Central corneal thickness in eyes with pseudoexfoliation syndrome in Kashmir Valley - a hospital based study
Abstract
Introduction: Pseudoexfoliation syndrome (PEX) is characterized by the production and accumulation of extracellular granular fibrillar material in many ocular tissues. Pseudoexfoliation has been closely associated with glaucoma and raised intraocular pressure (IOP) is the most important known risk factor for glaucoma. Central corneal thickness (CCT) may affect the accuracy of IOP measurements. Thus, it is possible to underestimate/overestimate the IOP reading in the PEX syndrome and overlook an early glaucomatous damage. The aim of our study was to determine the central corneal thickness (CCT) in eyes with pseudoexfoliation (PEX).
Methods: Total 2076 eyes (of 1224 patients) with pseudoexfoliation on clinical examination were enrolled in this prospective clinical study and CCT was measured in each eye using specular microscopy.
Results: Mean CCT (????m) in eyes with Pseudoexfoliation was 525.43 ± 34.27. CCT in eyes with Hypertensive PEX (513.2 ± 27.8) and PEX Glaucoma (509.22 ± 29.76) was significantly thinner than in eyes with Normotensive PEX (528.17± 30.33) (P = 0.001, P = 0.0001, respectively). There was no significant difference in CCT between the fellow eyes in cases of unilateral pseudoexfoliation (P = 0.54).
Conclusion: Mean central corneal thickness (CCT) in eyes with pseudoexfoliation is 525.4 µm and CCT is significantly thinner in Hypertensive PEX as well as Glaucomatous PEX eyes than Normotensive PEX eyes.
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References
2. Schumacher S, Schlotzer-Schrehardt U, Martus P, Lang W, Naumann GO. Pseudoexfoliation syndrome and aneurysms of the abdominal aorta. Lancet 2001 Feb;357(9253):359-60. [PubMed]
3. Schlotzer-Schrehardt UM, Koca MR, Naumann GOH, Volkholz H. Pseudoexfoliation syndrome: ocular manifestation of a systemic disorder?. Arch Ophthalmol. 1992 Dec;110(12):1752-6. doi:10.1001/archopht.1992.01080240092038. [PubMed]
4. Naumann GOH, Schlotzer-Schrehardt U. Keratopathy in pseudoexfoliation syndrome as a cause of corneal endothelial decompensation. Ophthalmology 2000 Jun;107(6):1111–24. doi:10.1016/S0161-6420(00)00087-7.
5. Vijaya L, Asokan R, Panday M, Choudhari NS, Sathyamangalam RV, Velumuri L et al. The Prevalence of Pseudoexfoliation and the Long-term Changes in Eyes With Pseudoexfoliation in a South Indian Population. J Glaucoma 2015 May;00:000–007. doi: 10.1097/IJG.0000000000000276. [PubMed]
6. Grodum K, Heijl A, Bengtsson B. Risk of glaucoma in ocular hypertension with and without pseudoexfoliation. Ophthalmology 2005 Mar;112(3):386–90. [PubMed]
7. Doughty MJ, Zaman ML. Human corneal thickness and its impact on intraocular pressure measures: a review and metaanalysis approach. Survey of Ophthalmology 2000 Mar;44(5):367–408. doi:10.1016/S0039-6257(00)00110-7. [PubMed]
8. Shah S, Chatterjee A, Mathai M, Kelly SP, Kwartz J, Henson D et al. Relationship between corneal thickness and measured intraocular pressure in a general ophthalmology clinic. Ophthalmology 1999 Nov;106(11):2154–60. doi:10.1016/S0161-6420(99)90498-0.
9. Ventura AC, Bohnke M, Mojon DS. Central corneal thickness measurements in patients with normal tension glaucoma, primary open angle glaucoma, pseudoexfoliation glaucoma, or ocular hypertension. Br J Ophthalmol. 2001 Jul;85(7):792-5. [PubMed]
10. Detorakis ET, Koukoula S, Chrisohoou F, Konstas AG, Kozobolis VP. Central corneal mechanical sensitivity in pseudoexfoliation syndrome. Cornea. 2005 Aug;24(6):688-91. [PubMed]
11. Yagci R, Eksioglu U, Midillioglu I, Yalvac I, Altiparmak E, Duman S. Central corneal thickness in primary open angle glaucoma, pseudoexfoliative glaucoma, ocular hypertension, and normal population. Eur J Ophthalmol. 2005 May-Jun;15(3):324-8. [PubMed]
12. Bechmann M, Thiel MJ, Roesen B, Ullrich S, Ulbig MW, Ludwig K. Central corneal thickness determined with optical coherence tomography in various types of glaucoma. Br J Ophthalmol. 2000 Nov;84(11):1233-7.
13. Inoue K, Okugawa K, Oshika T, Amano S. Morphological study of corneal endothelium and corneal thickness in pseudoexfoliation syndrome. Jpn J Ophthalmol. 2003 May-Jun;47(3):235-9.
14. Aghaian E, Choe JE, Lin S, Stamper RL. Central corneal thickness of Caucasians, Chinese, Hispanics, Filipinos, African Americans, and Japanese in a glaucoma clinic. Ophthalmology 2004 Dec;111(12):2211-9.
15. Puska P, Vasara K, Harju M, Setala K. Corneal thickness and corneal endothelium in normotensive subjects with unilateral exfoliation syndrome. Graefes Arch Clin Exp Ophthalmol. 2000 Aug;238(8):659-63. [PubMed]
16. Tai L, Khaw K, Ng C, Subrayan V. Central corneal thickness measurements with different imaging devices and ultrasound pachymetry. Cornea 2013 Jun;32(6):766–71.
17. Almubrad TM, Osuagwu UL, AlAbbadi I, Ogbuehi KC. Comparison of the precision of the Topcon SP-3000P specular microscope and an ultrasound pachymeter. Clin Ophthalmol. 2011;5:871-6. doi: 10.2147/OPTH.S21247. [PubMed]
18. Ogbuehi KC, Osuagwu UL. Repeatability and interobserver reproducibility of Artemis-2 high-frequency ultrasound in determination of human corneal thickness. Clin Ophthalmol. 2012; 6: 761-9. doi: 10.2147/OPTH.S31690. [PubMed]
19. Tomaszewski BT, Zalewska R, Mariak Z. Evaluation of the Endothelial Cell Density and the Central Corneal Thickness in Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma. Journal of Ophthalmology 2014;2014:123683. doi:10.1155/2014/123683. [PubMed]
20. Kitsos G, Gartzios C, Asproudis I, Bagli E. Central corneal thickness in subjects with glaucoma and in normal individuals (with or without pseudoexfoliation syndrome). Clin Ophthal. 2009;3:537-42. [PubMed]
21. Zheng X, Shiraishi A, Okuma S, Mizoue S, Goto T, Kawasaki S et al. In vivo confocal microscopic evidence of keratopathy in patients with pseudoexfoliation syndrome. Invest Ophthalmol Vis Sci. 2011 Mar;52(3):1755–61. doi: 10.1167/iovs.10-6098.