Corneal Hysteresis in Thais and Variation of Corneal Hysteresis in Glaucoma

Figures & data

Table 1 Demographic and Normative Data of Ocular Response Analyzer Parameters in Thais

	Women	Men	p value, 95% CI for Mean Difference
	327 Persons	138 Persons
Eyes	465 Eyes
-Right (426 eyes)	426
-Left (421 eyes)	39
Age (years)	57.21 ± 14.43 (14–87)
	56.51 ± 14.92 (14–87)	58.88 ± 13.09 (26–85)	p=0.16 [−5.25, 0.5]
Corneal hysteresis (CH) (mmHg)	10.18 ± 1.48 (5.2–16.80)
−1st, 2.5th and 5th percentile	6.7, 7.40 and 8.0
−95th, 97.5th and 99th percentile	12.58, 13.10 and 13.94
	10.29 ± 1.46	9.90 ± 1.49	p=0.009 [0.10, 0.69]
Corneal-compensated intraocular	15.01 ± 3.04
Pressure (IOPcc) (mmHg)	(6.50–23.10)
−1st, 2.5th and 5th percentile	8.36, 9.50, 10.40
−95th, 97.5th and 99th percentile	20.08, 21.00, 22.1
	14.9 ± 3.03	15.27 ± 3.04	p=0.229 [−0.98, 0.23]
Goldmann-correlated intraocular	14.24 ± 3.24
pressure (IOPg) (mmHg)	(5.80–24.10)
−1st, 2.5th and 5th	6.73, 7.70, 8.60
−95th, 97.5th and 99th	18.90, 19.54, 20.50
	14.18 ± 3.08	14.11 ± 3.00	p=0.827 [−0.54, 0.68]
Waveform score (WS)	6.6 (1.78)

Note: Student’s t-test.

Figure 1 Frequency distribution graph of ocular response analyzer parameters. (A) Frequency distribution graph of corneal hysteresis (CH). (B) Frequency distribution graph of corneal-compensated intraocular pressure (IOPcc). (C) Frequency distribution graph of Goldmann-correlated intraocular pressure (IOPg).

Figure 2 Box-plots of corneal hysteresis between women and men.

Figure 3 Scatter plot between ocular response analyzer parameters. (A) Scatter plot between corneal hysteresis (CH) and age. (B) Scatter plots between corneal-compensated intraocular pressure (IOPcc) and corneal hysteresis (CH).

Table 2 Demographic Data and Ocular Response Analyzer Parameters in Different Glaucoma Type

	Primary Open-Angle Glaucoma (POAG)	Primary Close-Angle Glaucoma (PACG)	Normal Tension Glaucoma (NTG)	Ocular Hypertension (OHT)	p-value^#
Number of eyes/ Number of patients	434 Eyes/272 patients	74 Eyes/48 patients	143 Eyes/ 79 patients	44 Eyes/30 patients
Male	177	11	25	16	<0.001^abe
Female	95	37	54	14
Age (years)	68.07 ± 10.04	68.48 ± 10.43	65.88 ± 11.66	59.39 ± 9.78	0.002^cef
Treatment					<0.001^ac
-Medication	421	45	143	24
-Selective laser trabeculoplasty	8	–	–	–
-Trabeculectomy	5	–	–	–
-Phacoemulsification	-	29	–	–
Anti-glaucoma medication (No.)	1.36 ± 0.5	1.32 ± 0.5	1.12 ± 0.4	1.2 ± 0.4	<0.001^b
-Prostaglandin analogues	414	46	141	24
-Carbonic anhydrase inhibitors	67	–	7	2
-Alpha agonist	4	–	–	–
-Beta blockers	89	16	12	3
Corneal hysteresis (CH) mmHg	8.74 ± 1.52	9.09 ± 1.72	9.55 ± 1.67	10.10 ± 1.40	<0.001^bce
Corneal-compensated intraocular pressure (IOPcc) mmHg	17.19 ± 4.62	16.65 ± 4.28	13.94 ± 2.82	19.92 ± 4.95	<0.001^bcdef
Goldmann-correlated intraocular pressure (IOPg) mmHg	14.82 ± 4.73	14.62 ± 4.32	12.30 ± 2.93	19.75 ± 4.83	<0.001^bcdef
Waveform score (WS)	6.88 ± 1.79	6.85 ± 1.89	6.35 ± 1.89	6.64 ± 1.61	0.361
Goldmann applanation tonometry (GAT) mmHg	15.15 ± 4.32	15.30 ± 3.95	12.70 ± 2.78	19.51 ± 3.14	<0.001^b

Notes: ^#One-way ANOVA for continuous data and chi-square test for categorical data. ^#Generalized estimating equation (GEE) for ocular response analyzer parameters. ^aSignificant difference between OAG and ACG, ^bSignificant difference between OAG and NTG, ^cSignificant difference between OAG and OTH, ^dSignificant difference between ACG and NTG, ^eSignificant difference between ACG and OTH, ^fSignificant difference between NTG and OTH.

Table 3 Post Hoc Comparisons of Corneal Hysteresis (CH), Corneal-Compensated Intraocular Pressure (IOPcc) and Goldmann-Correlated Intraocular Pressure (IOPg) Between Primary Open-Angle Glaucoma (POAG), Primary Close-Angle Glaucoma (PACG), Normal Tension Glaucoma (NTG) and Ocular Hypertension (OHT)

Corneal Hysteresis (CH)
			95% CI for Mean Difference
		Mean Difference	Lower	Upper	SE	t	p bonf
POAG	PACG	−0.359	−0.867	0.149	0.197	−1.820	0.415
	NTG	−0.815	−1.202	−0.427	0.150	−5.416	<0.001
	OHT	−1.367	−2.006	−0.728	0.248	−5.511	<0.001
PACG	NTG	−0.456	−1.032	0.121	0.224	−2.035	0.253
	OHT	−1.008	−1.777	−0.240	0.298	−3.378	0.005
NTG	OHT	−0.552	−1.247	0.142	0.270	−2.047	0.246
Corneal-Compensated Intraocular Pressure (IOPcc)
			95% CI for Mean Difference
		Mean Difference	Lower	Upper	SE	t	p bonf
POAG	PACG	0.598	−0.829	2.025	0.554	1.079	1.000
	NTG	3.221	2.132	4.309	0.423	7.620	< 0.001
	OHT	−2.671	−4.466	−0.876	0.697	−3.832	< 0.001
PACG	NTG	2.623	1.002	4.244	0.629	4.168	< 0.001
	OHT	−3.269	−5.428	−1.109	0.839	−3.898	< 0.001
NTG	OHT	−5.892	−7.844	−3.939	0.758	−7.770	< 0.001
Goldmann-Correlated Intraocular Pressure (IOPg)
			95% CI for Mean Difference
		Mean Difference	Lower	Upper	SE	t	p bonf
POAG	PACG	0.158	−1.261	1.577	0.551	0.287	1.000
	NTG	2.539	1.457	3.622	0.420	6.041	< 0.001
	OHT	−4.913	−6.698	−3.128	0.693	−7.089	< 0.001
PACG	NTG	2.381	0.770	3.993	0.626	3.806	< 0.001
	OHT	−5.071	−7.218	−2.924	0.834	−6.082	< 0.001
NTG	OHT	−7.452	−9.394	−5.511	0.754	−9.886	< 0.001

Notes: P-value and confidence intervals adjusted for comparing a family of four estimates (confidence intervals corrected using the turnkey method).

Table 4 Demographic Data and Ocular Response Analyzer Parameters in Different Glaucoma Severity

	Primary Open-Angle Glaucoma (POAG)	Primary Close-Angle Glaucoma (PACG)	Normal Tension Glaucoma (NTG)	p-value^#
Glaucoma Stage
-Early	225 (51.85%)	27 (36.48%)	91 (63.64%)	1.00
-Moderate	74 (17.05%)	14 (18.92%)	32 (22.38%)	0.049^a
-Severe	135 (31.10%)	33 (44.60%)	20 (13.98%)	<0.001^a
Age (years)	68.07 ± 10.04	68.48 ± 10.43	65.88 ± 11.66	0.38
-Early	65.75 ± 9.89	68.78 ± 8.64	62.27 ± 11.02	0.188
-Moderate	68.76 ± 9.90	71.13 ± 4.85	71.81 ± 10.09	0.188
-Severe	71.23 ± 9.50	65.95 ± 12.52	77.60 ± 7.96	0.189
Corneal hysteresis (CH) mmHg	8.74 ± 1.52	9.09 ± 1.72	9.55 ± 1.67	<0.001^a
-Early	9.22 ± 1.47	9.85 ± 1.45	9.47 ± 1.38	0.055
-Moderate	8.74 ± 1.23	9.04 ± 1.68	9.75 ± 2.42	0.095
-Severe	7.92 ± 1.40	8.45 ± 1.74	9.77 ± 1.34	<0.001^a
p-value^#	<0.001^cde	0.004^de	0.525
Corneal-compensated intraocular pressure (IOPcc) mmHg	17.19 ± 4.62	16.65 ± 4.28	13.94 ± 2.82	<0.001^ab
-Early	16.58 ± 4.07	16.38 ± 4.42	14.15 ± 2.67	<0.001^ab
-Moderate	16.77 ± 3.89	16.86 ± 2.94	13.21 ± 3.27	<0.001^ab
-Severe	18.61 ± 5.90	16.73 ± 4.70	14.05 ± 2.76	<0.001^ab
p-value^#	0.001^de	0.910	0.379
Goldmann-correlated intraocular pressure (IOPg), mmHg	14.82 ± 4.73	14.64 ± 4.37	12.30 ± 2.93	<0.001^ab
-Early	14.63 ± 4.09	15.27 ± 4.47	12.41 ± 3.14	<0.001^ab
-Moderate	14.27 ± 4.22	14.81 ± 3.70	11.75 ± 2.30	<0.001^ab
-Severe	15.46 ± 5.88	14.05 ± 4.60	12.57 ± 2.79	0.002^a
p-value^#	0.241	0.565	0.399
Goldmann applanation tonometry (GAT), mmHg	15.15 ± 4.32	15.30 ± 3.95	12.70 ± 2.78	<0.001^ab
-Early	14.54 ± 3.72	15.90 ± 3.93	12.79 ± 2.79	<0.001^ab
-Moderate	15.25 ± 4.14	15.33 ± 3.75	12.55 ± 2.14	<0.001^ab
-Severe	16.11 ± 5.29	14.83 ± 4.25	12.50 ± 3.65	0.003^a
p-value^#	0.023d	0.678	0.898

Notes: ^#One-way ANOVA for continuous data and chi-square test for categorical data. ^#Generalized estimating equation (GEE) for ocular response analyzer parameters. ^aSignificant difference between OAG and NTG, ^bSignificant difference between ACG and NTG, ^cSignificant difference between early and moderate stage, ^dSignificant difference between early and severe stage, ^eSignificant difference between moderate and severe stage.

Figure 4 Box-plot of corneal hysteresis of primary open-angle glaucoma (POAG) and primary close-angle glaucoma (PACG) in different glaucoma severity. (A) Primary open-angle glaucoma (POAG). (B) Primary close-angle glaucoma (PACG).

Table 5 Corneal Hysteresis (CH) in Different Ethnics

Ethnics and Authors	Number	Corneal Hysteresis (CH)	Age (Years)
Caucasian, Spain	293 Eyes	12.12 ± 1.71 mm Hg	6–17 years
Bueno-Gimeno et al^Citation10	293 Participants
Caucasian, London, United Kingdom	264 Eyes from twin pairs	10.24 ± 1.54 mm Hg	54.1 (16–78)
Carbonaro et al^Citation29
Caucasian, Birmingham, United Kingdom	207 Eyes	10.7 ± 2.0 mm Hg (6.1–17.6)	62.1 ± 18.1 (18.1–87.1)
Shah et al^Citation30	105 Participants
Caucasian, United Kingdom	4184 Participants	10.00 ± 1.64 mmHg	48–91
Foster et al^Citation31		Women 10.18 ±1.58 mmHg
		Men 9.79 ±1.69 mmHg, P < 0.001
African and Caucasians, Brussels	30 African	9.2 ± 1.5 mmHg	43.9 ± 11.4
Detry-Morel et al^Citation9	25 Caucasians	10.8 ± 1.6 mmHg	58.4 ± 14.7
African and Caucasians, San Diego, USA	46 Eyes/ 37 blacks	9.70 ± 1.72 mmHg	58.41 ± 15.7
Leite et al^Citation32	135 Eyes/ 82 whites	10.44 ± 1.6 mmHg	66.00 ± 11.9
Middle easterner, Iran	506 Eyes	10.07 ± 1.61 mm Hg	28.43 ± 6.36 (18–35)
Sedaghat et al^Citation33	253 Participants
Middle easterner, Egypt	194 Eyes	10.25 ± 0.12 mmHg (6.5–14.4)	45 years
Ali^Citation34	98 Participants	11.1 ± 0.14 mmHg	Younger age (19–40 years)
		9.8 ± 0.21 mmHg	Older age (40–71 years)
Asian, Singapore	271 Eyes from 186 Chinese, 50 Malay, 33 Indian, and 2 other	11.78 ± 1.55 mmHg (6.93–16.53)	13.97 ± 0.89
Lim et al^Citation35
Asian, rural Chinese secondary school children.	1233 Eyes from 1293 participants	10.7 ± 1.6 mmHg	14.7 ± 0.8
Song et al^Citation36
Asian, Seoul, Korea	958 Eyes from 958 patients	10.1 ± 1.4 mmHg (7.1–17.2)	26.7
Hwang et al^Citation37
Asian, Taipei, Taiwan	292 Healthy eyes/ 292 person	10.16 ± 1.55 mmHg (8–14)	66.51 ±  12.12 (33–87)
Wang el al^Citation38
This study	465 Eyes from 465 participants	10.18 ± 1.48 mmHg (5.2 to 16.80)	57.21 ± 14.43 (14–87)
		Women 10.29 ± 1.46 mmHg
		Men 9.90 ± 1.49 mmHg, p=0.009

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