Hornhaut-Pachymetrie und Augeninnendruck

Zusammenfassung

Die großen Glaukomstudien der letzten Jahre haben die Bedeutung des intraokularen Drucks bei der Diagnostik des Glaukoms und die Bedeutung der Augeninnendrucksenkung als Eckpfeiler der Glaukomtherapie bestätigt. Sowohl bei der exakten Messung des Augeninnendrucks als auch bei seiner diagnostischen Bewertung scheint die zentrale Hornhautdicke eine wesentliche Rolle zu spielen. Zahlreiche Studien haben gezeigt, dass die Hornhautdicke bei verschiedenen Formen des Glaukoms systematische Unterschiede aufweist. Da eine von der Norm abweichende Hornhautdicke möglicherweise eine artifizielle Veränderung des Messwerts bei der Applanationstonometrie zur Folge haben kann, stellt die Nichtberücksichtigung der zentralen Hornhautdicke möglicherweise die wichtigste Fehlerquelle bei der Glaukomdiagnostik dar. Korrekturen am applanatorisch gemessenen Augeninnendruck sind auf verschiedene Weise möglich, wobei zum Teil erheblich voneinander abweichende Ergebnisse gewonnen wurden. Das Fehlen eines allgemein akzeptierten Algorithmus für die Korrektur des applanatorisch gemessenen Augeninnendrucks sollte allerdings nicht von einem breiten Einsatz der Pachymetrie abhalten, da sie wertvolle Zusatzinformationen für das individuelle Glaukomrisiko liefern kann.

Abstract

Just recently studies on glaucoma have emphasised the significance of intraocular pressure in the diagnosis of glaucoma and the importance of intraocular pressure reduction in the management of glaucoma. Central corneal thickness appears to play an important role in the exact measurement of intraocular pressure and in the diagnostic assessment of glaucoma. Numerous studies have verified that corneal thickness shows systematic differences in different forms of glaucoma. Since deviations of corneal thickness from normal can possibly result in an artificial change of Goldmann applanation values, it would be a most important source of error in the diagnosis of glaucoma to ignore central corneal thickness. Corrections of intraocular pressure measured with applanation tonometry can be achieved in various ways but there is considerable divergence in the results. The absence of a generally accepted algorithm for the correction of intraocular pressure measured with applanation tonometry should not prevent us from a wide application of pachymetry, since it delivers valuable additional information on the individual risk of glaucoma.

Schlüsselwörter

Hornhautdicke - Pachymetrie - Augeninnendruck - Glaukom

Key words

Corneal thickness - pachymetry - intraocular pressure - glaucoma

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