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  • Low Corneal Hysteresis and Risk of Glaucoma Progression

    By Lynda Seminara
    Selected by Russell N. Van Gelder, MD, PhD
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    Journal Highlights

    Ophthalmology, April 2023

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    In an Ophthalmic Technology Assessment for the Academy, Sit et al. explored the utility of corneal hysteresis (CH) to assist clinicians in diagnosing glaucoma and assessing the risk of disease progres­sion. Results of their analysis showed that CH is lower when glaucoma is present and that low CH signals faster disease progression, even in patients whose IOP is well controlled.

    The researchers began by searching PubMed for relevant peer-reviewed articles published through July 2022. The search re­turned 423 abstracts, which were examined to rule out reviews and non-English articles. Studies that met the inclusion criteria were original research in adults, focused on CH measured by the Ocular Response Analyzer, and identified the risk of glaucoma progression or differentiated patients with glaucoma from healthy subjects. The final analysis set comprised four cohort studies, four cross-sectional studies, two case series, and three case-control studies.

    Relative to normal controls, most patients with primary open-angle glau­coma (POAG), primary angle-closure glaucoma, pseudoexfoliative glaucoma, or pseudoexfoliation syndrome were found to have lower CH. However, the interpretation of low CH in patients who had high IOP or were using hypo-tensive medications was hindered by the influence of these parameters on CH measurements. Moreover, CH was lower in treatment-naive patients with normal-tension glaucoma than in healthy controls whose IOP was similar. In patients with POAG, lower CH was linked to higher risk of glaucoma progression based on visual field or structural markers, even for those with well-controlled IOP. Most of the findings suggest that measuring CH is a potential adjunct for iden­tifying patients with glaucoma or gauging the risk of progression.

    Further re­search is needed to explore any causal relationship, said the authors. If low CH is found to be a causative factor for glaucoma and its progression, the alteration of ocular tissue properties to increase CH could become a new therapeutic target, independent of IOP reduction. The authors emphasized that measuring CH can complement the standard structural and functional assessments performed in patients with confirmed or suspected glaucoma.

    The original article can be found here.