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Mark R. Lesk, MSc, MD; Ali S. Hafez, MD, PhD; Denise Descovich, MD

Arch Ophthalmol. 2006;124:1568-1572.

Objectives  To investigate changes in optic nerve head topography and blood flow after therapeutic intraocular pressure reduction and to correlate them with central corneal thickness.

Methods  Sixteen patients with open-angle glaucoma and 16 patients with ocular hypertension underwent Heidelberg retina tomography and scanning laser Doppler flowmetry in 1 eye before and at least 2 months after a mean 35% sustained therapeutic reduction in intraocular pressure. Patients were assigned to a thin or thick group based on their median central corneal thickness.

Results  Compared with 16 patients with thick corneas (mean ± SD central corneal thickness, 587 ± 31 µm), the 16 patients with thin corneas (518 ± 32 µm) had greater reductions in mean (36 ± 32 vs 4 ± 36 µm, P = .003) and in maximum cup depth (73 ± 107 vs 4 ± 89 µm, P = .02). These changes were not statistically significantly different between the patients with open-angle glaucoma and those with ocular hypertension. Smaller mean ± SD improvements in neuroretinal rim blood flow were seen in patients with thinner corneas compared with those with thicker corneas (35 ± 80 vs 110 ± 111 arbitrary units, P = .04).

Conclusion  Patients with open-angle glaucoma and ocular hypertension with thinner corneas show significantly greater shallowing of the cup, a surrogate marker for lamina cribrosa displacement (compliance), and smaller improvements of neuroretinal rim blood flow after intraocular pressure reduction.

Author Affiliations: Department of Ophthalmology, University of Montreal, and Ophthalmology Research Unit, Centre de Recherche Guy-Bernier, Maisonneuve-Rosemont Hospital, Montreal, Quebec.

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