The association between corneal hysteresis and glaucoma in the Canadian longitudinal study on aging

This study investigated the association between corneal hysteresis and glaucoma in the Canadian Longitudinal Study on Aging using self-reported diagnosis and an objective definition based on deep learning-predicted retinal nerve fiber layer thickness from fundus photographs. A total of 52,511 eyes from 27,334 participants were included. Glaucoma was objectively defined as predicted retinal nerve fiber layer thickness less than 70 μm in at least one eye. Multivariable logistic regression models assessed the association between corneal hysteresis and each glaucoma definition after adjusting for confounding variables. Sensitivity analyses evaluated alternative retinal nerve fiber layer thresholds and eye-level definitions. Eyes from participants with self-reported glaucoma had lower mean corneal hysteresis than eyes from participants without glaucoma (9.51 ± 2.14 vs. 10.1 ± 1.96 mmHg; P < 0.001). Lower corneal hysteresis was independently associated with higher odds of self-reported glaucoma (odds ratio 1.074 per 1 mmHg lower; P < 0.001) and objectively defined glaucoma (odds ratio 1.163 per 1 mmHg lower; P < 0.001). Lower corneal hysteresis was consistently associated with glaucoma, with stronger associations observed using an objective retinal nerve fiber layer-based definition. These findings suggest that corneal hysteresis may provide useful information about susceptibility to glaucomatous structural damage.