Effect of prostaglandin analogues on the biomechanical corneal properties in patients with open-angle glaucoma and ocular hypertension measured with dynamic scheimpflug analyzer.
Martínez-Sánchez Marta Isabel, Bolívar Gema, Sideroudi Haris, Teus Miguel A
AI Summary
Prostaglandin treatment for glaucoma significantly decreased corneal stiffness, suggesting standard IOP measurements may overestimate drug efficacy due to corneal softening.
Abstract
Purpose
The aim of the study is to evaluate the effect of topical prostaglandin (PG) treatment on the corneal biomechanical properties in treatment-naïve patients with either primary open-angle glaucoma (POAG) or ocular hypertension (OHT) using the Corvis ST device.
Methods
This is an observational study. We analyzed the Corvis ST dynamic corneal response parameters of our database using the newest software available. Thirty-four eyes of 34 patients were included. They were all newly diagnosed and treatment-naïve. Patients were evaluated at baseline and after 6 months of treatment with prostaglandin analogues. Ultrasound pachymetry, Optical Coherence Tomography (OCT) and a 24-2 visual field test were performed in baseline visit. Goldman Applanation Tonometry (GAT-IOP) and Corvis ST dynamic corneal response parameters were registered at baseline and at the 6-month visit.
Results
After 6 months of treatment, the IOP decrease (Δ) values obtained with the different tonometers were ΔGAT -6.5 ± 3.7, ΔIOPnct -4.4 ± 5.7 and ΔbIOP -3.8 ± 5.4. The differences between ΔGAT vs ΔIOPnct, ΔGAT vs ΔbIOP, and ΔIOPnct vs ΔbIOP, were statistically significant (p < 0.05 for all comparisons). Statistically significant lower values of the stress-strain index (SSI) (1.77 ± 0.3 at baseline vs 1.54 ± 0.27 at the 6-month visit) were found (p = 0.0002).
Conclusion
The SSI provided by the Corvis ST seems to decrease significantly after topical prostaglandin therapy. We believe that our results support the hypothesis that topical PG therapy does decrease the corneal stiffness and thus, that the ocular hypotensive effect of these drugs is overestimated if GAT is used for IOP measurement.
MeSH Terms
Shields Classification
Key Concepts4
After 6 months of treatment with prostaglandin analogues in treatment-naïve patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT), the IOP decrease (Δ) values obtained with different tonometers were ΔGAT -6.5 ± 3.7, ΔIOPnct -4.4 ± 5.7, and ΔbIOP -3.8 ± 5.4.
Statistically significant differences were found between ΔGAT vs ΔIOPnct, ΔGAT vs ΔbIOP, and ΔIOPnct vs ΔbIOP (p < 0.05 for all comparisons) after 6 months of treatment with prostaglandin analogues in treatment-naïve patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT).
Statistically significant lower values of the stress-strain index (SSI) were found (1.77 ± 0.3 at baseline vs 1.54 ± 0.27 at the 6-month visit, p = 0.0002) after topical prostaglandin therapy in treatment-naïve patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT).
The stress-strain index (SSI) provided by the Corvis ST device seems to decrease significantly after topical prostaglandin therapy, supporting the hypothesis that topical prostaglandin (PG) therapy decreases corneal stiffness and thus, the ocular hypotensive effect of these drugs is overestimated if Goldman Applanation Tonometry (GAT) is used for IOP measurement in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT).
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