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      Correlation of central corneal thickness and axial length to the optic disc and peripapillary atrophy among healthy individuals, glaucoma and ocular hypertension patients

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          Abstract

          Purpose

          Clinical observational study for the correlation between the central corneal thickness (CCT), axial length (AXL), optic disc area (D), cupping area (C) and peripapillary atrophy (PPA), in healthy eyes (group A), eyes with primary open angle glaucoma (POAG) (group B) and eyes with ocular hypertension (OH) (group C), in order to assess the possible contribution of this correlation to the diagnosis or prognosis of glaucoma.

          Methods

          Ninety eyes of 90 persons participated in the study (30 eyes of 30 persons in each group). All eyes underwent intraocular pressure measurement, visual field testing, endothelial cell count (ECC), measurement of the CCT and AXL, and gonioscopy. After dilation of the pupil, a digital photograph of each optic disc was performed, followed by PPA, D area and C area measurements.

          Results

          We found a statistically significant difference in the C/D area ratio between healthy and POAG eyes and a moderate negative relationship between AXL and D in healthy eyes. We also found a moderate negative relationship between CCT and C/D area ratio in POAG eyes and a strong negative relationship between PPA and D in OH eyes.

          Conclusions

          CCT was not correlated with PPA and AXL in any one of the three groups. OH eyes seem to have more tolerant and stable disc and peripapillary area compared to healthy and POAG eyes.

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          Most cited references21

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          The Ocular Hypertension Treatment Study: baseline factors that predict the onset of primary open-angle glaucoma.

          The Ocular Hypertension Treatment Study (OHTS) has shown that topical ocular hypotensive medication is effective in delaying or preventing the onset of primary open-angle glaucoma (POAG) in individuals with elevated intraocular pressure (ocular hypertension) and no evidence of glaucomatous damage. To describe baseline demographic and clinical factors that predict which participants in the OHTS developed POAG. Baseline demographic and clinical data were collected prior to randomization except for corneal thickness measurements, which were performed during follow-up. Proportional hazards models were used to identify factors that predicted which participants in the OHTS developed POAG. In univariate analyses, baseline factors that predicted the development of POAG included older age, race (African American), sex (male), larger vertical cup-disc ratio, larger horizontal cup-disc ratio, higher intraocular pressure, greater Humphrey visual field pattern standard deviation, heart disease, and thinner central corneal measurement. In multivariate analyses, baseline factors that predicted the development of POAG included older age, larger vertical or horizontal cup-disc ratio, higher intraocular pressure, greater pattern standard deviation, and thinner central corneal measurement. Baseline age, vertical and horizontal cup-disc ratio, pattern standard deviation, and intraocular pressure were good predictors for the onset of POAG in the OHTS. Central corneal thickness was found to be a powerful predictor for the development of POAG.
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            Racial variations in the prevalence of primary open-angle glaucoma. The Baltimore Eye Survey.

            --To compare the prevalence of primary open-angle glaucoma between black and white Americans. --The design was a population-based prevalence survey of a noninstitutionalized black and white population aged 40 years or older from the eastern and southeastern health districts of Baltimore, Md. A multistage random sampling strategy was used to identify 7104 eligible participants, of whom 5308 (2395 blacks, 2913 whites) received an ophthalmologic screening examination. Those with abnormalities were referred for definitive diagnostic evaluation. --Primary open-angle glaucoma was defined based on evidence of glaucomatous optic nerve damage, including abnormal visual fields and/or severe optic disc cupping, and was independent of intraocular pressure. --Age-adjusted prevalence rates for primary open-angle glaucoma were four to five times higher in blacks as compared with whites. Rates among blacks ranged from 1.23% in those aged 40 through 49 years to 11.26% in those 80 years or older, whereas rates for whites ranged from 0.92% to 2.16%, respectively. There was no difference in rates of primary open-angle glaucoma between men and women for either blacks or whites in this population. Based on these data, an estimated 1.6 million persons aged 40 years or older in the United States have primary open-angle glaucoma. --Black Americans are at higher risk of primary open-angle glaucoma than their white neighbors. This may reflect an underlying genetic susceptibility to this disease and indicates that additional efforts are needed to identify and treat this sight-threatening disorder in high-risk communities.
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              Blood supply of the optic nerve head and its role in optic atrophy, glaucoma, and oedema of the optic disc.

              S Hayreh (1969)
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                Author and article information

                Journal
                Clin Ophthalmol
                Clinical Ophthalmology
                Clinical Ophthalmology (Auckland, N.Z.)
                Dove Medical Press
                1177-5467
                1177-5483
                December 2008
                December 2008
                : 2
                : 4
                : 981-988
                Affiliations
                [1 ] University of Athens, Department of Ophthalmology, Athens, Greece
                [2 ] Athens University Medical School, Department of Ophthalmology, Athens, Greece
                Author notes
                Correspondence: George Tomais, 9 Kriezi Str, Ilioupolis, Athens 16342, Greece, Tel +30 21 0364 6660, Fax +30 21 0940 7785, Email gematom@ 123456yahoo.gr
                Article
                co-2-981
                2699778
                19668457
                e9a14ba0-e560-444a-8210-113c5df2b03b
                © 2008 Tomais et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.
                History
                Categories
                Original Research

                Ophthalmology & Optometry
                peripapillary,glaucoma,corneal thickness,axial length,optic disc,cupping
                Ophthalmology & Optometry
                peripapillary, glaucoma, corneal thickness, axial length, optic disc, cupping

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