Purpose

To assess and compare the corneal biomechanics of normal-tension glaucoma (NTG), high-tension glaucoma (HTG), and normal controls based on stiffness and modulus. The correlations among central corneal thickness (CCT), visual field, retinal nerve fiber layer (RNFL) thickness, and corneal biomechanics in glaucoma eyes were also evaluated.

Design

A prospective, cross-sectional, comparative study.

Methods

This study included 334 eyes of 108 NTG patients, 113 HTG patients, and 113 control subjects at Zhongshan Ophthalmic Center, Sun Yat-Sen University. Corneal biomechanics were evaluated using a corneal indentation device (CID) and corneal visualization Scheimpflug technology (Corvis ST). Visual field and RNFL thickness were obtained using standard automated perimetry and spectral-domain optical coherence tomography. One-way analyses of variance with Bonferroni post hoc tests and a multivariable linear regression analysis with adjustment were conducted. Correlations among corneal biomechanical parameters, CCT, visual field, and RNFL thickness were analyzed.

Results

The corneal stiffness of the NTG patients (71.0 ± 10.9 N/m) was significantly lower than that of the HTG patients (77.3 ± 15.6 N/m; P = .001) and the CCT- and IOP-matched normal controls (75.6 ± 11.0 N/m; P = .023). The patients in the NTG group had lower corneal stiffness than those in the control group (β = -4.88, 95% CI –9.002, –0.758; P = .020) after adjusting for confounders. Stiffness was positively correlated with CCT in the NTG group (P = .028) but not in the HTG group (P = .509). There was no significant correlation (P > .05) between corneal biomechanics, visual field, or RNFL thickness.

Conclusions

The corneas of NTG patients were softer than those of HTG patients and controls, as assessed by CID, which were associated with thinner CCT. These might suggest different ocular biomechanical properties in NTG and HTG.

中文翻译：

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正常眼压性青光眼的角膜硬度和模量

目的

根据硬度和模量评估和比较正常眼压青光眼 (NTG)、高眼压青光眼 (HTG) 和正常对照组的角膜生物力学。还评估了青光眼患者中央角膜厚度 (CCT)、视野、视网膜神经纤维层 (RNFL) 厚度和角膜生物力学之间的相关性。

设计

一项前瞻性、横断面、比较研究。

方法

这项研究包括中山大学中山眼科中心的 108 名 NTG 患者、113 名 HTG 患者和 113 名对照受试者的 334 只眼睛。使用角膜压痕装置 (CID) 和角膜可视化 Scheimpflug 技术 (Corvis ST) 评估角膜生物力学。使用标准自动视野测量和光谱域光学相干断层扫描获得视野和 RNFL 厚度。进行了 Bonferroni 事后检验的单向方差分析和带调整的多变量线性回归分析。分析角膜生物力学参数、CCT、视野和RNFL厚度之间的相关性。

结果

NTG 患者的角膜硬度 (71.0 ± 10.9 N/m) 显着低于 HTG 患者 (77.3 ± 15.6 N/m; P  = .001) 和 CCT 和 IOP 匹配的正常对照组 (75.6 ± 11.0 牛/米；P  = .023）。在调整混杂因素后，NTG 组患者的角膜硬度低于对照组（β  = -4.88, 95% CI –9.002, –0.758；P  = .020）。NTG 组的刚度与 CCT 呈正相关（P  = .028），但在 HTG 组中则没有（P  = .509）。角膜生物力学、视野或 RNFL 厚度之间没有显着相关性 ( P > .05)。

结论

根据 CID 评估，NTG 患者的角膜比 HTG 患者和对照组的角膜更柔软，这与较薄的 CCT 相关。这些可能表明 NTG 和 HTG 具有不同的眼部生物力学特性。