Association Between Central Corneal Thickness and Disease Severity in Primary Open-Angle Glaucoma

Background: Primary open-angle glaucoma is a leading cause of irreversible blindness worldwide. Although elevated intraocular pressure is the primary modifiable risk factor, disease progression may occur despite normal pressure levels. Central corneal thickness influences intraocular pressure measurement and may independently affect glaucoma severity. Understanding the relationship between central corneal thickness and disease severity can improve risk stratification and clinical management of primary open-angle glaucoma. Objectives: To evaluate the relationship between central corneal thickness and the severity of primary open-angle glaucoma among adult patients. Methods: A hospital-based cross-sectional study was conducted at Lions Charitable Eye Institute and Hospital from July to December 2024. 92 adults with primary open-angle glaucoma were included. Participants underwent comprehensive ophthalmic evaluation, including intraocular pressure measurement, gonioscopy, pachymetry, and visual field analysis. Central corneal thickness was correlated with glaucoma severity using appropriate statistical tests, with significance set at p < 0.05. Results: The study included 92 participants with a mean age of 57.2 ± 12.4 years; 54.3% were male. Mean central corneal thickness was 521.7 ± 28.5 µm, with 30.4% having CCT <500 µm. Mild, moderate, and severe POAG were observed in 30.4%, 38.0%, and 31.5% respectively. Mean CCT decreased with severity. Mean intraocular pressure was 23.4 ± 4.2 mmHg. Conclusion: Central corneal thickness is an important clinical parameter influencing glaucoma severity assessment and should be routinely considered in primary open-angle glaucoma evaluation.