The correlation between corneal endothelial cell density, central corneal thickness and retinal nerve fibre layer thickness in glaucoma suspects and newly detected primary glaucoma patients.

Purpose: To correlate corneal endothelial cell density, central corneal thickness and retinal nerve fiber layer thickness in glaucoma suspects and newly detected primary glaucoma patients. Patients and Methods: This duration-based, case-control study included 219 patients of which 80 were glaucoma suspects, 60 primary open- angle glaucoma and 79 were controls. The data was collected at the department of ophthalmology at Vydehi Institute of Medical Sciences and Research Center, Bangalore. Specular microscopy and Optical Coherence Tomography were performed on each patient and analysed. Results: The mean endothelial cell density showed a significant difference in glaucoma suspects and primary open angle glaucoma in comparison with controls. The CCT showed only a minimal difference between the three groups. The comparative analysis of RNFL in controls, glaucoma suspects and primary open angle glaucoma showed that primary open angle glaucoma showed the highest thinning among the three groups. The mean value between the controls, glaucoma suspects and primary open angle glaucoma was significant with a p value <0.001. Conclusion: Eyes with lower ECD were found to have thinner RNFL and Larger CDR in glaucoma suspects and newly detected cases of primary open angle glaucoma and the rate of RNFL and endothelial cell damage was directly proportional to increasing IOP. The CCT in the three groups showed only minimal difference. Thus, corneal parameters like ECD and CCT when used in combination with RNFL thickness are paramount in predicting the chances of future development of progressive glaucomatous optic neuropathy among glaucoma suspects and newly detected primary open angle glaucoma patients.