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  • Corneal Hysteresis and Glaucoma Progression

    By Jean Shaw
    Selected By: Richard K. Parrish II, MD
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    Journal Highlights

    American Journal of Ophthalmology, April 2020

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    Wong et al. investigated the relation­ship between corneal hysteresis (CH) and displacement of the anterior lami­na cribrosa surface (ALCS) in patients with glaucoma. They found that lower CH was associated with ALCS displace­ment over time, suggesting that it is a risk factor for glaucoma progression.

    For this prospective observational case series, the researchers evaluated 96 patients (147 eyes) who either had glaucoma or were glaucoma suspects. The patients were followed for a mean of 3.5 years and 7.9 visits.

    The researchers used the Ocular Re­sponse Analyzer (ORA) to measure CH and spectral-domain optical coherence tomography (SD-OCT) to assess mean ALCS depth and choroidal thickness. The rate of change in ALCS depth was calculated using linear mixed effect models.

    Of the 147 eyes evaluated, 108 (73.4%) showed no significant ALCS displacement over time. However, 17 eyes (11.5%) showed posterior displacement, while 22 (15%) showed anterior displacement. Eyes with posterior displacement progressed more frequently than eyes with either anterior displace­ment or stable ALCS—and CH was significantly associated with a faster rate of posterior displacement during follow-up. Specifically, the researchers noted, for every 1 mm Hg decrease in CH, posterior displacement of the ALCS occurred at a rate of approxi­mately 0.66 μm per year.

    The results support the hypothesis that lower CH predisposes an eye to developing structural or functional glaucoma progression, the researchers said, as it serves as a marker for poste­rior ALCS displacement. Studies with a larger sample size and longer follow-up are needed.

    The original article can be found here.