Central corneal thickness and its relationship to intraocular pressure in children

Objective: Central corneal thickness (CCT) has emerged as an important predictive factor for the development of glaucomatous damage. Although a child's cornea reaches adult thickness by the age of 3, little has been reported about normal CCT measurements in eyes of children. We wished to test the hypotheses that (1) there is a correlation between increasing CCT and increasing intraocular pressure (IOP) in the eyes of children, (2) the CCT in the eyes of children with ocular hypertension is greater than that in eyes of normal pediatric subjects, and (3) the average CCT of black children is less than that of white children. Methods: We performed a retrospective chart review of 69 pediatric patients seen in the office of one ophthalmologist between January 1997 and December 2001 in whom CCT was measured by ultrasound pachymetry. We categorized the subjects into diagnostic groups of controls, glaucoma, glaucoma suspects, and ocular hypertension based on IOP, cup-to-disc ratio, and visual field parameters. Results: The average CCT for the control patients was 555+/-37 mum; for patients with glaucoma, it was 563+/-33 mum; for glaucoma suspects, 559+/-39 mum; and for those with ocular hypertension, 595+/-39 mum. The difference between the control and ocular hypertensive groups was significant (P<0.02). The difference in CCT between the black control subjects and the white ones (537+/-36 mum vs. 564+/-28 mum) was not statistically significant (P +/- 0.125). Conclusions: Central corneal thickness is greater in children with ocular hypertension than in control subjects or those with glaucoma, and the values for CCT in these children correlate closely with values reported for adults. Corneas of black children may be thinner than the corneas of white children. Ophthalmology 2004; 111:2220-2223 (C) 2004 by the American Academy of Ophthalmology.