B) 26.2 ± 4.1, C) 17.2 ± 3.4 mmHg. Group A) did have an optic disk size measuring 3.91 ± 0.66, group B) 3.65 ± 0.61 and C) 2.56 ± 0.30 mm2.
Conclusions: Macrodisks with elevated IOP have a higher corneal curvature (about ¾ Dpt) and a thicker (20 mm) central cornea. An exactly evaluation of optic disk morphology in combination with pachymetric and keratometric measurements in relation to IOP could avoid an overtreatment in patients with suspect primary open angle glaucoma.
Supported by SFB 539, project A1 and A2