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  • Corneal Hysteresis and Rates of Neuroretinal Rim Change

    By Jean Shaw
    Selected by Henry D. Jampel, MD, MHS
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    Journal Highlights

    Ophthalmology Glaucoma, September/October 2022

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    Jammal and Medeiros set out to eval­uate the impact of corneal hysteresis (CH) as a risk factor for progressive neuroretinal rim loss in glaucoma, using spectral-domain OCT of Bruch membrane opening minimum rim width (MRW). They found that lower CH measurements were associated with faster loss of the neuroretinal rim. In addition, they found that the predictive ability of CH was superior to that of central corneal thickness (CCT).

    For this prospective observational cohort study, the researchers assessed 70 participants (118 eyes) with glau­coma, all of whom had open angles on gonioscopy. The patients’ mean age at baseline was 71.2 ± 10 years. Thirty-two (46%) were women, and 25 (36%) were Black. Participants were evaluated at baseline and at six-month intervals, for an average follow-up time of 3.9 ± 1.3 years. Linear mixed models were used to investigate the relation­ship between the rates of MRW loss and baseline CH. Multivariable analyses were used to adjust for IOP, CCT, age, race, and baseline disease severity.

    At baseline, global MRW was 194 ± 60.3 μm. The average rate of MRW change was –.33 μm per year. A lower CH was significantly associated with MRW change: after adjustment for con­founders, each 1-mm Hg lower mea­surement of CH was associated with a faster MRW loss of –.38 μm per year (p = .019). With regard to mean IOP, each 1-mm Hg higher reading in pressure was correlated with a –.35 μm per year faster change in MRW (p < .001). In the analysis of predictive strength, the mean IOP was the strongest predictive factor (R2 = 23%), followed by CH (R2 = 14%) and baseline disease severity (R2 = 6%). CCT explained only 3% of the variability in slopes of change in global MRW.

    These results suggest that a clinical assessment of CH may contribute to the understanding of a patient’s risk of glaucoma progression, with CH prov­ing to be a more important predictive factor than CCT, the authors said.

    The original article can be found here.