Chelvin C A Sng1, Marcus Ang, Keith Barton. 1. aGlaucoma Service, Moorfields Eye Hospital, London, UK bDepartment of Ophthalmology, National University Health System cSingapore Eye Research Institute dSingapore National Eye Centre, Singapore, Singapore eNational Institute for Health Research, Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital fDepartment of Epidemiology and Genetics, Institute of Ophthalmology, University College, London, UK.
Abstract
PURPOSE OF REVIEW: The purpose of this review is to summarize the role of central corneal thickness (CCT) in the clinical management of a glaucoma patient. RECENT FINDINGS: The prognostic value of CCT is well recognized in patients with ocular hypertension. However, its predictive value in other glaucoma suspects and patients with established glaucoma is less certain. Tonometry artefacts can result from variations in CCT. However, an adequately validated correction algorithm for Goldmann applanation tonometry measurements does not exist. Newer methods of tonometry are potentially less influenced by CCT but are limited in their clinical use. There may also be biological and genetic associations between corneal thickness and glaucoma. Demographics, environmental factors, glaucoma treatment and the measurement device used have a significant influence on CCT, and should be considered when interpreting the effect of cornea thickness in patients with glaucoma. New measurements of the biomechanical properties of the cornea are likely to be better approximations of the globe biomechanics than CCT, but these require further evaluation. SUMMARY: The clinical significance of CCT is well recognized in the context of glaucoma diagnosis and management, though the extent of its importance remains debatable. Corneal biomechanical properties may be more significantly associated with glaucoma than CCT.
PURPOSE OF REVIEW: The purpose of this review is to summarize the role of central corneal thickness (CCT) in the clinical management of a glaucomapatient. RECENT FINDINGS: The prognostic value of CCT is well recognized in patients with ocular hypertension. However, its predictive value in other glaucoma suspects and patients with established glaucoma is less certain. Tonometry artefacts can result from variations in CCT. However, an adequately validated correction algorithm for Goldmann applanation tonometry measurements does not exist. Newer methods of tonometry are potentially less influenced by CCT but are limited in their clinical use. There may also be biological and genetic associations between corneal thickness and glaucoma. Demographics, environmental factors, glaucoma treatment and the measurement device used have a significant influence on CCT, and should be considered when interpreting the effect of cornea thickness in patients with glaucoma. New measurements of the biomechanical properties of the cornea are likely to be better approximations of the globe biomechanics than CCT, but these require further evaluation. SUMMARY: The clinical significance of CCT is well recognized in the context of glaucoma diagnosis and management, though the extent of its importance remains debatable. Corneal biomechanical properties may be more significantly associated with glaucoma than CCT.
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