Researchers at the Duke Eye Center in Durham, NC, have found that about a quarter of eyes with well-controlled IOP can still show glaucomatous visual field (VF) progression over time. They cited thin central corneal thickness (CCT) and corneal hysteresis as major risk factors.

The study analyzed 179 eyes that had mean follow-up of 4.3±0.8 years and IOP less than 18mm Hg. Of these eyes, 42 demonstrated VF progression. Researchers found no significant difference between progressing and stable patients in baseline mean deviation, mean IOP, IOP fluctuation or peak IOP. However, they found that progressing eyes had significantly lower CH and thinner CCT compared with stable eyes. Having these factors resulted in a 68% higher risk of progression.

The researchers believe that studying corneal biomechanics can reveal a better picture of VF progression, they said in the study.

Susanna BN, Ogata  NG, Jammal AA, et al. Corneal biomechanics and visual field progression in eyes with seemingly well-controlled intraocular pressure. Ophthalmology. August 9, 2019. [Epub ahead of print].