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Dynamic Scheimpflug Ocular Biomechanical Parameters in Healthy and Medically Controlled Glaucoma Eyes

Miki, Atsuya MD, PhD*; Yasukura, Yuichi MD*,†; Weinreb, Robert N. MD; Yamada, Tomomi PhD§; Koh, Shizuka MD, PhD*,∥; Asai, Tomoko MD, PhD*,¶; Ikuno, Yasushi MD*,#; Maeda, Naoyuki MD, PhD*; Nishida, Kohji MD, PhD*

doi: 10.1097/IJG.0000000000001268
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Purpose: To evaluate the relationship between biomechanical parameters measured with a dynamic Scheimpflug analyzer and glaucoma.

Patients and Methods: Cross-sectional observational data of 47 eyes of 47 consecutive subjects with medically controlled primary open-angle glaucoma and 75 eyes of 75 healthy subjects examined with a dynamic Scheimpflug analyzer (Corvis ST) were retrospectively investigated. Eight biomechanical parameters were compared between eyes with and without glaucoma using multivariable models adjusting for intraocular pressure (IOP), central corneal thickness, age, and axial length.

Results: In multivariable models, glaucoma was negatively correlated with A1 time (P<0.001, coefficient=−0.5535), A2 time (P=0.008, coefficient=−0.1509), radius (P=0.011, coefficient=−0.4034), and whole eye movement (P<0.001, coefficient=−0.0622). Negative correlation between glaucoma and 3 parameters (A1 time, A2 time, and radius) consistently indicate larger deformability of the cornea and negative correlation between glaucoma and whole eye movement indicate smaller eye movement, in glaucoma eyes. There were significant correlations of many biomechanical parameters with other baseline factors (8 parameters with IOP, 2 with central corneal thickness, 4 with age, and 7 with axial length).

Conclusions: Eyes with medically controlled glaucoma were more deformable than healthy eyes, which may increase the risk of optic nerve damage through an underestimation of IOP and biomechanical vulnerability of the globe. Many parameters showed a significant correlation with baseline factors, suggesting the importance of adjustment for these confounding factors when evaluating the correlation between biomechanical parameters and ocular diseases. These results suggest the relevance of measuring biomechanical properties of glaucoma eyes for accurate IOP measurement and risk assessment.

*Department of Ophthalmology, Osaka University Graduate School of Medicine

Department of Ophthalmology, Yodogawa Christian Hospital

§Department of Medical Innovation, Data Coordinating Center, Osaka University Hospital

Department of Innovative Visual Science, Osaka University Graduate School of Medicine

#Ikuno Eye Center, Osaka

Asai Eye Clinic, Hyogo, Japan

Viterbi Department of Ophthalmology and Shiley Eye Institute, Hamilton Glaucoma Center, University of California, San Diego, La Jolla, CA

Disclosure: A.M.: reports personal fees from Santen Pharmaceutical, Pfizer Japan, Kowa Co. Ltd., Otsuka Pharmaceutical, Alcon Pharma, Scampo Pharma, Senju Pharmaceutical, Novartis Pharma, Topcon, Ellex Inc., HOYA, and JFC sales plan, and a grant from JSPS, outside the submitted work. R.N.W.: reports research support from Carl Zeiss Meditec, Genentech, Heidelberg Engineering, Konan, Optovue, Tomey, Topcon, Allergan, Bausch & Lomb, ForSight, and Unity, National Eye Institute (R01EY029058) and an unrestricted grant from Research to Prevent Blindness (New York, NY). S.K.: reports personal fees from Johnson & Johnson, Alcon Pharma, Santen Pharmaceutical, Otsuka Pharmaceuticals, Menicon, Oculus, Shire, and SEED, and research support from JSPS and Johnson & Johnson, outside the submitted work. Y.I.: reports personal fees from Novartis, Bayer, Alcon Surgical, Senju Pharmaceutical, Santen, and research support from Tomey, outside the submitted work. N.M.: reports personal fees from Santen Pharmaceutical, Otsuka Pharmaceuticals, Topcon, Abbott Medical Optics, Johnson & Johnson, and Tomey, and research support from Alcon Laboratories, outside the submitted work. K.N.: reports personal fees from Otsuka Pharmaceutical, Abbott Medical Optics Japan, HOYA, Wacamoto, MSD, Pfizer, Novartis, Santen, Johnson & Johnson, Senju, and Takeda, and research support from Otsuka Pharmaceuticals, HOYA, Wakamoto, Pfizer, Novartis, Santen, and Menicon, and grants from NIBIOHN, MEXT, NEDO, and JSPS, outside the submitted work. The remaining authors declare no conflict of interest.

Reprints: Atsuya Miki, MD, PhD, Department of Ophthalmology, Osaka University Graduate School of Medicine, 2-2 Yamada-Oka, Suita, Osaka 565-0871, Japan (e-mail: amiki@ophthal.med.osaka-u.ac.jp).

Received January 11, 2019

Accepted March 24, 2019

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