目的:探讨眼内压(IOP)变化与角膜生物力学特性之间的关系,确定青光眼患者眼压变化与角膜生物力学特性之间的定量关系,并观察排除高水平眼压影响的不同类型青光眼之间的差异。
方法:前瞻性临床队列研究。
方法:设置:机构。
方法:纳入未接受治疗的原发性开角型青光眼或高眼压(OHT)患者。
方法:使用Goldmann压平眼压计测量眼压。使用角膜压痕装置和角膜可视化Scheimpflug技术评估了角膜生物力学。药物治疗用于降低IOP。在基线访视时和此后的每个星期在一个月内进行重复测量。使用配对t检验比较降低IOP治疗前后的IOP和角膜生物力学指标。单向方差分析用于调查组间的潜在差异,使用Bonferroni事后校正进行多重组间比较。
方法:眼压改变后的角膜生物力学参数。
结果:81名参与者(平均年龄,41.63±17.33年)纳入本研究。该队列包括20例正常眼压青光眼(NTG)患者,47患有高眼压青光眼(HTG),14与OHT基线角膜硬度(88.58±18.30N/m)和角膜模量(0.71±0.16MPa)大于眼压后降低值(67.15±9.24N/m和0.54±0.08MPa,分别;P<0.001)。眼压变化与角膜生物力学参数变化的关系为Δ角膜刚度=2.06*ΔIOP+6.47(P<0.001),Δ角膜模量=0.017*ΔIOP+0.051(P<0.001)。降低IOP后,NTG组第4周的平均角膜硬度(60.97±6.36N/m)明显低于HTG(67.25±9.01N/m)和OHT(75.62±6.52N/m,P<0.001)组。此外,HTG患者的僵硬度低于OHT患者(P=0.003)。
结论:眼压的变化对角膜生物力学参数有影响。眼压降低后,观察到角膜刚度和模量降低。当高水平IOP的影响被排除时,角膜生物力学根据青光眼的类型而变化。HTG角膜比OHT角膜软,NTG角膜更柔软。
OBJECTIVE: To investigate the relationship between intraocular pressure (IOP) changes and corneal biomechanical properties, determine the quantitative relationship between IOP changes and corneal biomechanical properties in patients with glaucoma and observe the differences among different types of glaucoma when the effects of high-level IOP were excluded.
METHODS: Prospective clinical cohort study.
METHODS: Setting: Institutional.
METHODS: Treatment-naive patients with primary open-angle glaucoma or ocular hypertension (OHT) were included.
METHODS: IOP was measured using a Goldmann applanation tonometer. Corneal biomechanics were evaluated using a corneal indentation device and corneal visualization Scheimpflug technology. Medication therapy was used for IOP reduction. Repeated measurements were taken at the baseline visit and each week thereafter within a month. Paired t tests were used to compare IOP and corneal biomechanical metrics before and after IOP-lowering therapy. One-way analysis of variance was employed to investigate potential differences across groups, with a Bonferroni post hoc correction administered for multiple intergroup comparisons.
METHODS: Corneal biomechanical parameters following IOP changes.
RESULTS: Eighty-one participants (mean age, 41.63 ± 17.33 years) were included in this study. The cohort comprised 20 patients with normal-tension glaucoma (NTG), 47 with high-tension glaucoma (HTG), and 14 with OHT. The baseline corneal stiffness (88.58±18.30 N/m) and corneal modulus (0.71±0.16 MPa) were greater than the post-IOP reduction values (67.15±9.24 N/m and 0.54±0.08 MPa, respectively; P<0.001). The relationships between changes in IOP and changes in corneal biomechanical parameters were Δ corneal stiffness=2.06*ΔIOP+6.47 (P<0.001) and Δ corneal modulus=0.017*ΔIOP+0.051 (P<0.001). After IOP reduction, the mean corneal stiffness at the 4th week in the NTG group was significantly lower (60.97±6.36 N/m) than that in the HTG (67.25±9.01 N/m) and OHT (75.62±6.52 N/m, P < 0.001) groups. Additionally, the stiffness of HTG patients was lower than that of OHT patients (P = 0.003).
CONCLUSIONS: Changes in IOP have an impact on corneal biomechanical parameters. Decreases in corneal stiffness and modulus were observed after IOP reduction. When the effect of high-level IOP was excluded, corneal biomechanics varied according to the type of glaucoma. The HTG corneas were softer than the OHT corneas, and the NTG corneas were even softer.