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Terauchi R, Wada T, Fukai K, Tatemichi M, Sano K, Nishijima E, Ogawa S, Noro T, Ito K, Kato T, Kato K, Nakano T. Association Between Days of the Week and Intraocular Pressure: Japan Ningen Dock Study. J Glaucoma 2024; 33:262-269. [PMID: 37974321 DOI: 10.1097/ijg.0000000000002333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 10/25/2023] [Indexed: 11/19/2023]
Abstract
PRCIS The analysis of intraocular pressure (IOP) by day of the week using the mega database showed a periodic weekly pattern with the highest value on Monday. PURPOSE To evaluate IOP by the day of the week. PATIENTS AND METHODS Annual health checkup examinees between April 2014 and March 2015 were cross-sectionally evaluated. As a result, 655,818 participants [51.5±10.5 (range: 20-96) years, 40.1% women] from 103 medical centers were included. IOP was measured using a noncontact tonometer. The mean IOPs of each day of the week were compared using multiple comparison test and multiple linear regression analysis. Wednesday was set as the reference. Moreover, weekly IOP variations stratified by sex and age were also evaluated. RESULTS Mean IOPs from Monday to Sunday were 13.19±2.97, 13.06±2.92, 13.05±2.91, 13.05±2.92, 13.12±2.94, 13.10±2.96, and 13.16±2.78 mm Hg. IOP was significantly higher on Monday, Friday, and Saturday than those on Wednesday ( P <0.001, <0.001, 0.002). After adjusting for factors affecting IOP, the IOPs on Monday and Saturday were higher than those on Wednesday [β=0.097 (95% CI: 0.074-0.121), P <0.001; β=0.032 (95% CI: 0.005-0.059), P =0.019]. Men had significantly higher IOPs on Monday and Saturday than on Wednesday [β=0.142 (95% CI: 0.110-0.173), P <0.001; β=0.053 (95% CI: 0.017-0.089), P =0.004], whereas women did not have a significant trend. Participants aged below 65 years had higher IOPs on Monday ( P <0.001 in under 60 years; P =0.003 in 60-64 years), while those aged 65 years or older did not ( P =0.856). CONCLUSION IOP values may have a periodic weekly pattern. The high IOP on Monday was more pronounced in men aged less than 65 years.
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Affiliation(s)
| | - Takashi Wada
- Health Science, The Jikei University Graduate School of Medicine, Tokyo
| | - Kota Fukai
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara
| | - Masayuki Tatemichi
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara
| | | | | | | | | | - Kyoko Ito
- Centre for Preventive Medicine, The Jikei University School of Medicine
| | - Tomohiro Kato
- Centre for Preventive Medicine, The Jikei University School of Medicine
| | - Kiminori Kato
- Department of Prevention of Noncommunicable Diseases and promotion of Health Checkup, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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2
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van den Bosch JJON, Pennisi V, Rao HL, Mansouri K, Weinreb R, Thieme H, Hoffmann MB, Choritz L. Reproducibility of consecutive automated telemetric noctodiurnal IOP profiles as determined by an intraocular implant. Br J Ophthalmol 2024:bjo-2022-323080. [PMID: 38408856 DOI: 10.1136/bjo-2022-323080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 01/27/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Intraocular pressure (IOP) monitoring in glaucoma management is evolving with novel devices. We investigated the reproducibility of 24 hour profiles on two consecutive days and after 30 days of self-measurements via telemetric IOP monitoring. METHODS Seven primary patients with open-angle glaucoma previously implanted with a telemetric IOP sensor in one eye underwent automatic measurements throughout 24 hours on two consecutive days ('day 1' and 'day 2'). Patients wore an antenna adjacent to the study eye connected to a reader device to record IOP every 5 min. Also, self-measurements in six of seven patients were collected for a period of 30 days. Analysis included calculation of hourly averages to correlate time-pairs of day 1 versus day 2 and the self-measurements vers day 2. RESULTS The number of IOP measurements per patient ranged between 151 and 268 on day 1, 175 and 268 on day 2 and 19 and 1236 during 30 days of self-measurements. IOP time-pairs of automatic measurements on day 1 and day 2 were significantly correlated at the group level (R=0.83, p<0.001) and in four individual patients (1, 2, 6 and 7). IOP time-pairs of self-measurements and day 2 were significantly correlated at the group level (R=0.4, p<0.001) and in four individual patients (2, 5, 6 and 7). CONCLUSIONS Twenty-four hour automatic measurements of IOP are correlated on consecutive days and, though to a lesser degree, with self-measurements. Therefore a virtual 24-hour IOP curve might be constructed from self-measurements. Both options provide an alternative to frequent in-office IOP measurements.
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Affiliation(s)
- Jacqueline J O N van den Bosch
- Department of Ophthalmology, Otto von Guericke University Magdeburg, Magdeburg, Germany
- Department of Ophthalmology, University Medical Centre Groningen, Groningen, The Netherlands
| | - Vincenzo Pennisi
- Department of Ophthalmology, University Medical Centre Groningen, Groningen, The Netherlands
| | | | - Kaweh Mansouri
- Swiss Visio, Montchoisi Clinic, Glaucoma Research Centre, Lausanne, Switzerland
- Department of Ophthalmology, University of Colorado School of Medicine, Denver, Colorado, USA
| | - Robert Weinreb
- Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Hagen Thieme
- Department of Ophthalmology, University Medical Centre Groningen, Groningen, The Netherlands
| | - Michael B Hoffmann
- Department of Ophthalmology, University Medical Centre Groningen, Groningen, The Netherlands
| | - Lars Choritz
- Department of Ophthalmology, University Medical Centre Groningen, Groningen, The Netherlands
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3
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Nicou CM, Passaglia CL. Characterization of intraocular pressure variability in conscious rats. Exp Eye Res 2024; 239:109757. [PMID: 38123009 PMCID: PMC10922224 DOI: 10.1016/j.exer.2023.109757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/10/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023]
Abstract
Elevation of mean intraocular pressure (IOP) has long been recognized as a leading risk factor for glaucoma. Less is known about the possible contribution of moment-to-moment variations in IOP to disease development and progression due to limitations of tonometry, the prevailing method of IOP measurement. Tonometry provides good estimates of mean IOP but not IOP variance. The aim of this study was to quantitatively characterize IOP variability via round-the-clock IOP telemetry in conscious unrestrained rats. The anterior chamber of one eye was implanted with a microcannula connected to a wireless backpack telemetry system, and IOP data were collected every 4 s for one week. The cannula was then repositioned under the conjunctiva, and control data were collected for an additional week. IOP statistics were computed in 30-min intervals over a 24-h period and averaged across days. All animals exhibited a diurnal variation in mean IOP, while deviations about the mean were independent of time of day. Correlation analysis of the deviations revealed transient and sustained components, which were respectively extracted from IOP records using an event detection algorithm. The amplitude and interval distributions of transient and sustained events were characterized, and their energy content was estimated based on outflow tissue resistance of rat eyes. Transient IOP events occurred ∼231 times per day and were typically ≤5 mmHg in amplitude and 2-8 min in duration, while sustained IOP events occurred ∼16 times per day and were typically ≤5 mmHg in amplitude and 20-60 min in duration. Both persisted but were greatly reduced in control recordings, implying minor contamination of IOP data by motion-induced telemetry noise. Sustained events were also often synchronous across implanted animals, indicating that they were driven by autonomic startle and stress responses or other physiological processes activated by sensory signals in the animal housing environment. Not surprisingly, the total daily fluidic energy applied to resistive outflow pathways was determined primarily by basal IOP level. Nevertheless, transient and sustained fluctuations collectively contributed 6% and diurnal fluctuations contributed 9% to daily IOP energy. It is therefore important to consider the cumulative impact of biomechanical stress that IOP fluctuations apply over time to ocular tissues.
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Affiliation(s)
- Christina M Nicou
- Medical Engineering Department, University of South Florida, Tampa, FL, 33620, USA
| | - Christopher L Passaglia
- Medical Engineering Department, University of South Florida, Tampa, FL, 33620, USA; Ophthalmology Department, University of South Florida, Tampa, FL, 33620, USA.
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4
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Ezepue CO, Anyatonwu OP, Duru CC, Odini F, Nwachukwu NZ, Onoh C, Nwachukwu N, Oguonu CA. Effects of music on the preoperative and intraoperative anxiety through the assessment of pupil size and vital signs (blood pressure, respiratory, and pulse rates) among cataract surgery patients at UNTH-Enugu. FRONTIERS IN OPHTHALMOLOGY 2024; 3:1340752. [PMID: 38983030 PMCID: PMC11182256 DOI: 10.3389/fopht.2023.1340752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 12/14/2023] [Indexed: 07/11/2024]
Abstract
Background/Aim To examine how music can impact preoperative and intraoperative anxiety via assessment of physiological markers such as pupil size, blood pressure, pulse rate, and respiratory rate. Methods This is a randomized interventional study of individuals aged 50 years and above who were scheduled for and undergoing cataract surgery under regional anesthesia, with music (test group) randomly matched with similar individuals undergoing the same procedure but without music (control group). The surgeries were performed in the operating theater of the Department of Ophthalmology, University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu. Using a systematic random sampling method, a total of 98 patients were grouped into two. Both groups completed the State-Trait Anxiety Inventory (STAI) questionnaire at baseline, immediately upon entrance into the preoperative room and 5 min after intervention. Relevant study indices (blood pressure, pulse, respiratory rate, and pupil diameter) were measured and recorded, and these served as baseline parameters. The STAI questionnaire was then administered. Results were analyzed using the SPSS version 20 and analysis of variance was used to compare means of variables measured at baseline, preoperative before intervention, and preoperative after intervention. Categorical variables were compared using the Chi-square test. Student's t-test was used to analyze the continuous variables. Results Our analysis, using the multiple linear regression, showed that music has an effect on preoperative anxiety and intraoperative anxiety by positively affecting the blood pressure, pulse rate, respiratory rate, and pupil diameter (P ≤ 0.001). Conclusion Music reduces preoperative and intraoperative anxiety evidenced by its effect on the physiological biomarkers.
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Affiliation(s)
| | - Obinna Princewill Anyatonwu
- Department of Optometry, Faculty of Medicine and Health Sciences, Abia University Uturu, Okigwe, Abia, Nigeria
| | - Christian Chukwuka Duru
- Department of Optometry, Faculty of Medicine and Health Sciences, Imo State University, Owerri, Nigeria
| | - Franklin Odini
- Department of Community Medicine, Federal Medical Centre Umuahia, Umuahia, Abia, Nigeria
| | - Nkiru Zuada Nwachukwu
- Department of Ophthalmology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Chidimma Onoh
- Department of Psychiatry, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Nwamaka Nwachukwu
- Department of Ophthalmology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Chukwunonso Afam Oguonu
- Department of Ophthalmology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
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5
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Stuart KV, Pasquale LR, Kang JH, Foster PJ, Khawaja AP. Towards modifying the genetic predisposition for glaucoma: An overview of the contribution and interaction of genetic and environmental factors. Mol Aspects Med 2023; 93:101203. [PMID: 37423164 PMCID: PMC10885335 DOI: 10.1016/j.mam.2023.101203] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/26/2023] [Accepted: 07/05/2023] [Indexed: 07/11/2023]
Abstract
Glaucoma, the leading cause of irreversible blindness worldwide, is a complex human disease, with both genetic and environmental determinants. The availability of large-scale, population-based cohorts and biobanks, combining genotyping and detailed phenotyping, has greatly accelerated research into the aetiology of glaucoma in recent years. Hypothesis-free genome-wide association studies have furthered our understanding of the complex genetic architecture underpinning the disease, while epidemiological studies have provided advances in the identification and characterisation of environmental risk factors. It is increasingly recognised that the combined effects of genetic and environmental factors may confer a disease risk that reflects a departure from the simple additive effect of the two. These gene-environment interactions have been implicated in a host of complex human diseases, including glaucoma, and have several important diagnostic and therapeutic implications for future clinical practice. Importantly, the ability to modify the risk associated with a particular genetic makeup promises to lead to personalised recommendations for glaucoma prevention, as well as novel treatment approaches in years to come. Here we provide an overview of genetic and environmental risk factors for glaucoma, as well as reviewing the evidence and discussing the implications of gene-environment interactions for the disease.
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Affiliation(s)
- Kelsey V Stuart
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jae H Kang
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Paul J Foster
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
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6
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Bhanvadia SB, Brar MS, Delavar A, Tavakoli K, Saseendrakumar BR, Weinreb RN, Zangwill LM, Baxter SL. Assessing Usability of Smartwatch Digital Health Devices for Home Blood Pressure Monitoring among Glaucoma Patients. INFORMATICS (MDPI) 2022; 9:79. [PMID: 36873830 PMCID: PMC9980658 DOI: 10.3390/informatics9040079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Glaucoma is a leading cause of blindness worldwide. Blood pressure (BP) dysregulation is a known risk factor, and home-based BP monitoring is increasingly used, but the usability of digital health devices to measure BP among glaucoma patients is not well studied. There may be particular usability challenges among this group, given that glaucoma disproportionately affects the elderly and can cause visual impairment. Therefore, the goal of this mixed-methods study was to assess the usability of a smart watch digital health device for home BP monitoring among glaucoma patients. Adult participants were recruited and given a smartwatch blood pressure monitor for at-home use. The eHEALS questionnaire was used to determine baseline digital health literacy. After a week of use, participants assessed the usability of the BP monitor and related mobile app using the Post-study System Usability Questionnaire (PSSUQ) and the System Usability Scale (SUS), standardized instruments to measure usability in health information technology interventions. Variations in scores were evaluated using ANOVA and open-ended responses about participants' experience were analyzed thematically. Overall, usability scores corresponded to the 80th-84th percentile, although older patients endorsed significantly worse usability based on quantitative scores and additionally provided qualitative feedback describing some difficulty using the device. Usability for older patients should be considered in the design of digital health devices for glaucoma given their disproportionate burden of disease and challenges in navigating digital health technologies, although the overall high usability scores for the device demonstrates promise for future clinical applications in glaucoma risk stratification.
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Affiliation(s)
- Sonali B. Bhanvadia
- Hamilton Glaucoma Center, Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, CA 92093, USA
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, CA 92093, USA
| | - Manreet S. Brar
- Hamilton Glaucoma Center, Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, CA 92093, USA
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, CA 92093, USA
| | - Arash Delavar
- Hamilton Glaucoma Center, Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, CA 92093, USA
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, CA 92093, USA
| | - Kiana Tavakoli
- Hamilton Glaucoma Center, Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, CA 92093, USA
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, CA 92093, USA
| | - Bharanidharan Radha Saseendrakumar
- Hamilton Glaucoma Center, Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, CA 92093, USA
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, CA 92093, USA
| | - Robert N. Weinreb
- Hamilton Glaucoma Center, Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, CA 92093, USA
| | - Linda M. Zangwill
- Hamilton Glaucoma Center, Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, CA 92093, USA
| | - Sally L. Baxter
- Hamilton Glaucoma Center, Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, CA 92093, USA
- Health Department of Biomedical Informatics, University of California San Diego, La Jolla, CA 92093, USA
- Correspondence: ; Tel.: +1-(858)-246-4604
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7
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Abu EK, Antiri EO, Ocansey S, Ntodie M, Abokyi S, Abraham CH. Associations between personality traits and adherence to treatment in patients with primary open–angle glaucoma in an African population. Clin Exp Optom 2022:1-7. [DOI: 10.1080/08164622.2022.2075253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Emmanuel K Abu
- Department of Optometry and Vision Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Ebenezer O Antiri
- Department of Optometry and Vision Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Stephen Ocansey
- Department of Optometry and Vision Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Michael Ntodie
- Department of Optometry and Vision Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Samuel Abokyi
- Department of Optometry and Vision Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Carl Halladay Abraham
- Department of Optometry and Vision Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
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8
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Nicou CM, Pillai A, Passaglia CL. Effects of acute stress, general anesthetics, tonometry, and temperature on intraocular pressure in rats. Exp Eye Res 2021; 210:108727. [PMID: 34390732 DOI: 10.1016/j.exer.2021.108727] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/30/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
Intraocular pressure (IOP) is important for eye health as abnormal levels can led to ocular tissue damage. IOP is typically estimated by tonometry, which only provides snapshots of pressure history. Tonometry also requires subject cooperation and corneal contact that may influence IOP readings. The aim of this research was to investigate IOP dynamics of conscious animals in response to stressors, common anesthetics, tonometry, and temperature manipulations. An eye of male Brown-Norway rats was implanted with a fluid-filled cannula connected to a wireless telemetry system that records IOP continuously. Stress effects were examined by restricting animal movements. Anesthetic effects were examined by varying isoflurane concentration or injecting a bolus of ketamine. Tonometry effects were examined using applanation and rebound tonometers. Temperature effects were examined by exposing anesthetized and conscious animals to warm or cool surfaces. Telemetry recordings revealed that IOP fluctuates spontaneously by several mmHg, even in idle and anesthetized animals. Environmental disturbances also caused transient IOP fluctuations that were synchronous in recorded animals and could last over a half hour. Animal immobilization produced a rapid sustained elevation of IOP that was blocked by anesthetics, whereas little-to-no IOP change was detected in isoflurane- or ketamine-anesthetized animals if body temperature (BT) was maintained. IOP and BT decreased precipitously when heat support was not provided and were highly correlated during surface temperature manipulations. Surface temperature had no impact on IOP of conscious animals. IOP increased slightly during applanation tonometry but not rebound tonometry. The results show that IOP is dynamically modulated by internal and external factors that can activate rapidly and last long beyond the initiating event. Wireless telemetry indicates that animal interaction induces startle and stress responses that raise IOP. Anesthesia blocks these responses, which allows for better tonometry estimates of resting IOP provided that BT is controlled.
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Affiliation(s)
- Christina M Nicou
- Medical Engineering Department, University of South Florida, Tampa, FL, 33620, USA
| | - Aditi Pillai
- Medical Engineering Department, University of South Florida, Tampa, FL, 33620, USA
| | - Christopher L Passaglia
- Medical Engineering Department, University of South Florida, Tampa, FL, 33620, USA; Ophthalmology Department, University of South Florida, Tampa, FL, 33620, USA.
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9
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Gillmann K, Weinreb RN, Mansouri K. The effect of daily life activities on intraocular pressure related variations in open-angle glaucoma. Sci Rep 2021; 11:6598. [PMID: 33758276 PMCID: PMC7988182 DOI: 10.1038/s41598-021-85980-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 02/26/2021] [Indexed: 12/13/2022] Open
Abstract
The recent advent of continuous intraocular pressure (IOP) telemetry has led to an increased awareness of the importance of IOP fluctuations, and theories have emerged that IOP variations could play as much a role in glaucoma progression as the mean level of IOP. The aim of the present study was to evaluate the direct effect of common daily activities on IOP-related profiles. Primary open-angle glaucoma and glaucoma suspect patients were prospectively enrolled from specialist clinics at the University of California San Diego (UCSD), USA. Patients were fitted with a SENSIMED Triggerfish (TF) contact lens sensor (CLS) and were instructed to return to their usual daily activities for 24 h. They were asked to record each specific activity or event in a diary. The protocol was repeated twice. The following events were recorded: "walking/cycling", "resistance training", "yoga/meditation", and "emotional stress". CLS measurements recorded 60-to-30 min prior to each event were used as a baseline reference, and all IOP-related fluctuations for 120 min after the start of each event were reported in relation to this reference. Forty relevant events from 22 CLS recordings in 14 patients were retrieved from the diaries. Walking/cycling (n = 10) caused a small but statistically significant elevation of the IOP-related profile during the activity (p = 0.018). Resistance training (n = 11) caused a persistent elevation of the IOP-related profile from the onset of the activity (p = 0.005) through 120 min after the activity was stopped (p = 0.007). Yoga/meditation (n = 4) caused a sustained drop in the IOP-related profiles through to 120 min, although this was not statistically significant (p > 0.380). Emotional stress (n = 13) was associated with a gradual elevation of the IOP-related profile from the start of the stressful stimulus. Both early and late variations were statistically significant (p = 0.038 and p = 0.021, respectively). The present study suggests that emotional stress and resistance training may be associated with persistent IOP-related profile elevation.
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Affiliation(s)
- Kevin Gillmann
- Glaucoma Research Center, Montchoisi Clinic, Swiss Visio, Lausanne, Switzerland.,Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA
| | - Kaweh Mansouri
- Glaucoma Research Center, Montchoisi Clinic, Swiss Visio, Lausanne, Switzerland. .,Department of Ophthalmology, University of Colorado School of Medicine, Denver, CO, USA.
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10
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Pe'er O, Chiu E, Arad D, Lelescu C, Ross M, Ofri R. Does the order of intraocular pressure measurement affect tonometry results? Vet Ophthalmol 2021; 24 Suppl 1:146-153. [PMID: 33538076 DOI: 10.1111/vop.12861] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 12/22/2020] [Accepted: 12/30/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To determine whether the order of intraocular pressure (IOP) measurement affects readings, regardless of which eye is measured first. METHODS Intraocular pressure was measured in 31 and 41 dogs using applanation and rebound tonometry, respectively. Initially, IOP was measured in the first (randomly chosen) eye (reading A), followed by measurement in the fellow eye (reading B), and a third (repeated) measurement in the first eye (reading C). After 15 minutes, measurements were repeated in reverse order (readings D - F). RESULTS Applanation tonometry revealed significant differences between readings A & B (15.6 ± 2.3 and 14.8 ± 2.7 mm Hg, respectively, p = .02), A & C (15.6 ± 2.3 and 14.5 ± 2.4 mm Hg, respectively, p = .002), D & E (14.5 ± 2.3 and 13.7 ± 2.1 mm Hg, respectively, p = .02), D & F (14.5 ± 2.3 and 13.9 ± 1.9 mm Hg, respectively, p = .05), and A & E (15.6 ± 2.3 and 13.7 ± 2.1 mm Hg, respectively, p = .001). Rebound tonometry yielded similar results, with additional differences between B & C (19.1 ± 3.0 and 18.2 ± 2.4 mm Hg, respectively, p = .002) and E & F (18.7 ± 3.3 and 18.2 ± 3.3 mm Hg, respectively, p = .02). CONCLUSIONS Intraocular pressure measured in the first eye, whether right or left, is higher than in the fellow eye. Repeated tonometry in the same visit could result in a significant IOP decrease, though the magnitude may not be clinically appreciable.
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Affiliation(s)
- Oren Pe'er
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Eni Chiu
- Petshome Veterinary Hospital, Shanghai, China
| | - Dikla Arad
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Cristina Lelescu
- The University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca (USAMVCN), Cluj-Napoca, Romania
| | - Maya Ross
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Ron Ofri
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
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11
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Abe RY, Silva TC, Dantas I, Curado SX, Madeira MS, de Sousa LB, Costa VP. Can Psychologic Stress Elevate Intraocular Pressure in Healthy Individuals? Ophthalmol Glaucoma 2020; 3:426-433. [PMID: 32768362 DOI: 10.1016/j.ogla.2020.06.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/16/2020] [Accepted: 06/23/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE To investigate if a stress event can influence intraocular pressure (IOP) in a group of healthy individuals. DESIGN Case-control study. PARTICIPANTS A total of 28 healthy subjects were included: 17 in the stress group and 11 in the control group. METHODS The Trier Social Stress Test (TSST) is a tool to evaluate cortisol response to psychologic stimulation based on the stress induced by public speaking. All participants underwent a modified diurnal tension curve (DTC) 1 week before the TSST, with 3 IOP measurements performed between 8:00 am and 2:00 pm. We evaluated the response to the TSST measuring the levels of salivary cortisol, IOP, and heart rate before, immediately after, and 40 minutes after TSST. The State Trait Anxiety Inventory (STAI) was applied to evaluate the levels of anxiety at the same time intervals. MAIN OUTCOME MEASURES Changes in IOP (mmHg), salivary cortisol, heart rate, and STAI scores. RESULTS At baseline, there were no significant differences between case and controls regarding age (52.2 ± 6.26 vs. 53.8 ± 8.4 years, P = 0.661), gender (52.94% male vs. 45.45% female, P = 0.669), and ethnicity. Salivary cortisol (6.8 nmol/l, P < 0.001) and heart rate (7.2 beats/min, P = 0.035) increased significantly after the TSST. We observed a mean IOP increase of 1.0 mmHg (right eye, P = 0.003) and 1.1 mmHg (left eye, P = 0.004) when comparing IOP measurements obtained during the DTC and immediately after TSST. In addition, 35% (6/17) of the subjects in the TSST group showed an IOP increase higher than 2 mmHg after the test compared with 18% (2/11) in the control group. The STAI state score significantly increased after the stress event compared with baseline (P = 0.026) and decreased from poststress to the recovery period (P = 0.006) in the TSST group. The control group did not show significant changes in IOP, heart rate, salivary cortisol levels, and STAI scores. CONCLUSIONS Significant elevations of IOP, salivary cortisol, STAI scores, and heart rate occurred after inducing psychologic stress with TSST in a group of healthy individuals.
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Affiliation(s)
- Ricardo Y Abe
- Hospital Oftalmológico de Brasília, Brasília, Distrito Federal, Brazil; Department of Ophthalmology - University of Campinas, Campinas, Brazil.
| | - Thairis C Silva
- Hospital Oftalmológico de Brasília, Brasília, Distrito Federal, Brazil
| | | | | | - Mariana S Madeira
- Hospital Oftalmológico de Brasília, Brasília, Distrito Federal, Brazil
| | | | - Vital P Costa
- Department of Ophthalmology - University of Campinas, Campinas, Brazil
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Yong PT, Arif N, Sharanjeet-Kaur S, Hairol MI. Double Eyelid Tape Wear Affects Anterior Ocular Health among Young Adult Women with Single Eyelids. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217701. [PMID: 33105550 PMCID: PMC7672649 DOI: 10.3390/ijerph17217701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/29/2020] [Accepted: 10/09/2020] [Indexed: 11/16/2022]
Abstract
Many East Asians apply double eyelid tape to create the double eyelid effect temporarily as a means of increasing their beauty. This study evaluated the effects of four-week wear of double eyelid tape on anterior ocular health in young adult women with single eyelids. Twenty-nine participants who met the inclusion criteria were recruited. The participants’ anterior ocular health was examined including blinking characteristics (blink pattern and blink rate), ocular surface health (presence of corneal abrasion, corneal staining, conjunctival staining, corneal curvatures, meibomian gland dysfunction), tear break up time, intraocular pressure, and subjective comfort level. Participants were required to apply the double eyelid tape for at least eight hours a day and five days a week for four weeks. The parameters were re-measured at the end of each week. There was a significant increase in conjunctival staining, corneal staining, and meibomian gland dysfunction, with a significant reduction in tear break-up time and intraocular pressure. By week 3, all participants had incomplete blinks. There was no significant change in symptoms and subjective comfort level reported. Therefore, patients and eye care practitioners should be aware of the potential implications of double eyelid tape wear on ocular health, with no significant change in subjective comfort.
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Affiliation(s)
- Pui Theng Yong
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (P.T.Y.); (N.A.)
| | - Norlaili Arif
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (P.T.Y.); (N.A.)
| | - Sharanjeet Sharanjeet-Kaur
- Centre for Rehabilitation & Special Need Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia;
| | - Mohd Izzuddin Hairol
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (P.T.Y.); (N.A.)
- Correspondence:
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13
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Jasien JV, Girkin CA, Downs JC. Effect of Anesthesia on Intraocular Pressure Measured With Continuous Wireless Telemetry in Nonhuman Primates. Invest Ophthalmol Vis Sci 2019; 60:3830-3834. [PMID: 31529079 PMCID: PMC6750888 DOI: 10.1167/iovs.19-27758] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 08/09/2019] [Indexed: 12/28/2022] Open
Abstract
Purpose To compare the effects of both injectable anesthesia (ketamine/dexmedetomidine versus ketamine/xylazine) and inhalant anesthesia (isoflurane) on IOP using continuous, bilateral IOP telemetry in nonhuman primates (NHP). Methods Bilateral IOP was recorded continuously using a proven implantable telemetry system in five different sessions at least 2 weeks apart in four male rhesus macaques under two conditions: ketamine (3 mg/kg) with dexmedetomidine (50 μg/kg) or ketamine with xylazine (0.5 mg/kg) for induction, both followed by isoflurane for maintenance. IOP transducers were calibrated via anterior chamber manometry. Bilateral IOP was averaged over 2 minutes after injectable anesthetic induction and again after isoflurane inhalant had stabilized the anesthetic plane, then compared to baseline IOP measurements acquired immediately prior to anesthesia (both before and after initial human contact). Results When compared to pre-contact baseline measurements, ketamine/dexmedetomidine injectable anesthesia lowers IOP by 1.5 mm Hg on average (P < 0.05), but IOP did not change with ketamine/xylazine anesthesia. IOP returned to baseline levels shortly after isoflurane gas anesthesia was initiated. However, injectable anesthesia lowered IOP by an average of 5.4 mm Hg when compared to that measured after initial human contact (P < 0.01). Conclusions Anesthetic effects on IOP are generally small when compared to precontact baseline but much larger when compared to IOP measures taken after human contact, indicating that IOP is temporarily elevated due to acute stress (similar to a "white coat effect") and then decreased with anesthetic relaxation. Anesthetic induction with ketamine/xylazine and maintenance with isoflurane gas should be used when IOP is measured postanesthesia.
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Affiliation(s)
- Jessica V. Jasien
- Vision Science Graduate Program, School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Christopher A. Girkin
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - J. Crawford Downs
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
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14
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Turner DC, Miranda M, Morris JS, Girkin CA, Downs JC. Acute Stress Increases Intraocular Pressure in Nonhuman Primates. Ophthalmol Glaucoma 2019; 2:210-214. [PMID: 31799505 DOI: 10.1016/j.ogla.2019.03.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose To quantify intraocular pressure (IOP) change and time course during stressful activity. Study Design Experimental Study. Subjects Three nonhuman primates (NHPs). Methods Bilateral IOP and aortic blood pressure (BP) were recorded continuously, then averaged for periods of 8-30 seconds before, during, and after a common anesthetic induction procedure (cage squeeze followed by intramuscular injection). Experiments were repeated four times in each NHP. Main Outcome Measures IOP, BP, and heart rate (HR) change during an anesthetic induction procedure. Results IOP, mean arterial pressure (MAP), and HR increased rapidly and significantly by 27%, 38%, 34%, respectively, in anticipation of anesthetic induction (Figure; p<0.05). IOP rose ~10% within 10 seconds of hearing the technician enter the outer anteroom door, and reached its maximum within ~1 minute of first anticipating human contact. IOP fell to below baseline levels within 1 minute after anesthetic induction. Conclusions IOP increases rapidly and significantly in response to stressful situations in the nonhuman primate.
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Affiliation(s)
- Daniel C Turner
- Department of Vision Sciences, School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Michelle Miranda
- The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Jeffrey S Morris
- The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Christopher A Girkin
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - J Crawford Downs
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Gillmann K, Hoskens K, Mansouri K. Acute emotional stress as a trigger for intraocular pressure elevation in Glaucoma. BMC Ophthalmol 2019; 19:69. [PMID: 30849950 PMCID: PMC6408777 DOI: 10.1186/s12886-019-1075-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 02/28/2019] [Indexed: 11/10/2022] Open
Abstract
Background Stress-induced activation of the sympathetic nervous system leads to a cascade of metabolic reactions. Emotional stress is a more specific form of stress in which the stressor is a psychological response to a situation subjectively perceived as traumatic. Stress hormones can have a wide range of effects on the body, however, it is still unclear if and how it can affect ophthalmic physiology. This report presents a case of severe ocular hypertension in which emotional stress was the only cause elicited, and explores potential aggravating factors. Case presentation A 78-year-old, personality type A, lady with a history of pseudo-exfoliative glaucoma presented with an acute asymmetrical raise in intraocular pressure (IOP) immediately following a family breakdown. Her IOP had previously remained stable following a deep sclerectomy in the right eye and an Ex-PRESS shunt in the left eye. Her examination was entirely normal otherwise, with a patent filtration and diffuse bleb as confirmed with anterior segment OCT imaging. Near-normalisation of her IOP was observed within 24 h, concomitantly with the reduction of her stress levels. No other cause for the transient acute hypertensive episode were found. Conclusions This case report suggests that acute emotional stress could severely affect IOP in patients suffering from glaucoma. This could be important when looking after glaucoma patients. It would also suggest that the personnality types, and the emotional and social context are more factors to take into account in glaucoma studies. These observations are based on a single case report and would need to be verified on a larger scale.
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Affiliation(s)
- Kevin Gillmann
- Glaucoma Research Center, Montchoisi Clinic, Swiss Visio Network, Lausanne, Switzerland
| | - Kirsten Hoskens
- Glaucoma Research Center, Montchoisi Clinic, Swiss Visio Network, Lausanne, Switzerland
| | - Kaweh Mansouri
- Glaucoma Research Center, Montchoisi Clinic, Swiss Visio Network, Lausanne, Switzerland. .,Department of Ophthalmology, University of Colorado School of Medicine, Denver, CO, USA.
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