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The cornea is one of the tissues responsible for covering and protecting the inner structures of the eye. Central corneal thickness (CCT) is defined as the distance between the anterior epithelial surface and the posterior surface of the endothelial layer. This parameter plays a very important role regarding intraocular pressure (IOP) measurement, evaluation of corneal uniformity, selection of a suitable technique for corneal refractive surgery and the planning of surgical procedures to overcome corneal disease. This comprehensive review elucidates the multifaceted factors influencing the central corneal thickness. Recognising the impact of these factors not only enhances our understanding of corneal dynamics but also contributes significantly to the refinement of diagnostic and therapeutic strategies in ophthalmology. [ABSTRACT FROM AUTHOR]

Background: Glaucoma, a chronic optic neuropathy, is the leading cause of irreversible blindness globally. The difficulties in the identification and treatment of open-angle glaucoma lie in the multifactorial nature of the disease, including individual variations, various risk factors, and the need for personalized treatment plans. Lowering intraocular pressure (IOP) is the only proven treatment for glaucoma, and controlling its fluctuations is crucial in preventing disease progression. Aims and Objectives: This study aimed to evaluate the association between IOP and various factors in primary open-angle glaucoma (POAG) subjects and compare it to control subjects. Materials and Methods: The study utilized a case-control design that included a total of 144 participants, divided into two groups: 72 individuals recently diagnosed with POAG and 72 apparently healthy subjects without glaucoma. The age range of the participants was between 40 and 75 years old, and both sexes were represented in the study. The factors examined were age, systolic blood pressure (SBP), diastolic blood pressure (DBP), and central corneal thickness (CCT). Results: The results of the study showed that individuals with POAG had significantly higher IOP, older age, higher SBP, and higher DBP compared to the control group. In addition, CCT was significantly lower in the POAG group. There were significant positive correlations between IOP and SBP, DBP, and CCT in both the POAG and control groups. There was also a significant negative correlation between age and IOP in both the groups. Conclusion: Determination of a target IOP and achieving the set target IOP does not give complete assurance that glaucoma progression will be prevented, as many other factors also play a part in it. The findings of this study highlight the importance of considering these factors when determining the target IOP for glaucoma treatment. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to evaluate anterior segment parameters across various phenotypes of polycystic ovary syndrome (PCOS), considering body mass index (BMI), serum estradiol and testosterone levels. Materials and Methods: This prospective study included 116 women with PCOS, with each of the four distinct phenotype comprising 29 women. Additionally, 29 healthy women were included in the control group. All participants underwent comprehensive ophthalmologic examinations, including intraocular pressure (IOP) measurements. Anterior segment parameters, such as central corneal thickness (CCT), axial length (AL), aqueous depth (AD), anterior chamber depth (ACD), and lens thickness (LT) were measured using optic biometry. Endothelial cell density (ECD) was assessed using non-contact specular microscopy. The BMI was calculated, and serum levels of estradiol and testosterone were noted. Results: IOP was found to be significantly higher (p = 0.003) and CCT was significantly thicker (p = 0.004) in all phenotypes of PCOS compared to the control group. BMI, serum estradiol and free testosterone were found to correlate with both IOP and CCT. AL, AD, ACD and LT values showed no significant differences compared to the control group. Although ECD tend to be higher in the PCOS phenotypes, this difference was not statistically significant (p > 0.05). Conclusion: Given our findings that CCT and IOP are significantly elevated in PCOS phenotypes. PCOS should be considered as an important factor when evaluating female patients for anterior segment diseases and glaucoma. [ABSTRACT FROM AUTHOR]

Purpose: To determine if early central corneal thickness (CCT) and best-corrected visual acuity (BCVA) changes indicate graft detachment after uncomplicated Descemet membrane endothelial keratoplasty (DMEK). Methods: In this analysis of our prospectively collected ADDA registry data (https://drks.de/search/de/trial/DRKS00027180), 45 pseudophakic eyes underwent DMEK surgery at the Department of Ophthalmology, RWTH Aachen University. Anterior segment optical coherence tomography (AS-OCT), the presence of stromal ripples on the posterior corneal surface, and BCVA measurements were assessed prior to, 1 day, 1 week, 1 month, and 6 months after surgery. Results: Eyes were categorized into three groups: no graft detachment (group 1) (20/45; 44.4%), < 1/3 graft detachment (group 2) (14/45; 31.1%), ≥ 1/3 graft detachment followed by rebubbling (group 3) (11/45; 24.4%). Eyes in group 3 had a greater CCT prior to (746.8 ± 95.8 µm vs. 665.0 ± 74.4 µm, P = 0.041), and 1 week (666.8 ± 119.5 µm vs. 556.5 ± 56.8 µm, P = 0.001) after DMEK compared to group 1. By 1 month, CCT in all groups aligned. Comparing prior to and 1 week after DMEK, none of the eyes in group 1 had an increase in CCT, while the CCT increased in 25.0% of eyes in group 2 and 22.2% in group 3. In group 1, 90.0% had a CCT of < 600 µm 1 week after DMEK, compared to only 50.0% in group 2 and 36.4% in group 3. In group 1, 90.0% (18/20) had an improved BCVA 1 week after DMEK, while in groups 2 and 3, 86.7% (12/14) and 18.2% (2/11) improved, respectively. One patient in group 3 showed posterior stromal ripples 1 day and 1 week after DMEK. Conclusion: If 1 week after uncomplicated DMEK CCT is < 600 µm and has decreased from before surgery, BCVA has improved, and there are no posterior stromal ripples, a graft detachment ≥ 1/3 and the need for rebubbling are very unlikely. In all other cases, meticulous slit-lamp and OCT inspection of the peripheral graft for detachments should be advised. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate and compare the accuracy of measuring central corneal thickness (CCT) using an ultrasonic pachymeter and a noncontact specular microscope and whether they can be used interchangeably in adult patients with healthy cornea. Methodology: A comparative and observational study was carried out in adult patients coming to the ophthalmology outpatient department (OPD) in a tertiary care hospital in Western India. In all patients, CCT is measured using an ultrasonic pachymeter and a noncontact specular microscope to perform a comparative study. Statistical analysis was done using paired t-test. Two-tailed hypothesis was applied. Results: This study included a sample size of 300 eyes of 150 adult patients. We want to test whether CCT values by Ultrasound Pachymeter and Noncontact specular Microscope is significantly different for right eyes and left eyes of the same patients, therefor we applied paired t-test for statistical analysis. T value for the right eye CCT measurement was −0.4 and the value of P was 0.69. T value for the left eye CCT measurement was −0.79 and the value of P was 0.43. P > 0.05 suggested that the results were nonsignificant. Conclusion: Our study suggests that the noncontact specular microscope produces CCT values that do not vary significantly from ultrasonic pachymeter. In subjects with healthy cornea, ultrasound pachymeter and specular microscope can be used interchangeably.

Abstract Purpose The objective of this study was to evaluate anterior segment parameters across various phenotypes of polycystic ovary syndrome (PCOS), considering body mass index (BMI), serum estradiol and testosterone levels. Materials and Methods This prospective study included 116 women with PCOS, with each of the four distinct phenotype comprising 29 women. Additionally, 29 healthy women were included in the control group. All participants underwent comprehensive ophthalmologic examinations, including intraocular pressure (IOP) measurements. Anterior segment parameters, such as central corneal thickness (CCT), axial length (AL), aqueous depth (AD), anterior chamber depth (ACD), and lens thickness (LT) were measured using optic biometry. Endothelial cell density (ECD) was assessed using non-contact specular microscopy. The BMI was calculated, and serum levels of estradiol and testosterone were noted. Results IOP was found to be significantly higher (p = 0.003) and CCT was significantly thicker (p = 0.004) in all phenotypes of PCOS compared to the control group. BMI, serum estradiol and free testosterone were found to correlate with both IOP and CCT. AL, AD, ACD and LT values showed no significant differences compared to the control group. Although ECD tend to be higher in the PCOS phenotypes, this difference was not statistically significant (p > 0.05). Conclusion Given our findings that CCT and IOP are significantly elevated in PCOS phenotypes. PCOS should be considered as an important factor when evaluating female patients for anterior segment diseases and glaucoma.

Purpose: To investigate the agreement between the Goldmann tonometer (GAT), the air-puff tonometer, and the iCare tonometer in intraocular pressure (IOP) evaluation as well as their association with central corneal thickness (CCT) in normal participants, glaucoma patients, and patients following refractive surgery. Methods: This is a cross-sectional study conducted on 204 eyes from 102 patients. The study consisted of three equal groups: group I (control group, n = 34), group II (glaucoma patients on medication, n = 34), and group III (refractive surgery patients, n = 34). All patients were subjected to examination (complete ocular examination, refraction, and IOP measurement). Results: A total of 102 participants were included in the study with both genders distributed equally. The mean ± standard deviation age was 44.12 ± 12.8 years in the control group while it was 46.29 ± 13.24 years in the glaucoma group and 40.68 ± 15.86 years in the refractive surgery group. Overall, there was a high correlation between the three methods. The mean IOP measured by GAT was 14.03 ± 3.43. The mean IOP measured by iCare was 15.16 ± 3.46. The mean IOP measured by air-puff was 16.66 ± 3.6. The iCare showed the most significant agreement with the GAT (intraclass correlation coefficient [ICC] 0.985, P > 0.05) and the mean difference in IOP between GAT and iCare was 1.1 (95% limits of agreement, −0.62–+2.85 mmHg). The mean difference in IOP between iCare and air-puff was 1.5 and it was 2.6 between GAT and air-puff. There were no significant differences in IOP measurements between GAT and iCare tonometer or between iCare tonometer and air-puff in all groups (P > 0.05). However, there were significant differences in IOP measurements between GAT and air-puff in all groups (P < 0.001). The ICC between all studied methods was strong (ICC > 0.92 for all). Regarding CCT, the mean CCT was 517.14 ± 29.82 μm. There were significant positive correlations between increasing CCT and increasing IOP by GAT, iCare, and air-puff tonometer among the three groups (P < 0.001). Conclusions: In conclusion, the iCare tonometer, specifically the iCare PRO RT model, is a reliable and efficient alternative instrument for assessing IOP. The IOP values obtained with the iCare PRO RT were found to be consistent with those obtained using the air-puff and GAT.

Abstract Background Age-related eye diseases (AREDs) have become increasingly prevalent with the aging population, serving as the leading causes of visual impairment worldwide. Epigenetic clocks are generated based on DNA methylation (DNAm) levels and are considered one of the most promising predictors of biological age. This study aimed to investigate the bidirectional causal association between epigenetic clocks and common AREDs or glaucoma endophenotypes. Methods Instrumental variables for epigenetic clocks, AREDs, and glaucoma endophenotypes were obtained from corresponding genome-wide association study data of European descent. Bidirectional two-sample Mendelian randomization (MR) was employed to explore the causal relationship between epigenetic clocks and AREDs or glaucoma endophenotypes. Multivariable MR (MVMR) was used to determine whether glaucoma endophenotypes mediated the association of epigenetic clocks with glaucoma. Multiple sensitivity analyses were conducted to confirm the robustness of MR estimates. Results The results showed that an increased intrinsic epigenetic age acceleration (HorvathAge) was significantly associated with an increased risk of primary open-angle glaucoma (OR = 1.04, 95% CI 1.02 to 1.06, P = 6.1E−04). The epigenetic age acceleration (EEA) of HannumAge was related to a decreased risk of primary angle-closure glaucoma (OR = 0.92, 95% CI 0.86 to 0.99, P = 0.035). Reverse MR analysis showed that age-related cataract was linked to decreased HannumAge (β = −0.190 year, 95% CI −0.374 to −0.008, P = 0.041). The EEA of HannumAge (β = −0.85 μm, 95% CI −1.57 to −0.14, P = 0.019) and HorvathAge (β = −0.63 μm, 95% CI −1.18 to −0.08, P = 0.024) were associated with decreased central corneal thickness (CCT). PhenoAge was related to an increased retinal nerve fiber layer thickness (β = 0.06 μm, 95% CI 0.01 to 0.11, P = 0.027). MVMR analysis found no mediation effect of CCT in the association of HannumAge and HorvathAge with glaucoma. DNAm-based granulocyte proportions were significantly associated with presbyopia, rhegmatogenous retinal detachment, and intraocular pressure (P

Background: The intraocular pressure (IOP) ranges of premature newborns are not the same as those in full-term newborns and adult population. There are no unified standards for IOP in infants, much less premature newborn. Research on the topic is very conflicting and needs to be expanded upon. To assess IOP in premature and full-term newborns and factors influencing it. Methods: Using a hand-held rebound tonometer, IOP was measured in 548 eyes of 274 preterm infants (gestational age ranging from 26 to 32 weeks) shortly after birth and at weekly intervals for one month. Results: The mean gestational age for premature newborns was 30.23±2.34 weeks (25-35 weeks), for full-term newborn it was 39.19±0.91 weeks (37-41 weeks). Mean IOP values in preterm infants were 21.95±4.36 mmHg (ranging from 11.1 to 32 mmHg), while for full-term were 13.5±2.9 (from 10.5 to 25.1 mmHg). At the end of the first month the mean IOP decreased to 17.66 ± 2.21 mm Hg (P < .001) for preterm newborns, while not changing in a statistically significant way for the full-term ones (P>0.5). Central corneal thickness was found to be among the major factors associated with increased IOP (P

Background: Age-related eye diseases (AREDs) have become increasingly prevalent with the aging population, serving as the leading causes of visual impairment worldwide. Epigenetic clocks are generated based on DNA methylation (DNAm) levels and are considered one of the most promising predictors of biological age. This study aimed to investigate the bidirectional causal association between epigenetic clocks and common AREDs or glaucoma endophenotypes. Methods: Instrumental variables for epigenetic clocks, AREDs, and glaucoma endophenotypes were obtained from corresponding genome-wide association study data of European descent. Bidirectional two-sample Mendelian randomization (MR) was employed to explore the causal relationship between epigenetic clocks and AREDs or glaucoma endophenotypes. Multivariable MR (MVMR) was used to determine whether glaucoma endophenotypes mediated the association of epigenetic clocks with glaucoma. Multiple sensitivity analyses were conducted to confirm the robustness of MR estimates. Results: The results showed that an increased intrinsic epigenetic age acceleration (HorvathAge) was significantly associated with an increased risk of primary open-angle glaucoma (OR = 1.04, 95% CI 1.02 to 1.06, P = 6.1E−04). The epigenetic age acceleration (EEA) of HannumAge was related to a decreased risk of primary angle-closure glaucoma (OR = 0.92, 95% CI 0.86 to 0.99, P = 0.035). Reverse MR analysis showed that age-related cataract was linked to decreased HannumAge (β = −0.190 year, 95% CI −0.374 to −0.008, P = 0.041). The EEA of HannumAge (β = −0.85 μm, 95% CI −1.57 to −0.14, P = 0.019) and HorvathAge (β = −0.63 μm, 95% CI −1.18 to −0.08, P = 0.024) were associated with decreased central corneal thickness (CCT). PhenoAge was related to an increased retinal nerve fiber layer thickness (β = 0.06 μm, 95% CI 0.01 to 0.11, P = 0.027). MVMR analysis found no mediation effect of CCT in the association of HannumAge and HorvathAge with glaucoma. DNAm-based granulocyte proportions were significantly associated with presbyopia, rhegmatogenous retinal detachment, and intraocular pressure (P < 0.05). DNAm-based plasminogen activator inhibitor-1 levels were significantly related to age-related macular degeneration and intraocular pressure (P < 0.05). Conclusion: The present study revealed a causal association between epigenetic clocks and AREDs. More research is warranted to clarify the potential mechanisms of the biological aging process in AREDs. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the percent change in central corneal thickness (%ΔCCT) during air-puff-induced deformation as an indicator of corneal biomechanical response. Methods: Forty ex vivo human eyes from forty donors were imaged using the CorVis ST at experimentally controlled intraocular pressure (IOP) of 10, 20, 30, and 40 mmHg, followed by uniaxial strip testing to calculate tensile modulus. The CorVis ST research software tracked the anterior and posterior cornea edges and determined the dynamic corneal response (DCR) parameters. Eyes were excluded if image quality or posterior tracking issues were present. Custom algorithms were used to calculate CCT during deformation using a ray-tracing method to correct for Scheimpflug and optical distortion within each image. Correlation and stepwise regression analyses between the shape-related DCR parameters and %ΔCCT were conducted. A mixed model analysis was performed to test the effect of IOP and the strongest significant predictors of the stepwise regression on %ΔCCT. The significance threshold was set to p < 0.05. Results: Thirty eyes were ultimately analyzed and CCT increased significantly from the pre-deformation state to the highest concavity state at each IOP level (p < 0.001). IOP and multiple shape DCRs were found to be significantly related to %ΔCCT (p < 0.0001). The strongest predictor of %ΔCCT was integrated inverse radius (IIR) (p < 0.0001; partial R2 = 0.4772) with no other parameter having a partial R2 value greater than 0.04. The mixed model analysis showed that IIR was the sole predictor (p = 0.0098) and IOP was no longer significant as a single predictor. However, the interaction of IIR with IOP (p = 0.0023) had a significant effect on %ΔCCT. Conclusion: Percent change in CCT is influenced by corneal stiffness as indicated by the significant relationship with IIR. The %ΔCCT may be a potential biomarker for determining differences in corneal deformation response with corneal diseases. [ABSTRACT FROM AUTHOR]

Purpose: Noncontact instruments like Pentacam Scheimpflug imaging allows assessment of corneal Pachymetry with good repeatability and reproducibility as compared to ultrasound. We aimed to differentiate corneal thinnest point and central corneal thickness on basis of magnitude and location, and its relation to age, sex, laterality, spherical equivalent and astigmatism in myopes. Study Design: Correlational study. Place and Duration of Study: Hashmani’s Hospital Karachi from March 2021 to May 2021. Methods: We enrolled 92 eyes (38 males, 54 females) of myopic adult patients from age 19-52 years. Prescreening of myopes (-0.75DS to -8.00DS) included refraction, slit-lamp biomicroscopy and fundoscopy. Participants with ocular disease, previous ocular surgery, contact lens and history of any eye drops use were excluded from the study. Pentacam was used to determine CCT, thinnest corneal thickness (TCT) and vector location of TCT. Results: Majority (77%) of the eyes had myopic astigmatism whereas 23% had simple myopia. We found statistically significant difference between CCT and TCT. Inferotemporal and inferonasal displacements of TCT were noted. No difference was noted between TCT and its location among the two sexes. We observed that alteration among the CCT and TCT in both age groups was statistically significant. Conclusion: CCT and TCT are separate measurements and both are important since their magnitudes and locations might differ greatly especially with age. Both reading have significance in determining post-operative risk of corneal ectasia, assessment for refractive surgeries and early detection of ectatic conditions like keratoconus. [ABSTRACT FROM AUTHOR]

Background: The intraocular pressure (IOP) ranges of premature newborns are not the same as those in full-term newborns and adult population. There are no unified standards for IOP in infants, much less premature newborn. Research on the topic is very conflicting and needs to be expanded upon. To assess IOP in premature and full-term newborns and factors influencing it. Methods: Using a hand-held rebound tonometer, IOP was measured in 548 eyes of 274 preterm infants (gestational age ranging from 26 to 32 weeks) shortly after birth and at weekly intervals for one month. Results: The mean gestational age for premature newborns was 30.23±2.34 weeks (25-35 weeks), for full-term newborn it was 39.19±0.91 weeks (37-41 weeks). Mean IOP values in preterm infants were 21.95±4.36 mmHg (ranging from 11.1 to 32 mmHg), while for full-term were 13.5±2.9 (from 10.5 to 25.1 mmHg). At the end of the first month the mean IOP decreased to 17.66 ± 2.21 mm Hg (P < .001) for preterm newborns, while not changing in a statistically significant way for the full-term ones (P>0.5). Central corneal thickness was found to be among the major factors associated with increased IOP (P<.001). Conclusion: Measured values of IOP are well outside the normal range for newborns. There is a tendency for decreasing IOP observed during the first month screening which decreases the value of the initial findings. The exact causes of the decrease of IOP are not completely clear up to this point. Use of eyelid speculum needs to be avoided to prevent artificial increase of IOP. [ABSTRACT FROM AUTHOR]

Our objective was to evaluate the topographic and surgical factors of early myopic regression between laser in situ keratomileusis (LASIK) and small-incision lenticule extraction (SMILE). A retrospective case–control study was conducted, and 368 and 92 eyes were enrolled in the LASIK and SMILE groups via propensity score matching (PSM). Visual acuity, refractive status, axial length, and topographic/surgical parameters were collected. Multiple linear regression was applied to the yield coefficient and the 95% confidence interval (CI) of the parameters. The cumulative incidence of early myopic regression was higher in the LASIK group (p < 0.001). In the SMILE group, a lower central corneal thickness (CCT) thinnest value and a higher corneal cylinder associated with early myopic regression were observed; meanwhile, in the LASIK group, a lower CCT thinnest value, a higher steep corneal curvature, a larger optic zone, and a lower flap thickness related to early myopic regression were observed (all p < 0.05). In the SMILE group, a higher CCT difference correlated with early myopic regression was observed compared to the LASIK group (p = 0.030), and higher steep corneal curvature and lower cap/flap thickness (both p < 0.05) correlated with early myopic regression were observed in the LASIK group compared to the SMILE group. In conclusion, CCT differences significantly influence early myopic regression in the SMILE group; meanwhile, corneal curvature and flap thickness affect early myopic regression principally in the LASIK group. [ABSTRACT FROM AUTHOR]

Purpose: To compare central corneal thickness (CCT) measured with optical coherence tomography (OCT) using an automatic algorithm (A-OCT) vs. manual measurements (M-OCT) with respect to the gold standard ultrasound pachymetry (USP). Methods: CCT measurements were performed on both eyes of 28 healthy subjects at four times of the day. A-OCT used an automatic software analysis of the corneal image, M-OCT was performed by two operators by setting a digital calliper on the corneal borders, and USP was performed after corneal anesthesia. Measurements were compared using a three-way repeated measures ANOVA. Bland–Altman plots were used to evaluate the agreement between OCT measurements and USP. Results: Both A-OCT and M-OCT significantly underestimated the USP measures, with the mean difference, i.e., the systematic error, being larger for A-OCT (− 19.0 µm) than for M-OCT (− 6.5 µm). Good reproducibility between the two operators was observed. Bland–Altman plots showed that both OCT methods suffered from proportional errors, which were not affected by time and eye. Conclusions: Measuring CCT with OCT yielded lower values than USP. Therefore, clinicians should be aware that corneal thickness values may be influenced by the measurement method and that the various devices should not be used interchangeably in following up a given patient. Intriguingly, M-OCT had less systematic error than A-OCT, an important outcome that clinicians should consider when deciding to use an OCT device. [ABSTRACT FROM AUTHOR]

Introduction: Cataract surgery poses a risk to corneal endothelial cells. This study aimed to assess the protective effect of rho-associated kinase inhibitor eye drop (ripasudil) on corneal endothelial cells after cataract surgery over 12 months. Methods: We conducted a prospective, non-randomized, non-blinded comparative study including 43 patients divided into two groups: the ripasudil group (22 patients, 23 eyes) and the control group (21 patients, 21 eyes). All patients had grade 3 nuclear cataract and underwent uneventful phacoemulsification with intraocular lens implantation. In the ripasudil group, one drop of ripasudil hydrochloride hydrate (Glanatec® ophthalmic solution 0.4%) was administered three times a day for 5 days. Outcome measures included central corneal thickness (CCT) and endothelial cell density (ECD), which were evaluated preoperatively and 12 months postoperatively. Results: In the ripasudil group, the median ECD was 2398 (interquartile range [IQR] 410, 2201–2611) cells/mm2 at baseline and 2262 (IQR 298, 2195–2493) cells/mm2 at 12 months postoperatively. In the control group, the median ECD was 2503 (IQR 390, 2340–2730) cells/mm2 at baseline and 2170 (IQR 324, 2049–2373) cells/mm2 at 12 months postoperatively. Endothelial cell loss (ECL) was 12.8% in the control group, significantly reduced to 4.5% in the ripasudil group (p = 0.001*). CCT (p = 0.042), age (p = 0.383), sex (p = 0.944), and duration of surgery (p = 0.319) were not significant factors. No adverse effects were observed in either of the groups. Conclusions: Incorporating ripasudil into postoperative management could help maintain corneal endothelial cell integrity and reduce cell loss after cataract surgery, potentially decreasing the need for endothelial transplantation in patients who have undergone intraocular surgeries. [ABSTRACT FROM AUTHOR]

IntroductionSystemic lupus erythematosus (SLE) is a chronic autoimmune disease affecting multiple systems and classified under connective tissue disorders. Ocular involvement occurs in up to 30% of SLE cases, with the cornea being particularly susceptible to thinning due to immune-complex deposits and its predominantly type I collagen composition. This corneal thinning is clinically significant in glaucoma, where patients with reduced central corneal thickness (CCT) may have up to a threefold increased risk of developing glaucoma, as well as in refractive surgery. However, existing studies on CCT in SLE are limited and marked by substantial heterogeneity in methodology, technology, criteria, and participant numbers, resulting in conflicting findings. Based in our hypothesis that SLE-related corneal lysis may result in decreased CCT, this study aims to determine and compare the mean CCT values between SLE patients and healthy controls to obtain a more precise understanding of the potential relationship.Methods and analysisA cross-sectional observational study will be conducted, enrolling SLE patients and age-and sex-matched healthy controls recruited from ophthalmology consultations. Exclusion criteria will be applied to rule out other corneal thinning risk factors. A pilot study estimated a minimum sample size of 34 participants per group. CCT measurements will be obtained using Zeiss HD Cirrus 5,000 optical coherence tomography (OCT) on a randomly selected eye, following concordance analysis using the Kappa index. Statistical analysis will include descriptive, bivariate, and multivariate methods. The study protocol was approved by the ethics committee.DiscussionThe cornea’s vulnerability to thinning and lysis in SLE, which impacts CCT, is crucial for the accurate assessment of glaucoma, the leading cause of irreversible blindness worldwide and the second leading cause in Europe. Given that patients with reduced CCT are at a significantly higher risk of developing glaucoma, further research is necessary to understand the association between SLE and CCT. Our study aims to enhance methodological rigor compared to prior research by determining an appropriate sample size and exclusively enrolling SLE patients to increase participant homogeneity. If a significant difference in CCT between groups and an association between CCT and SLE are found, a prospective study will be considered.

Purpose: The purpose of this study was to evaluate the correlations and consistency among the central corneal thickness (CCT) of healthy myopic patients measured with three different anterior segment analysis systems. Design: This was a retrospective study. The study included myopia patients who had undergone preoperative examinations in the refractive surgery department of our hospital between January 2021 and December 2023. The CCT was measured separately using Pentacam, Sirius, and IOLMaster 700. Methods: Statistical analysis was conducted using SPSS software. Correlations among the three groups of measured values were assessed using the Pearson method, and a simple scatter plot and fitting line were drawn. Bland‒Altman scatter plots and 95 % limits of agreement (LoAs) were used to evaluate consistency in the data among the systems. Results: A total of 269 patients participated in the study, including 134 males (49.8 %) and 135 females (50.2 %). The CCT measurements by Pentacam, Sirius, and IOLMaster 700 instruments were found to be 541.63 ± 31.67 μm, 541.74 ± 33.36 μm, and 548.90 ± 34.19 μm respectively; significant differences were observed among these measurements (p < 0.05). Significant differences were also observed in CCT between Pentacam and IOLMaster 700 as well as between Sirius and IOLMaster 700 (p < 0.05). The CCT measurements by all three devices showed high positive correlation with all p values less than 0.001: Pentacam and Sirius, r = 0.972; Pentacam and IOLMaster 700, r = 0.966; and Sirius and IOLMaster 700, r = 0.962. The respective 95 % LoAs were -0.18∼0.18; -1.51∼-1.11; and -1.52∼-1. Conclusion: The results indicate that there is a high correlation in measuring CCT for healthy myopic eyes using three different anterior segment analysis systems. However, the differences in the values measured by the three devices were statistically significant. Therefore, in actual clinical practice, it is suggested that the same device should be used to measure and evaluate the CCT across visits.

Background & Aims: Glaucoma usually undiagnosed in general population. People usually ignores the symptoms and came late when disease already get worsened. This study aimed to compare intraocular pressures in general population having inclusion criteria with different types of tonometers and its correlation with central corneal thickness in patients presenting in OPD at Ophthalmology Department of Sir T hospital, Bhavnagar, Gujarat. Materials & Methods: In this Hospital based cross-sectional observational study with 9-month duration, 72 patients between the ages of 30–75 years were evaluated, after taking into consideration the inclusion and exclusion criteria. Detailed history taken including chief complaints, past history, family history, personal history followed by general and systemic examination. 72 patients having inclusion exclusion criteria were analyzed with three different tonometers (Goldmann applanation, Non-contact tonometer (NCT), Schiotz tonometer), and the correlation between each other were measured. Then central corneal thickness is measured with OCT Tomography, and the results were compared to intraocular pressure (IOP). Results: When compared to the non-contact tonometer, we found that the Schiotz tonometer had the highest correlation. These associations were also seen in people with diabetes and hypertension. Nonetheless, as patients age, there is a corresponding rise in the correlation between the gold standard approach and the tonometer. Conclusion: All the tonometer showed significant correlation with the gold standard technique (Goldmann applanation tonometer), over a range of intra ocular pressure, between the ages of 30 -75 years, in diabetics and hypertensive patients, and in the patients with different CCT values.

Abstract Introduction Cataract surgery poses a risk to corneal endothelial cells. This study aimed to assess the protective effect of rho-associated kinase inhibitor eye drop (ripasudil) on corneal endothelial cells after cataract surgery over 12 months. Methods We conducted a prospective, non-randomized, non-blinded comparative study including 43 patients divided into two groups: the ripasudil group (22 patients, 23 eyes) and the control group (21 patients, 21 eyes). All patients had grade 3 nuclear cataract and underwent uneventful phacoemulsification with intraocular lens implantation. In the ripasudil group, one drop of ripasudil hydrochloride hydrate (Glanatec® ophthalmic solution 0.4%) was administered three times a day for 5 days. Outcome measures included central corneal thickness (CCT) and endothelial cell density (ECD), which were evaluated preoperatively and 12 months postoperatively. Results In the ripasudil group, the median ECD was 2398 (interquartile range [IQR] 410, 2201–2611) cells/mm2 at baseline and 2262 (IQR 298, 2195–2493) cells/mm2 at 12 months postoperatively. In the control group, the median ECD was 2503 (IQR 390, 2340–2730) cells/mm2 at baseline and 2170 (IQR 324, 2049–2373) cells/mm2 at 12 months postoperatively. Endothelial cell loss (ECL) was 12.8% in the control group, significantly reduced to 4.5% in the ripasudil group (p = 0.001*). CCT (p = 0.042), age (p = 0.383), sex (p = 0.944), and duration of surgery (p = 0.319) were not significant factors. No adverse effects were observed in either of the groups. Conclusions Incorporating ripasudil into postoperative management could help maintain corneal endothelial cell integrity and reduce cell loss after cataract surgery, potentially decreasing the need for endothelial transplantation in patients who have undergone intraocular surgeries.

Abstract We sought to evaluate the topographic risk factors for early myopic regression after small-incision lenticule extraction (SMILE). A retrospective case‒control study was conducted, and individuals who underwent SMILE surgery were enrolled. Among them, 406 and 14 eyes were categorized into the nonregression and regression groups, respectively. The preoperative and postoperative parameters in the two groups were collected, including spherical refraction (SE), axial length (AXL) and topographic data. A generalized linear model was adopted to analyze the difference in each parameter between the two groups. After 6 months, UCVA decreased in the regression group, and SE increased in the regression group (both P

Introduction: To compare early postoperative effects of uncomplicated phacoemulsification surgery on corneal endothelial cells and thickness in patients with pseudoexfoliation syndrome (PEX). Methods: One eye each of 32 patients with PEX and 32 age-matched non-PEX subjects was evaluated preoperatively and on the 1st, 7th, and 30th days after uncomplicated phacoemulsification surgery in this retrospective case-control study. Nuclear firmness, corneal edema (CE), anterior chamber reaction (ACR) intensity were graded by a slit-lamp microscope. Endothelial cell density (ECD), coefficient of variation in cell area (CV), hexagonal cell ratio (HEX), and central corneal thickness (CCT) were measured using a non-contact specular microscope. Results: There was no significant group-difference in age, sex, corneal edema (CE), anterior chamber reaction (ACR), coefficient of variation in cell area (CV), and hexagonal cell ratio (HEX). Mean effective phaco time (EPT) was significantly lower intraoperatively (p<0.001) and logarithm of the minimum angle of resolution (logMAR) values of best-corrected visual acuity (BCVA) were significantly higher on both 1st (p<0.001), 7th (p=0.011), and 30th (p=0.025) days postoperatively in the PEX group than in the non-PEX group. Mean ECD was significantly lower in the PEX group than in the non-PEX group on 7th (p=0.013), and 30th (p=0.037) days postoperatively. The mean CCT significantly differed only on the 1st (p<0.001) day postoperatively. Discussion and Conclusion: Eyes with PEX presented lower corneal ECD and decreased BCVA after uncomplicated phacoemulsification surgery. Further, there was no association between CCT and PEX existence preoperatively and in the early postoperative period. [ABSTRACT FROM AUTHOR]

Introduction: Glaucoma causes a reduction of contrast sensitivity (CS) while thinner central corneal thickness is (CCT) associated with the risk of glaucoma. Thus, in glaucoma suspect patients, CS and CCT measurements may better evaluate and monitor the disease. The purpose of this study was to compare CS and CCT between a Primary Open Angle Glaucoma (POAG) suspect group and a normal group of similar age. Methods: CS was measured with the Pelli-Robson CS chart, while CCT was measured with a hand-held pachymeter. In total, 115 glaucoma suspects and 102 normal participants were included. Results: There was a significant effect of the clinical condition on CS [F(1,209)=5.409, p=0.02]. The effect of age on CS was also significant [F(3,209)=20.419, p<0.001]. The interaction between age and clinical condition was not statistically significant [F(3,209)=0.815, p=0.49]. CS of POAG suspects was significantly lower than that of the normal group for the younger age groups (40 to 59 years old) but not for the older age groups (50 to 80 years old). There was no significant effect of clinical condition on CCT [F(3,209)=0.754, p=0.39]. However, there was a significant effect of age on CCT [F(3,209)=3.789, p=0.01]. Conclusion: Contrast sensitivity measurement is potentially useful to be integrated with routine investigations for POAG suspect patients, especially those who are younger than 60 years old. Measurements of central corneal thickness alone may not be able to differentiate between POAG suspects and visually normal individuals. [ABSTRACT FROM AUTHOR]

The VEMoS-AXL system is a new optical biometer based on spectral domain optical coherence tomography (SD-OCT) that has been tested in terms of intrasession repeatability and compared with a swept-source optical coherence tomography biometer (SS-OCT), which is recognized as the gold standard for the performance of an agreement analysis. A biometric analysis was performed three consecutive times in 120 healthy eyes of 120 patients aged between 18 and 40 years with the SD-OCT system, and afterwards, a single measurement was obtained with the SS-OCT system. Within-subject standard deviations were 0.004 mm, 4.394 µm, and 0.017 mm for axial length (AL), central corneal thickness (CCT), and anterior chamber depth (ACD) measures obtained with the SD-OCT biometer, respectively. The agreement between devices was good for AL (limits of agreement, LoA: −0.04 to 0.03 mm) and CCT (LoA: −4.36 to 14.38 µm), whereas differences between devices were clinically relevant for ACD (LoA: 0.03 to 0.21 mm). In conclusion, the VEMoS-AXL system provides consistent measures of anatomical parameters, being most of them interchangeable with those provided by the SS-OCT-based gold standard. [ABSTRACT FROM AUTHOR]

ObjectiveTo investigate the pathogenesis of Primary Angle-Closure Glaucoma (PACG) and its relationship with the anatomical structure of the anterior segment by obtaining biometric parameters using the IOL-Master 700.MethodsA retrospective case–control study was conducted. Clinical data from 39 PACG patients and 40 normal controls treated at the Aier Eye Hospital affiliated with Wuhan University from January to December 2022 were collected. Anterior chamber depth (AC), white-to-white (WTW), lens thickness (LT), central corneal thickness (CCT), axial length (AL), corneal curvature (K1), corneal curvature (K2), and lens position (LP) were measured using the IOL-Master 700 to analyze the characteristics and differences in the anterior segment structure of both groups. Statistical methods included independent sample t-tests and logistic regression analysis.ResultsSignificant differences were found in the anterior segment biometric parameters between PACG patients and normal controls (p

Introduction: Glaucoma, a leading cause of blindness worldwide, is primarily caused by elevated intraocular pressure (IOP). Accurate and reliable IOP measurements are the key to diagnose the pathology in time and to provide for effective treatment strategies. The currently available methods for measuring IOP include contact and non contact tonometers (NCT), which estimate IOP based on the corneal deformation caused by an external load, that in the case of NCT is an air pulse. The deformation of the cornea during the tonometry is the result of the coupling between the IOP, the mechanical properties of the corneal tissue, the corneal thickness, and the external force applied. Therefore, there is the need to decouple the four contributions to estimate the IOP more reliably.Methods: This paper aims to propose a new methodology to estimate the IOP based on the analysis of the mechanical work performed by the air jet and by the IOP during the NCT test. A numerical eye model is presented, initially deformed by the action of a falling mass to study the energy balance. Subsequently, Fluid-Structure Interaction (FSI) simulations are conducted to simulate the action of Corvis ST.Results and discussion: The new IOP estimation procedure is proposed based on the results of the simulations. The methodology is centred on the analysis of the time of maximum apex velocity rather than the point of first applanation leading to a new IOP estimation not influenced by the geometrical and mechanical corneal factors.

Takahiro Tanaka, Koichi Nishitsuka, Hiroto Obata Department of Ophthalmology, Saitama Medical Center, Saitama Medical University, Kawagoe-shi, Saitama, JapanCorrespondence: Koichi Nishitsuka, Department of Ophthalmology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama, Japan, Tel +81-49-228-3682, Fax +81-49-225-5722, Email mlc12186@nifty.comPurpose: Ocular parameters are not only useful for diagnosing diseases but also for guiding treatment approaches. A lot of previous studies have reported ocular parameters and its relations before cataract surgery. However, despite ethnic differences in ocular biometry, few reports have dealt with Japanese. Hence, this retrospective cross-sectional study aimed to measure parameters of preoperative cataract patients and examines the correlations between each parameter in Japanese elderly people.Patients and Methods: The 210 subjects had their ocular axial lengths measured with OA-2000. The endpoints were ocular axial length (AL), central corneal thickness (CCT), average anterior corneal radius of curvature (CR), white-to-white (WTW), anterior chamber depth (ACD), and lens thickness (LT). Our analyses utilized the eye with the longer AL in each person. Each parameter was analyzed for correlations in a round-robin manner. Regression analyses were performed on parameters correlated with AL.Results: The parameters correlated with AL were CR (r = 0.33, P < 0.0001), WTW (r = 0.29, P < 0.0001), ACD (r = 0.59, P < 0.0001), and LT (r = − 0.30, P < 0.0001). These parameters related to AL in all simple regression equations (CR (P < 0.0001), WTW (P = 0.0002), ACD (P < 0.0001), LT (P = 0.0001)). In multiple regression analyses, CR, ACD, and LT might relate to AL (CR (P = 0.0002), ACD (P < 0.0001), LT (P = 0.018)). LT tended to be thinner as AL increased, while CR, WTW, and ACD tended to increase.Conclusion: This information may be useful in developing strategies for ophthalmic surgery, as it provides information on the location of intraocular tissues. Various parameters have been used in intraocular lens (IOL) power calculations in recent years and knowledge of the interrelationship among parameters may be useful in determining IOL power according to ethnicity in the future.Keywords: preoperative cataract patients, central corneal thickness, average anterior corneal radius of curvature, white-to-white, anterior chamber depth, lens thickness

Introduction/Objective. Intraocular pressure is an important parameter of eye health, especially when glaucoma is suspected. So far, few studies have been published that aimed to determine the average value of intraocular pressure and central corneal thickness in a healthy population aged 20–30 years. The aim of this study was to determine the distribution of the values of intraocular pressure and central corneal thickness in healthy student population. Methods. In a cross-sectional study, intraocular pressure and central corneal thickness were measured on a sample of a healthy population, aged 22–37 years. Intraocular pressure was measured using the Goldmann applanation tonometry method, while central corneal thickness was measured using ultrasound pachymetry. The analysis of numerical values was done using the methods of descriptive statistics. Results. By measuring intraocular pressure and central corneal thickness in 641 subjects (1282 eyes), the average value of intraocular pressure was determined to be 14.79 ± 2.31 mmHg, and central corneal thickness was 553.92 ± 25.56 μm. By comparing two groups of subjects, one male group and the other one female, we determined that there was no statistically significant difference in the average value of intraocular pressure (t-test, p > 0.05), and the average value of central corneal thickness (t-test, p > 0.05) between the sexes. Conclusion. The determined average value of intraocular pressure and central corneal thickness is similar to those determined in other cross-sectional studies of this type. No statistically significant difference was found in the intraocular pressure values and the central thickness of the cornea by sex.

Purpose: Corneal thinning is common in rheumatoid arthritis (RA), thereby affecting the central corneal thickness (CCT). Effect of hydroxychloroquine (HCQ) in RA has abounding literature on retinal toxicity, but there is lack of data on its corneal effects. Methods: A cross-sectional study was carried out to compare CCT in RA patients before treatment initiation (Group 1) with CCT in those on HCQ for ≥3 months (Group 2). Results: Fifty patients were enrolled in each group. The mean age was 44.36 years with similar age, gender distribution and visual acuity in both groups. The mean CCT of patients in the cohort was 521.80 μm ± 32.57 μm and 523.94 μm ± 33.40 μm in the right eye (RE) and left eye (LE), respectively. Mean CCT in Group 1 was (RE) 522.80 μm/(LE) 524.26 μm and in Group 2 was (RE) 520.80 μm/(LE) 523.62 μm, and there was no significant difference in CCT between both the groups. Median duration of HCQ usage in Group 2 was 24 months, with the median cumulative dosage being 171 g and a majority having a dosage of 200 mg/day. There was no significant correlation between the duration/cumulative dosage of HCQ intake and CCT. No corneal deposits were identified in any patient. Conclusion: CCT of RA patients was similar to those reported in the Indian literature. However, there was no significant change in CCT or corneal deposits identified with an HCQ dosage of 200–400 mg/day. Longer follow-up would provide clarity on the impact of duration and cumulative dosage of HCQ on corneal changes and CCT.

Objective: to identify the features of biomechanical parameters of the fibrous capsule of the eye in patients after radial keratotomy (RK). Materials and methods. 87 eyes were examined after radial keratotomy, the average age was 59.8 ± 0.83 years. With glaucoma 47 eyes, without — in 40 eyes. Patients were divided into three groups: 17 eyes with a central corneal thickness (CCT) of less than 530 microns; 30 eyes with a CCT of 530–580 microns; 40 eyes with a CCT of more than 580 microns. The control group consists of myopic patients without glaucoma, without PES, over 45 years old. Corneal tomography and biomechanical parameters were measured using Pentacam (Oculus) and CorVis ST, respectively. Results. in the eyes after RK, the corneal stiffness (DA ratio, R) is higher in comparison with the control and increases with an increase in CCT. The stiffness of the fibrous capsule of the eye (SP-A1) after RK is reduced in comparison with the control and increases with an increase in CCT. The SSI analysis showed a higher stiffness of the eyeball than in the control, regardless of the CCT. BGF is higher in the eyes after RK compared to the control with the maximum value for thin corneas. Hyperopic shift (HS) after RK is distinctive for eyes with glaucoma. With a CCT of more than 580 microns, HS is a clinical glaucoma detector, with thin corneas, it is not. Conclusion. The eye after RC is characterized by an increase in the stiffness of the cornea, a decrease in the stiffness of the fibrous capsule of the eye, a general increase in the stiffness of the eyeball and HS.

Sandra Owusu,1 Ebenezer Zaabaar,1,2 Michael Agyemang Kwarteng,3,4 Samuel Ankamah,5 John Baptist Vianney Abowine,6 Samuel Kyei1,7 1Department of Optometry and Vision Science, University of Cape Coast, Cape Coast, Ghana; 2Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong; 3Department of Optometry, Bindura University of Science Education, Bindura, Zimbabwe; 4Discipline of Optometry, University of Kwazulu-Natal, Durban, South Africa; 5University of Ghana Library System, University of Ghana, Accra, Ghana; 6Dr. Rose Mompi Eye Hospital, Hohoe, Ghana; 7Biomedical and Clinical Research Center, University of Cape Coast, Cape Coast, GhanaCorrespondence: Samuel Kyei, Email skyei@ucc.edu.ghAbstract: Scheimpflug Pentacam Tomography is becoming crucial in the diagnosis and monitoring of keratoconus, as well as in pre- and post-corneal refractive care, but there are still some inconsistencies surrounding its evidence base diagnostic outcome. Therefore, this study aimed at employing meta-analysis to systematically evaluate the keratometric, pachymetric, and pachymetric progression indices used in the diagnosis of Keratoconus. The review protocol was registered with PROSPERO (Identifier: CRD4202310058) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed, MEDLINE, Web of Science, and EMBASE were used for data search, followed by a quality appraisal of the included studies using the revised tool for the quality assessment of diagnostic accuracy studies (QUADAS-2). Meta-analysis was conducted using the meta (6.5.0) and metafor (4.2.0) packages in R version 4.3.0, as well as Stata. A total of 32 studies were included in the analysis. All keratometry (K) readings (flattest meridian, K1; steepest meridian, K2, maximum, Kmax) were significantly steeper in keratoconic compared to normal eyes: [MD (95% CI)], K1 [2.67 (1.81; 3.52)], K1-back [− 0.71 (− 1.03; − 0.39)], K1-front [4.06 (2.48; 5.63)], K2 [4.32 (2.89; 5.75)], K2-back [− 1.25 (− 1.68; − 0.82)], K2-front [4.82 (1.88; 7.76)], Kmax [7.57 (4.80; 10.34)], and Kmean [2.80 (1.13; 4.47)]. Additionally, corneal thickness at the center, CCT [− 61.19 (− 73.79; − 48.60)] and apex, pachy-apex [− 41.86 (− 72.64; − 11.08)] were significantly thinner in keratoconic eyes compared to normal eyes. The pooled estimates for pachymetric progression index (PPI): PPImin [0.66 (0.43; 0.90)], PPImax [1.26 (0.87; 1.64)], PPIavg [0.90 (0.68; 1.12)], and Ambrosio relational thickness (ART): ARTmax [− 242.77 (− 288.86; − 196.69)], and ARTavg [− 251.08 (− 308.76; − 195.39)] revealed significantly more rapid pachymetric progression in keratoconic eyes than in normal eyes. The Pentacam Scheimpflug-derived keratometric, pachymetric, and pachymetric progression indices are good predictors in discriminating KC from normal eyes.Keywords: corneal topography, keratometric readings, central corneal thickness, keratoconus, pachymetric progression

Background: Cataracts being a disease with a very high prevalence, have been treated with various surgical and conservative forms for centuries. The aim of our study was to determine the correlation between central corneal thickness (CCT) and post-operative astigmatism after phacoemulsification. Methods and Results: This prospective, observational study was carried out in the Clinic of Ophthalmology at the University Clinical Center of Kosovo. The study included 101 eyes of patients who underwent cataract surgery with phacoemulsification for treatment and intra-ocular lens (IOL) implantation. Patients were divided into two groups, depending on the central thickness of the cornea. Group 1 included 29 patients who had CCT

Purpose: To compare the differences between eyes with pseudoexfoliative glaucoma (PXG) when they are divided into two groups (hypertensive PXG and normotensive PXG) according to the intraocular pressure (IOP). Methods: This is a retrospective study. Data from 86 hypertensive PXG eyes and 80 normotensive PXG eyes were included. Hypertensive PXG was defined as PXG with IOP ≥ 22 mmHg, and normotensive PXG was defined as with IOP ≤ 21 mmHg). Central corneal thickness (CCT) was measured by ultrasound pachymetry. Lamina cribrosa thickness (LT) was evaluated using swept-source optical coherence tomography. Results: No significant differences were observed between hypertensive and normotensive PXG in terms of age, gender, axial length, hypertension, or diabetes. Normotensive PXG eyes had thinner CCT than hypertensive PXG eyes (p = 0.02). To compare LT, a sub-analysis was performed after matching age, VF MD and retinal nerve fiber layer thickness. The normotensive PXG group (n = 32) demonstrated significantly thinner LT compared with the hypertensive PXG group (n = 32) at similar ages and levels of glaucoma severity (p < 0.001). Conclusions: Eyes with normotensive PXG demonstrated thinner CCT and LT compared with those with hypertensive PXG, suggesting structural vulnerability to glaucoma. [ABSTRACT FROM AUTHOR]

Purpose: Corneal thinning is common in rheumatoid arthritis (RA), thereby affecting the central corneal thickness (CCT). Effect of hydroxychloroquine (HCQ) in RA has abounding literature on retinal toxicity, but there is lack of data on its corneal effects. Methods: A cross-sectional study was carried out to compare CCT in RA patients before treatment initiation (Group 1) with CCT in those on HCQ for ≥3 months (Group 2). Results: Fifty patients were enrolled in each group. The mean age was 44.36 years with similar age, gender distribution and visual acuity in both groups. The mean CCT of patients in the cohort was 521.80 μm ± 32.57 μm and 523.94 μm ± 33.40 μm in the right eye (RE) and left eye (LE), respectively. Mean CCT in Group 1 was (RE) 522.80 μm/(LE) 524.26 μm and in Group 2 was (RE) 520.80 μm/(LE) 523.62 μm, and there was no significant difference in CCT between both the groups. Median duration of HCQ usage in Group 2 was 24 months, with the median cumulative dosage being 171 g and a majority having a dosage of 200 mg/day. There was no significant correlation between the duration/cumulative dosage of HCQ intake and CCT. No corneal deposits were identified in any patient. Conclusion: CCT of RA patients was similar to those reported in the Indian literature. However, there was no significant change in CCT or corneal deposits identified with an HCQ dosage of 200–400 mg/day. Longer follow-up would provide clarity on the impact of duration and cumulative dosage of HCQ on corneal changes and CCT. [ABSTRACT FROM AUTHOR]

Purpose: Myopia is not only a refractive error, but also a sight-threatening disease. In the study, we searched for a relationship between the central corneal thickness (CCT) and the retinal ganglion cell complex (GCC) thickness in patients with myopia. Materials and Methods: This prospective cross-sectional study comprised 122 eyes of 122 subjects with mild to moderate myopia. The participants were divided into two groups according to the CCT; below 555 micrometer (Group 1) and above 555 micrometer (Group 2). The CCT was measured using an optical biometer device. All subjects also underwent slit-lamp examination and optical coherence tomography (OCT) imaging. The retinal nerve fiber layer (RNFL) thickness and the GCC thickness were automatically quantified. Results: The retinal GCC and ganglion cell-inner plexiform layer (GC-IPL) thickness were decreased in Group 1 compared with Group 2 (p=0.002 and p=0.007, respectively). The RNFL thickness was statistically significantly decreased only in the superior-temporal quadrant (p=0.041). There was a significantly positive correlation between CCT and GCC and GC-IPL thickness (r=0.218, p=0.016, and r=0.200, p=0.027, respectively). We did not find any significant correlation between CCT and RNFL thickness (p>0.05). Conclusions: There was a relationship between the CCT and GCC thickness in eyes with mild to moderate myopia. [ABSTRACT FROM AUTHOR]

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Purpose: To evaluate anterior and posterior segment parameters in the eyes of patients with systemic sclerosis (SSc) and examine the effect of disease and disease subtypes on these parameters. Methods: This cross-sectional study included 54 eyes of 27 SSc patients and 54 eyes of 27 age- and sex-matched healthy controls. In addition to a complete ophthalmologic examination, all patients were examined using a Scheimpflug camera, specular microscopy, and spectral domain optical coherence tomography. Results: The mean age of the patients was 52.5 ± 11.4 years and 19 patients were female. Anterior chamber volume, central corneal thickness, and central macular thickness (CMT) were significantly lower in the eyes of SSc patients compared to healthy controls (p = 0.01, p = 0.03, and p = 0.006, respectively). When evaluated according to SSc subtype, CMT was lower in diffuse SSc patients (p = 0.001), while mean retinal nerve fiber layer (RNFL) and inferior quadrant RNFL values were lower in limited SSc (p = 0.003 and p = 0.005, respectively). Conclusion: In the eyes of patients with SSc, some ocular parameters may show decreases compared to healthy individuals, presumably secondary to disease-related vasculopathy and fibrosis. CMT and RNFL parameters may be affected differently according to disease subtype. [ABSTRACT FROM AUTHOR]

Measurements of Central Corneal Thickness and Central Corneal Epithelial Thickness Using Anterior Segment Optical Coherence Tomography (OCT) to Identify Potential Changes in Patients with Facial Paralysis. Thirty patients diagnosed with unilateral idiopathic Facial Faralysis between 2020 and 2021 at the Ear, Nose, and Throat Clinic of Elazığ City Hospital were included in our study. There were eighteen male patients (60%) and twelve female patients (40%). The mean age of the patients was 38.03±7.05 years. Central corneal thickness and central corneal epithelial thickness measurements were performed on the affected and unaffected eyes of the patients using an optical coherence tomography device at the time of diagnosis and one month later. There was no statistically significant difference in central corneal thickness and central corneal epithelial thickness between the affected and control groups in measurements taken at the time of diagnosis and one month later (p>0.05). This study represents the first evaluation of corneal tissue, a highly potentially affected structure in Facial Paralysis, using optical coherence tomography in the literature. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was to examine the distribution of intraocular pressure (IOP) and central corneal thickness (CCT) by age and gender in the Turkish population. Methods: In this population-based cross-sectional study, 3556 patients aged 40 years and older in Eskişehir were examined. Demographic, systemic, and eye health questions were asked of all subjects. IOP was measured with a Tono-Pen and a CCT ultrasound pachymeter. Statistical significance was accepted as P < 0.05. Results: The mean age of the study was 56.86 ± 10.19 and 70.6% were women. The mean IOP was 16.06 ± 3.11 mm Hg and CCT was 553.83 ± 34.34 µm. IOP correlated positively with CCT (r = 0.137; P < 0.001). Age negatively correlated with IOP and CCT (r = −0.057, P < 0.001; r = 0.037, P = 0.05). When evaluated by gender, the mean age of women was 55.99 ± 9.98 years, IOP was 16.21 ± 3.10 mm Hg, and CCT was 552.44 ± 33.90 µm, whereas these values were 58.98 ± 10.41 years, 15.68 ± 3.11 mm Hg, and 557.17 ± 35.17 µm in men (P < 0.001 for each parameter). Multiple regression analysis revealed a significant correlation between IOP and CCT (unstandardized regression coefficient B = 0.013/µm, P < 0.001), age (B = –0.013/year, P < 0.05), and gender (B = 0.551, P < 0.001). CCT proved to be the independent variable with the greatest influence on IOP (standardized regression coefficient beta: 0.141, R2 = 0.028; F = 34.067; P = 0.000). Conclusion: In our study, IOP and CCT decreased with age in both genders. IOP was found to be positively correlated with CCT and female gender and negatively correlated with age, and CCT was the key variable for IOP. [ABSTRACT FROM AUTHOR]

Abstract Purpose To evaluate the repeatability and agreement of Fourier-domain optical coherence tomography (AOCT-1000 M and RTVue XR) and partial coherence interferometry biometer (IOL Master 500) in measuring corneal thickness mapping and axial length respectively. Methods Corneal thickness was measured by AOCT-1000 M and RTVue XR. Axial lengths were measured by AOCT-1000 M and IOL Master 500. The repeatability and agreement of corneal thickness and axial length were calculated in two groups of devices. The intraclass correlation coefficient (ICC) was used to verify the repeatability of the device. The 95% confidence interval of the difference compared to the set cut-off value was used to verify the agreement between the two devices. Results A total of 60 subjects with 58 eyes were included. The central corneal thickness measured by AOCT-1000 M and RTVue XR were 504.46 ± 42.53 μm and 504.43 ± 42.89 μm respectively. The average difference between groups was 0.03 ± 4.58 μm, and the 95% confidence interval was (-1.17, 1.24), which was far less than the set threshold value of 15 μm (P

AIM: To access the agreement of intraocular pressure (IOP) values obtained from biomechanically corrected tonometer [Corvis ST (CST)], non-contact tonometer (NCT), and Goldmann applanation tonometer (GAT) in children with NCT measured-IOP (NCT-IOP) values of 22 mm Hg or more, and related factors. METHODS: A total of 51 eyes with NCT-IOP≥22 mm Hg in children aged 7 to 14y were examined and IOP was measured by CST, NCT, and GAT. Based on GAT measured IOP (GAT-IOP), ocular hypertension (OHT) group (≥22 mm Hg, 24 eyes) and the non-OHT group (

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

Background: This study aimed to determine the correlation between central corneal thickness (CCT) and axial length (AL) in patients with refractive anomalies and emmetropes. Methods and Results: 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. The CCT values were higher in the hypermetropic group compared to the myopic group (561.5±25.3 vs. 517.9±37.3 mm, P

Our objective was to evaluate the topographic and surgical factors of early myopic regression between laser in situ keratomileusis (LASIK) and small-incision lenticule extraction (SMILE). A retrospective case–control study was conducted, and 368 and 92 eyes were enrolled in the LASIK and SMILE groups via propensity score matching (PSM). Visual acuity, refractive status, axial length, and topographic/surgical parameters were collected. Multiple linear regression was applied to the yield coefficient and the 95% confidence interval (CI) of the parameters. The cumulative incidence of early myopic regression was higher in the LASIK group (p < 0.001). In the SMILE group, a lower central corneal thickness (CCT) thinnest value and a higher corneal cylinder associated with early myopic regression were observed; meanwhile, in the LASIK group, a lower CCT thinnest value, a higher steep corneal curvature, a larger optic zone, and a lower flap thickness related to early myopic regression were observed (all p < 0.05). In the SMILE group, a higher CCT difference correlated with early myopic regression was observed compared to the LASIK group (p = 0.030), and higher steep corneal curvature and lower cap/flap thickness (both p < 0.05) correlated with early myopic regression were observed in the LASIK group compared to the SMILE group. In conclusion, CCT differences significantly influence early myopic regression in the SMILE group; meanwhile, corneal curvature and flap thickness affect early myopic regression principally in the LASIK group.

The aim of this study was to evaluate the influence of ultrasounds used in phacoemulsification during cataract surgery on the corneal structure and morphology in patients over 65 years. We compared the outcomes of phacoemulsification techniques in terms of corneal cell morphology in 77 patients over 65 years old and 43 patients under 65 years old. Corneal cell density, central corneal thickness and hexagonality were measured preoperatively and post-surgery (at 1 and 4 weeks) by specular microscopy. The effect of gender, axial length and anterior chamber depth on the parameters of corneal endothelium were evaluated. In both groups, a progressive decrease in endothelial cells was observed, starting from the first week post-surgery until the fourth postoperative week. The central corneal thickness increased in both groups with maximum values at the first week postoperatively, while their initial values were restored in the fourth week post-surgery, with no statistical difference between groups. Statistically significant differences were noticed in terms of cell hexagonality in the group over 65, showing smaller hexagonality at all preoperative and postoperative time points compared to group under 65. Our result highlights the importance of routine specular microscopy performed before surgery, regardless the age of the patients, with caution and careful attention to the phaco power intensity, ultrasound energy consumption and intraoperative manipulation of instruments, as well as proper use of viscoelastic substances to reduce corneal endothelium damage, especially in elderly patients.

Purpose: To explore intraocular pressure (IOP) and its associated parameters in an aged population. Methods: The epidemiologic Ural Very Old Study (UVOS) conducted in Bashkortostan/Russia included 1526 participants with an age of ≥85 years. Besides a whole series of ocular and systemic examinations, IOP was determined applying non-contact tonometry. Body mass index, diastolic blood pressure and age were the factors used to estimate the cerebrospinal fluid pressure (CSFP). Results: The study consisted of 904 participants (age: 88.6 ± 2.7 years) with available IOP readings and without anti-glaucomatous therapy. Mean IOP was 14.5 ± 5.1 mmHg (median: 14 mm Hg; Q1:11; Q3:16; 95%CI:8,25) and 14.8 ± 4.6 mmHg (median: 14 mm Hg; Q1:12; Q3:17; 95%CI:8,28) in the right and left eyes, respectively. Higher IOP correlated (multivariable analysis; correlation coefficient r2:0.32) with female sex (P

Background: Dilating the eye with tropicamide may alter the intraocular pressure (IOP) because of an obstruction of the iridocorneal angle, resulting in decreased aqueous outflow drainage. Also, the repeated application of eyedrops and instrumentation could lead to increased central corneal thickness (CCT), consequently affecting IOP. Aim: This study aimed to determine the effect of 1% tropicamide on CCT and IOP post-mydriasis among the University of Limpopo optometry students. Setting: The data were collected at the optometry clinic of the University of Limpopo. Methods: A within-subject experimental study was conducted on 59 healthy subjects aged 18 years – 28 years. A computer assisted simple random probability sampling was used to identify a sample of participants from the study population (N = 200). Baseline and post-mydriasis IOP (20 min, 30 min, and 45 min intervals) were measured with a Goldmann applanation tonometer. Central corneal thickness and IOP were analysed using means, correlations and paired t-tests. Results: The mean CCT pre-mydriasis was 504.68 μm, and post-dilation was 507.90 μm, 510.08 μm and 509.25 μm at 20 min, 30 min, and 45 min, P = 026, p = 0.033, P = 0.004, respectively. Moreover, the mean IOP pre-mydriasis was 15.97 mmHg, and post-dilation was 16.85 mmHg, 16.46 mmHg and 16.85 mmHg over 20 min, 30 min, and 45 min of followed-up time, p = 0.140, p = 0.432, and p = 0.183, respectively. Conclusion: Measuring IOP post-dilation is still valid; however, CCT should be measured before the instillation of tropicamide. Contribution: This study analysed the effect of 1% tropicamide on CCT and IOP post-mydriasis in a clinical South African context.

Purpose: To evaluate the repeatability and agreement of Fourier-domain optical coherence tomography (AOCT-1000 M and RTVue XR) and partial coherence interferometry biometer (IOL Master 500) in measuring corneal thickness mapping and axial length respectively. Methods: Corneal thickness was measured by AOCT-1000 M and RTVue XR. Axial lengths were measured by AOCT-1000 M and IOL Master 500. The repeatability and agreement of corneal thickness and axial length were calculated in two groups of devices. The intraclass correlation coefficient (ICC) was used to verify the repeatability of the device. The 95% confidence interval of the difference compared to the set cut-off value was used to verify the agreement between the two devices. Results: A total of 60 subjects with 58 eyes were included. The central corneal thickness measured by AOCT-1000 M and RTVue XR were 504.46 ± 42.53 μm and 504.43 ± 42.89 μm respectively. The average difference between groups was 0.03 ± 4.58 μm, and the 95% confidence interval was (-1.17, 1.24), which was far less than the set threshold value of 15 μm (P < 0.001). Both RTVue XR and AOCT-1000 M had very good ICC values of central corneal thickness (0.998 and 0.994, respectively). The average axial lengths measured by AOCT-1000 M and IOL Master 500 were 24.28 ± 1.25 mm and 24.29 ± 1.26 mm respectively and the 95% confidence interval was (-0.02, 0.01), which was less than the set threshold value of 0.15 mm (P < 0.001). The ICC for both devices were 1.000. Conclusion: Good repeatability and agreement were seen in measurements of central corneal thickness and axial length by AOCT-1000 M. [ABSTRACT FROM AUTHOR]