LAUSR

PURPOSE To evaluate the role of corneal hysteresis (CH) as a risk factor of central visual field (VF) progression in a cohort of glaucoma suspect and glaucoma patients DESIGN: Prospective cohort study. METHODS Two hundred forty-eight eyes of 143 subjects who were followed for an average of 4.8 years with a minimum of 5 visits with 10-2 and 24-2 VF tests were included. Univariable and multivariable linear mixed effects models were used to identify characteristics associated with the rate of change over time in 10-2 and 24-2 mean deviation (MD). Mixed effects logistic regression was used to evaluate characteristics associated with an increased likelihood of event-based 10-2 VF progression based on clustered pointwise linear regression (PLR) criterion. RESULTS The CH was significantly associated with 10-2 and 24-2 VF progression in the univariable trend-based analysis. In multivariable trend-based analyses, lower CH was associated with a faster rate of decline in 10-2 MD (0.07 dB/year per 1 mmHg, P<0.001) but not with 24-2 MD (P=0.490). In multivariable event-based analysis, lower CH was associated with an increased likelihood of 10-2 VF progression (OR=1.35 per 1mmHg lower, P=0.025). Similar results were found in eyes with early glaucomatous damage at the baseline (baseline 24-2 MD ≥-6dB). CONCLUSION Lower CH was associated with a statistically significant, but relatively small, increased risk of central VF progression on the 10-2 test grid. Given the substantial influence of central VF impairment on the quality of life, clinicians should consider using CH to assess the risk of progression in primary open angle glaucoma patients including those with early disease.