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ORIGINAL ARTICLE
Year : 1990  |  Volume : 38  |  Issue : 1  |  Page : 4-6

Corneal thickness and I.O.P. changes in rhegmatogenous retinal detachment


R. P. Centre for Ophthalmic Sciences, AIIMS, New Delhi - 110 029, India

Correspondence Address:
Raj Vardhan Azad
R. P. Centre for Ophthalmic Sciences, AIIMS, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


PMID: 2365441

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  Abstract 

Twenty patients with Rhegmatogenous retinal detachment were subjected to applanation tonometry and Corneal Thickness measurement to ascertain (i) the change in central & peripheral corneal thickness and (ii) effect of Intra Ocular Pressure on these corneal changes. Twenty age and sex matched controls also underwent similar investigation. It was observed that both the mean Intra Ocular Pressure and the corneal thickness (both Peripheral Corneal Thickness and Central Corneal Thickness] of the affected eye showed statistically significant reduction (P 0.001) when compared to Intra Ocular Pressure and Corneal Thickness changes of fellow-eyes and eyes of control subjects. In addition to these even the fellow eyes which had normal Intra Ocular Pressure, showed statistically low Central Corneal Thickness measurement, when compared with controls. In view of the above observation and reduction in Corneal Thickness measurement, the present study indicates generalised corneal changes in Rhegmatogenous retinal detachment unrelated to intraocular pressure.

Keywords: CT - Corneal Thickness; PCT - Periph-eral Corneal Thickness; CCT - Central Corneal Thick-ness; IOP - Intra Ocular Pressure


How to cite this article:
Azad RV, Mondal AK, Arora R, Tewari HK. Corneal thickness and I.O.P. changes in rhegmatogenous retinal detachment. Indian J Ophthalmol 1990;38:4-6

How to cite this URL:
Azad RV, Mondal AK, Arora R, Tewari HK. Corneal thickness and I.O.P. changes in rhegmatogenous retinal detachment. Indian J Ophthalmol [serial online] 1990 [cited 2020 Dec 1];38:4-6. Available from: https://www.ijo.in/text.asp?1990/38/1/4/24544



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  Introduction Top


Of late greater importance has been attached to the concept of multi-system defect in rhegmatogenous reti要al detachment. Although skin and retinal disorders coexist in a number of situations, the association of rhegmatogenous retinal detachment does find mention in the recent literature. [5],[6] The common ectodermal basis of the association has led to further expansion of this hy計othesis on to the corneas, an organ which shares com衫on embryonic origin with the retina. Although the stud虹es on corneas have confirmed defects in corneal thick要ess in cases of rhegmatogence retinal detachment. [4],[5] The nature of this defect and its dependence on Intra ocular-pressure has not been ellucidated. It is with these ideas that this work was undertaken.


  Material and methods Top


Twenty patients with rhegmatogenous retinal detach衫ent and twenty apparently healthy individuals as age and sex matched controls were included in this study.

A detailed history was taken in each case including his負ory of myopia and ocular trauma and family history of retinal detachment.

The clinical examination included both direct and indi訃ect ophthalmoscopy, corneal thickness measurement (CCT and PCT) and Applanation tonometry for all pa負ients and controls. During thickness measurements centering of the cornea was achieved by projecting the light directly over the centre of pupil.

All the cases having corneal diseas and patients who could not fix at the light during the thickness measure衫ent were excluded from this study. A statistical com計arison of CCT & PCT changes in normals, fellow eyes and affected eyes of retinal detachment were done. Also correlation of IOP changes and CCT changes were sought.


  Results Top


[Table - 1] shows the central corneal thickness (in mm) in the affected eyes, fellow eyes and the corresponding eyes of the controls. The mean central corneal thick要ess in the affected eyes was 0.4745 0.0338 mm, where the corresponding values in the fellow eyes and the control eyes were 0.5074 0.0247 mm and 0.5685 0.0153 mm respectively.

When the mean central corneal thickness of the affected eyes were compared with that of the fellow eyes and the control eyes, the results showed stastistically highly sig要ificant reduction in the central corneal thickness in the detachment eyes (P value < 0.01 and <0.001 respec負ively.)

When the central corneal thickness of the fellow eyes of the unilateral rhegmatogenous retinal detachment pa負ients were compared with that of the corresponding control eyes, the results also showed statisically signifi苞ant reduction of central corneal thickness (P value was <0.05).

[Table - 2] shows the peripheral corneal thickness in the affected eyes was 0.612 0.013 mm, where as mean peripheral corneal thickness in the fellow eyes and the control eyes were 0.661 0.014 mm and 0.675 0.001 mm respectively. When the peripheral corneal thickness of the affected eyes were compared with that of the fellow eyes, no statistically significant difference was noted. But when the same was compared with the corresponding control values, the results showed statis負ically significant reduction in peripheal corneal thick要ess of the detachment eyes (P value was <0.01). When the peripheral corneal thickness of the fellow eyes of the unilateral retinal detachement were compared with the corresponding control values, the results showed no statistically significant difference.

[Table - 3] shows the intraocular pressure in the affected eyes, fellow eyes and corresponding eyes of the con負rols. The mean IOP in the affected eyes (i.e. the eyes with rehegmalogenous retinal detachment) was 11.41 3.73 mm of Hg, whereas the IOP in the fellow eyes and control eyes were 18.8 3.78 and 17.9 2.00 mm of Hg respectively.

When the mean IOP of the affected eyes were compared with that of the fellow eyes and the control eyes, it showed statistically highly significant reduction in IOP in the detachment eyes (P value <0.001).


  Discussion Top


Generalised abnormalites have been described in fa衫ilia and bilateral retinal detachment in some interest虹ng case reports. [1],[2],[5],[6],[7],[8] The defect in corneal thickness has been a subject of controversy ever since its descrip負ion in the literature. [5],[6] In the present study we have shown that in case of rhegmatogenous retinal detach衫ent both the central as well as peripheral corneal thickness is decreased (P value < 0.001) when com計ared to normals. Our findings also indicate that not only the affected eye show these changes but the corneal thickness of the fellow eye is also decreased (P value < 0.5). Although previous work by Ehlers (1976) and Finn Kruse (1971) held contrary view regarding cor要eal thickness, in none of these studies fellow eye and P.C.T. Changes have been commented upon. There苯ore the present study indicates a uniform decrease in corneal thickness not limited to central the central por負ion of the cornea in the affected eyes.

On correlating the IOP changes with central thickness we found a simultaneous decrease of IOP and central corneal thickness in eyes with rhegmatogenous retinal detachment. However the fellow eyes of unilateral de負achment patient did show decrease in central corneal thickness even in the absence of decrease in intra ocular pressure. Therefore we feel that reduction in CCT is not dependent on the state of intra-ocular pressure as observed by Ehlers et al but on some other factors possibly genetic.

The peripheral thickness change, in the present study also showed a decrease in comparison to correspond虹ng controls. The PCT changes however have not been studied in the literature so far. We investigated the PCT changes with a view to ascertain the generalised corneal changes which occur in rhegmatogenous retinal detach衫ent and the answer has been affirmative. Therefore the very fact that (i) both the CCT and PCT are de苞reased in cases of rhegmatogenous retinal detach衫ent and (ii) the corneal changes are independent of I.O.P. variation further points to a generalised and dif苯use corneal genetic derangements in these cases. We believe that the reduction in corneal thickess in rhegma負ogenous retinal detachment is not governed by IOP changes but by other known factors which is related to rhegmatogenous retinal detachment possibly genetic[9].

 
  References Top

1.
Delaney WV. Heredity and retinal detachment. Geriatries 20:584-588 1965   Back to cited text no. 1
    
2.
Edmund J Familial retinal detachment Acta Ophthalmologica (Kbh) 39:644-654 1961.  Back to cited text no. 2
    
3.
Ehlers N&Kruse Hansen F: On the optical measurement of corneal thickness. Acta Oph. (Kbh) 49:65-81. 1971  Back to cited text no. 3
    
4.
Ehlers N. & Reise D. On corneal thickness and Intra ocular pressure. Acta Ophthal (Kbh) 45 809-813 1967.  Back to cited text no. 4
    
5.
Kruse Hansen F; Ehlers H; Bentzen'O' and Sogaard H. Central corneal thick ness and retinal detachment. Acta Oph (Kbh) 49:467-472. 1971.  Back to cited text no. 5
    
6.
Pemberton J.W. Mackenzee Feeman H, & Schepens C.L. Familial retinal de tachment and Ehlers Danlos Syndrome. Arch Ophthal 76:817-824. 1966   Back to cited text no. 6
    
7.
Roat, Longwone J. B. & Forrester R.M.: A childhood syndrome of bone dysplasia retinal detachment and deafness/develop, Med.Chil. Neurol. 9:467-473.1967  Back to cited text no. 7
    
8.
Van den Berg E.O.: Hereditary deisposition to retinal detachment in two families, Ophthalmologica 149: 236-240. 1965.  Back to cited text no. 8
    
9.
Wolter J.R. & Mac Vikar JE. Blue sclerae brittle bones and retinal detachment. J. Paediatrics ophthal, 13-16  Back to cited text no. 9
    



 
 
    Tables

  [Table - 1], [Table - 2], [Table - 3]



 

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Introduction
Material and methods
Results
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