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Central Corneal Thickness is not Related to Anterior Scleral Thickness or Axial Length

Oliveira, Cristiano MD*; Tello, Celso MD* †; Liebmann, Jeffrey MD‡ §; Ritch, Robert MD* †

doi: 10.1097/01.ijg.0000212220.42675.c5
Original Articles

Purpose To examine the relationship between central corneal thickness (CCT), scleral thickness (ST), refractive error, and axial length.

Methods One hundred forty eyes of 140 patients with no previous history of intraocular surgery were enrolled. Axial length, CCT, and ST were measured ultrasonically. Radial ultrasound biomicroscopy (UBM) images were obtained by a single examiner scanning the temporal corneoscleral limbus. ST was measured independently on the UBM images by two masked observers at scleral spur (ST1) and 2.0 and 3.0 mm posterior to it (ST2 and ST3).

Results Mean patient age was 57.0±15.7 (SD) years, and mean refractive error was –1.3±5.0 diopters. Intraclass correlation coefficients >0.75 indicated excellent agreement between the two observers for all ST measurements. There was a positive and significant correlation between CCT and ST1 (r=0.27, P=0.001) but not between CCT and ST2 (r=0.02, P=0.8), ST3 (r=0.06, P=0.5), refractive error (r=0.08, P=0.3), or axial length (r=0.07, P=0.4).

Conclusions CCT correlates with ST only at the scleral spur and is unrelated to refractive error or axial length. This study does not support the hypothesis that a thin CCT is a surrogate marker for abnormal scleral or laminar thickness as an independent cause of increased glaucoma risk.

*Department of Ophthalmology, New York Eye And Ear Infirmary, New York, NY

Department of Ophthalmology, New York Medical College, Valhalla, NY

Department of Ophthalmology, New York University, New York, NY

§Department of Ophthalmology, Manhattan Eye Ear and Throat Hospital, New York, NY

Supported in part by the Doris and Isaac Moinester Research Fund of New York Glaucoma Research Institute, New York, NY.

Presented in part at the annual meeting of the Association for Research in Vision and Ophthalmology (ARVO), April 2004.

Reprints: Robert Ritch, MD, 310 E. 14 St., Suite 304, New York, NY, 10003 (e-mail:

Received for publication June 9, 2005; accepted January 9, 2006

The authors have no proprietary interest in any material or device described in this paper.

© 2006 Lippincott Williams & Wilkins, Inc.