Relationship between corneal thickness and measured intraocular pressure in a general ophthalmology clinic
Relationship between corneal thickness and measured intraocular pressure in a general ophthalmology clinic
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DOI：
10.1016/s0161-6420(99)90498-0
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发表时间：
1999-11-01
期刊：
影响因子：
13.7
通讯作者：
McLeod, D
中科院分区：
文献类型：
--
作者：
Shah, S;Chatterjee, A;McLeod, D
目的：探讨角膜中央厚度（CCT）在某区综合医院青光眼患者分类中的影响因素。设计：单观察者横断面研究。参与者：在普通眼科诊所就诊的患者：235只临床正常眼，52只正常眼压型青光眼（NTG）， 335只原发性开角型青光眼（POAG）， 12只假剥脱型青光眼（PXE）， 42只慢性闭角型青光眼（CACG）， 232只疑似青光眼（GS）。干预：采用超声测厚法测量角膜中央厚度。主要观察指标：CCT与诊断的相关性。结果:意味着有条件现金转移支付为553.9μm(95%置信区间(Cl)的意思是,549.0 - -558.8μm)的临床正常的眼睛,550.1μm (Cl 95%, 546.6 - -553.7μm)在青光眼的眼睛,514.0μm (Cl 95%, 504.8 - -523.3μm) NTG的眼睛,530.7μm (Cl 95%, 511.2 - -550.1μm)的PXE的眼睛,559.9μm (Cl 95%, 546.8 - -573.0μm)在CACG眼睛,和579.5μm (Cl 95%, 574.8 - -584.1μm)在GS的眼睛。各组间平均CCT差异极显著（方差分析P < 0.001）。85%患有NTG的眼睛和36%患有POAG的眼睛的平均CCT为540 μ m或更少。结论：在地区综合医院青光眼评估患者中，CCT测量是可取的，以避免因CCT与眼压的关系而导致的错误分类。在这组眼睛中，角膜中央厚度本身并不是临床诊断的准确预测因子。然而,许多眼睛诊断出患有NTG薄角膜,这将会降低眼内压(IOP)的tonometrically记录,所以一个不同寻常的发现角膜厚度介绍一些疑问NTG的诊断,对GS的眼睛,眼睛最厚角膜,这将增加tonometrically IOP记录,因此,GS眼睛温和海拔眼压和厚角膜的可能在低风险类型,因此,许多“高IOPs”和厚CCT的患者不一定有高IOPs，可能不需要作为GS眼进行跟踪。
Objective: To assess whether central corneal thickness (CCT) is a confounding factor in the classification of patients attending for glaucoma assessment in a district general hospital.Design: Cross-sectional study by a single observer.Participants: Patients attending a general ophthalmic clinic: 235 clinically normal eyes, 52 eyes with normal-tension glaucoma (NTG), 335 eyes with primary open-angle glaucoma (POAG), 12 eyes with pseudoexfoliative glaucoma (PXE), 42 eyes with chronic angle closure glaucoma (CACG), and 232 glaucoma suspect (GS) eyes.Intervention: Central corneal thickness was measured using ultrasonic pachymetry.Main Outcome Measure: Correlation of CCT and diagnosis.Results: Mean CCT was 553.9 mu m (95% confidence intervals [Cl] for the mean, 549.0-558.8 mu m) in the clinically normal eyes, 550.1 mu m (95% Cl, 546.6-553.7 mu m) in the POAG eyes, 514.0 mu m (95% Cl, 504.8-523.3 mu m) in the NTG eyes, 530.7 mu m (95% Cl, 511.2-550.1 mu m) in the PXE eyes, 559.9 mu m (95% Cl, 546.8-573.0 mu m) in the CACG eyes, and 579.5 mu m (95% Cl, 574.8-584.1 mu m) in the GS eyes. The differences of mean CCT between the groups were highly significant (P < 0.001 analysis of variance). Eighty-five percent of eyes with NTG and only 36% of eyes with POAG had a mean CCT of 540 mu m or less. Thirteen percent of eyes with POAG and 42% of GS eyes had a mean CCT greater than 585 mu m.Conclusions: The CCT measurement is desirable in patients attending for glaucoma assessment in a district general hospital to avoid misclassification resulting from the relationship between CCT and tonometric pressure. Central corneal thickness alone is not an accurate predictor for the clinical diagnosis in this group of eyes. However, many eyes diagnosed as having NTG have thin corneas, which would tend to lower the tonometrically recorded intraocular pressure (IOP), so the finding of a less-than-normal thickness cornea introduces some doubt as to the diagnosis of NTG, For the GS eyes, most eyes had thick corneas, which would tend to increase the tonometrically recorded IOP, Thus, GS eyes with modest elevation of IOP and a thick cornea may be at low risk of progressing to POAG, Thus, many patients with "high IOPs" and a thick CCT do not necessarily have high IOPs and may not need to be followed as GS eyes.