Clinical Guidelines prev next

Apr 12 2006

The Role of CCT in Glaucoma Patients

posted by: J. James Thimons, OD, FAAO

The Ocular Hypertension Study (OHTS) was the first multi-center trial to demonstrate the relationship between CCT and risk of progression to glaucoma in Ocular Hypertensive patients. While this information has established a new standard in the care for our patients, it has also opened discussion regarding the usefulness of this information in areas other than Ocular Hypertensives.

Herndon, LW; Arch Ophthalmol., 2004; 122: 17-21 ‚ÄúCentral Corneal Thickness as a Risk Factor for Advanced Glaucoma Damage.‚Ä? This study is the first to review the implications of CCT in patients with traditional POAG and how this information can be used to assess risk in existent glaucoma patients. The analysis was conducted on 350 eyes of 190 glaucoma patients who underwent an Advanced Glaucoma Intervention Study (AGIS) score (IOPs, number of medications, visual field performance, vertical C/D, family history and Snellen acuity).

The study drew the conclusion that patients with more severe glaucomatous damage on initial examination had thinner CCTs (based on average CCT of 545 microns) than patients with lesser levels of disease. Thinner CCTs were associated with worsening in all outcome variables except number of glaucoma medications.

While there were some limitations to this study (the population was a university-based referral center that involve a more advanced level of glaucoma than is typically seen in the general practice), the data hold great promise for clinicians. The primary utilization of this information is its ability to identify those patients who are at higher risk for developing severe glaucomatous damage, thus enabling the clinician to differentiate care patterns, goal pressures, and long term management strategies.