Associations with corneal hysteresis in a population cohort: Results from 96,010 UK Biobank participants

Abstract Purpose To describe the distribution of corneal hysteresis (CH) in a large cohort and explore its associated factors and possible clinical applications. Design Cross-sectional study within the UK Biobank, a large cohort study in the United Kingdom. Participants We analyzed CH data from 93,345 eligible participants in the UK Biobank cohort, aged 40 to 69 years. Methods All analyses were performed using left eye data. Linear regression models were used to evaluate associations between CH and demographic, lifestyle, ocular and systemic variables. Piecewise logistic regression models were used to explore the relationship between self-reported glaucoma and CH. Main outcome measures CH (mmHg). Results The mean CH was 10.6 mmHg (10.4 mmHg in males and 10.8 mmHg in females). After adjusting for covariables, CH was significantly negatively associated with male sex, age, Black ethnicity, self-reported glaucoma, diastolic blood pressure and height. CH was significantly positively associated with smoking, hyperopia, diabetes, systemic lupus erythematosus (SLE), greater deprivation (Townsend index) and Goldmann-correlated intraocular pressure (IOPg). Self-reported glaucoma and CH were significantly associated when CH was less than 10.1mmHg (OR 0.86, 95%CI 0.79-0.94 per mmHg CH increase) after adjusting for covariables. When CH exceeded 10.1 mmHg, there was no significant association between CH and self-reported glaucoma. Conclusion In our analyses, CH was significantly associated with factors including age, sex and ethnicity which should be taken into account when interpreting CH values. In our cohort, lower CH was significantly associated with a higher prevalence of self-reported glaucoma when CH was less than 10.1mmHg. CH may serve as a biomarker aiding glaucoma case detection.