Association Between Central Corneal Thickness and Intraocular Pressure in Patients with Refractive Anomalies and Emmetropes

Mimoza Ismaili

 
International Journal of Biomedicine. 2023;13(3):91-95.
DOI: 10.21103/Article13(3)_OA6
Originally published September 5, 2023

Abstract: 

Background: The aim of this study was to determine the relationship between central corneal thickness (CCT) and intraocular pressure (IOP) in patients with refractive anomalies and emmetropes.
Methods and Results: This retrospective study was conducted in the Department of Ophthalmology at the University Clinical Center. The study included 330 respondents, with a total of 660 eyes, divided into two groups. The test group (TG) included 180 respondents with refractive anomalies (65 respondents with hypertropia, 65 with myopia, and 50 with astigmatism); the control group (CG) included 150 respondents with uncorrected visual acuity – 6/6 in both eyes. All respondents included in the research were aged 18–40, with an average age of 22.9 years. The values of CCT in TG was around 499.3–577.1 μm. From 360 eyes in the TG with refractive anomalies, the highest IOP values were found in the astigmatic group (20.6 mmHg) and the lowest values in the myopic group (15.3 mmHg) (P<0.001) and were statistically higher compared to the CG (P<0.001 in both cases).
We found a statistically significant, moderate positive correlation between the values of CCT and IOP in the hypermetropic group (rs=0.655, 95% CI: 0.540 to 0.745, P<0.0001) and a statistically significant low negative correlation (rs=-0.209, 95% CI: -0.373 to -0.033, P=0.0165) between the values of CCT and IOP in the myopic group. Also, a statistically significant low negative correlation (rs=-0.304, 95% CI: -0.510 to -0.152, P=0.0005) was found between the values of CCT and IOP in the astigmatism group.
Conclusion: The results of our study show that increasing the CCT values in the hypermetropic group leads to an increase in the IOP values. Therefore, these findings can be used as a reference for our population, which would assist in the early diagnosis of ocular hypertension.

Keywords: 
central corneal thickness • refractive anomaly • intraocular pression
References: 
  1. Gab-Alla AA. Reversal of Myopic Correction for Patients Intolerant to LASIK. J Ophthalmol. 2021 Dec 15;2021:7113676. doi: 10.1155/2021/7113676.
  2. Gordon MO, Beiser JA, Brandt JD, Heuer DK, Higginbotham EJ, Johnson CA, Keltner JL, Miller JP, Parrish RK 2nd, Wilson MR, Kass MA. The Ocular Hypertension Treatment Study: baseline factors that predict the onset of primary open-angle glaucoma. Arch Ophthalmol. 2002 Jun;120(6):714-20; discussion 829-30. doi: 10.1001/archopht.120.6.714.
  3. Brandt JD, Beiser JA, Kass MA, Gordon MO. Central corneal thickness in the Ocular Hypertension Treatment Study (OHTS). Ophthalmology. 2001 Oct;108(10):1779-88. doi: 10.1016/s0161-6420(01)00760-6. 
  4. Cockburn DM. Effects of corneal thickness on IOP measurement. Clin Exp Optom. 2004 May;87(3):185-6. 
  5. Abdull MM, Sivasubramaniam S, Murthy GV, Gilbert C, Abubakar T, Ezelum C, Rabiu MM; Nigeria National Blindness and Visual Impairment Study Group. Causes of blindness and visual impairment in Nigeria: the Nigeria national blindness and visual impairment survey. Invest Ophthalmol Vis Sci. 2009 Sep;50(9):4114-20. doi: 10.1167/iovs.09-3507.
  6. Aslan L, Aslankurt M, Yüksel E, Özdemir M, Aksakal E, Gümüşalan Y, Özdemir G. Corneal thickness measured by Scheimpflug imaging in children with Down syndrome. J AAPOS. 2013 Apr;17(2):149-52. doi: 10.1016/j.jaapos.2012.10.020. 
  7. Hashemi H, Asgari S, Mehravaran S, Emamian MH, Shariati M, Fotouhi A. The distribution of corneal thickness in a 40- to 64-year-old population of Shahroud, Iran. Cornea. 2011 Dec;30(12):1409-13. doi: 10.1097/ICO.0b013e31822018dd.
  8. Hoffmann EM, Lamparter J, Mirshahi A, Elflein H, Hoehn R, Wolfram C, Lorenz K, Adler M, Wild PS, Schulz A, Mathes B, Blettner M, Pfeiffer N. Distribution of central corneal thickness and its association with ocular parameters in a large central European cohort: the Gutenberg health study. PLoS One. 2013 Aug 1;8(8):e66158. doi: 10.1371/journal.pone.0066158. 
  9. Uçakhan OO, Gesoğlu P, Ozkan M, Kanpolat A. Corneal elevation and thickness in relation to the refractive status measured with the Pentacam Scheimpflug system. J Cataract Refract Surg. 2008 Nov;34(11):1900-5. doi: 10.1016/j.jcrs.2008.07.018. 
  10. Juwayli RMM, Farag AAR, Shalaby AAEA. Correlation between Refractive Errors and Intraocular Pressure after Adjusting by Central Corneal Thickness. The Egyptian Journal of Hospital Medicine. 2021 January;82(3):581-586.
  11. Qayum SH. Correlation between Central Corneal thickness and Intraocular Pressure measured with Goldmann Applanation Tonometer (GAT) in healthy individuals. JMSCR. 2019;7(5) May.
  12. Osman EA, Gikandi PW, Al-Jasser AA, Alotaibi M, Mousa A. Comparison of Goldmann Applanation, Noncontact Air Puff, and Tono-Pen XL Tonometry in Normal Controls versus Glaucoma Patients at a University Hospital in Riyadh, Saudi Arabia. Middle East Afr J Ophthalmol. 2018 Jan-Mar;25(1):8-13. doi: 10.4103/meajo.MEAJO_291_16. 
  13. Shafiq I. Influence of Central Corneal Thickness (CCT) on Intraocular Pressure (IOP) Measured with Goldmann Applanation Tonometer (GAT) in Normal Individuals. Pak J Ophthalmol. 2008;24(4).
  14. Ehlers N, Bramsen T, Sperling S. Applanation tonometry and central corneal thickness. Acta Ophthalmol (Copenh). 1975 Mar;53(1):34-43. doi: 10.1111/j.1755-3768.1975.tb01135.x. 
  15. Wei W, Fan Z, Wang L, Li Z, Jiao W, Li Y. Correlation analysis between central corneal thickness and intraocular pressure in juveniles in Northern China: the Jinan city eye study. PLoS One. 2014 Aug 22;9(8):e104842. doi: 10.1371/journal.pone.0104842. 
  16. Johnson M, Kass MA, Moses RA, Grodzki WJ. Increased corneal thickness simulating elevated intraocular pressure. Arch Ophthalmol. 1978 Apr;96(4):664-5. doi: 10.1001/archopht.1978.03910050360012.
  17. Whitacre MM, Stein RA, Hassanein K. The effect of corneal thickness on applanation tonometry. Am J Ophthalmol. 1993 May 15;115(5):592-6. doi: 10.1016/s0002-9394(14)71455-2.
  18. Wong TY, Klein BE, Klein R, Knudtson M, Lee KE. Refractive errors, intraocular pressure, and glaucoma in a white population. Ophthalmology. 2003 Jan;110(1):211-7. doi: 10.1016/s0161-6420(02)01260-5.
  19. Nomura H, Ando F, Niino N, Shimokata H, Miyake Y. The relationship between intraocular pressure and refractive error adjusting for age and central corneal thickness. Ophthalmic Physiol Opt. 2004 Jan;24(1):41-5. doi: 10.1046/j.1475-1313.2003.00158.x. 
  20. Hagishima M, Kamiya K, Fujimura F, Morita T, Shoji N, Shimizu K. Effect of corneal astigmatism on intraocular pressure measurement using ocular response analyzer and Goldmann applanation tonometer. Graefes Arch Clin Exp Ophthalmol. 2010 Feb;248(2):257-62. doi: 10.1007/s00417-009-1202-7. 

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Received May 16, 2023.
Accepted June 10, 2023.
©2023 International Medical Research and Development Corporation.