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First Author: L.Arutyunyan RUSSIA
Co Author(s): S. Anisimova
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To assess the diagnostic and prognostic value of the biomechanical coefficient in persons with glaucoma and suspected glaucoma.
Moscow, Eye center ḋEast sight recoveryṠ
26 patients aged 60.1ḟ3.4 with suspected glaucoma, 155 patients aged 67.0ḟ8.4 with POAG and 35 patients aged 62.8ḟ6.5 with no eye pathology have been examined. The central visual field was evaluated using SAP; structural changes of the optic disc were measured with HRT-II. Ocular Response Analyzer was used to measure corneal hysteresis (CH) and central corneal thickness (CCT). A new parameter, biomechanical coefficient (BC), was introduced: BC = CH/ CCT x 50.
In normal patients, BC values varied between 0.82 and 1.12. As glaucoma progressed, BK showed a statistically significant decrease. 29% patients with suspected glaucoma had low BC (0.73-0.78) and CH within 8.1- 9.9 mm Hg. A detailed examination showed local visual field defects in the paracental area (MD of 4.2dB, PSD 3.3 dB) and a drop in volume and area of the neuroretinal rim. Accordingly, glaucoma was diagnosed and hypotensive treatment prescribed. Follow-up examinations after 6 and 12 months demonstrated no negative dynamics. In 36% patients with normal optic disc figures, BK was lower than 0.82 (0.63-0.81), being the only reduced parameter (?<0,05). CH values lay within 7.1-9.8 mm Hg, CCT was 494-584 microns. In 6 and 12 months, 51% of such patients developed a depression of threshold photosensitivity and smoothing of the retinal surface profile, which underpinned the diagnosis of glaucoma and ascertained the diagnostic and prognostic value of BC. In 35% patients with suspected glaucoma, BK (0.891.16) and CH (10.1-13.6 mm Hg) were within the norm, CCT was high (576 to 602 microns). MD, PSD and optic disc parameters were within the norm, so the diagnosis of glaucoma was revoked.
The proposed biomechanical coefficient increases the effectiveness of diagnostics and prognosis if glaucoma is suspected.