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Cordeiro MF, Gandolfi S, Gugleta K, Normando EM, Oddone F. How latanoprost changed glaucoma management. Acta Ophthalmol 2024; 102:e140-e155. [PMID: 37350260 DOI: 10.1111/aos.15725] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 06/02/2023] [Accepted: 06/12/2023] [Indexed: 06/24/2023]
Abstract
Glaucoma is currently considered one of the leading causes of severe visual impairment and blindness worldwide. Topical medical therapy represents the treatment of choice for many glaucoma patients. Introduction of latanoprost, 25 years ago, with an entirely new mechanism of action from that of the antiglaucoma drugs used up to that time was a very important milestone. Since then, due mainly to their efficacy, limited systemic side effects and once daily dosing, prostaglandin analogues (PGAs) have become as the first-choice treatment for primary open-angle glaucoma. PGAs are in general terms well tolerated, although they are associated with several mild to moderate ocular and periocular adverse events. Among them, conjunctival hyperemia, eyelash changes, eyelid pigmentation, iris pigmentation and hypertrichosis around the eyes are the most prevalent. The objective of this paper is to review the role of PGAs in the treatment of glaucoma over the 25 years since the launch of Latanoprost and their impact on clinical practice outcomes.
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Affiliation(s)
- Maria Francesca Cordeiro
- Imperial College Healthcare NHS Trust, Western Eye Hospital, London, UK
- UCL Institute of Ophthalmology, London, UK
- Department of Surgery & Cancer, Irish Clinical Oncology Research Group, Imperial College London, London, UK
| | | | | | - Eduardo M Normando
- Department of Surgery & Cancer, Irish Clinical Oncology Research Group, Imperial College London, London, UK
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2
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Kolar R, Vicar T, Chmelik J, Jakubicek R, Odstrcilik J, Valterova E, Nohel M, Skorkovska K, Tornow RP. Assessment of retinal vein pulsation through video-ophthalmoscopy and simultaneous biosignals acquisition. BIOMEDICAL OPTICS EXPRESS 2023; 14:2645-2657. [PMID: 37342721 PMCID: PMC10278619 DOI: 10.1364/boe.486052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/19/2023] [Accepted: 04/19/2023] [Indexed: 06/23/2023]
Abstract
The phenomenon of retinal vein pulsation is still not a deeply understood topic in retinal hemodynamics. In this paper, we present a novel hardware solution for recording retinal video sequences and physiological signals using synchronized acquisition, we apply the photoplethysmographic principle for the semi-automatic processing of retinal video sequences and we analyse the timing of the vein collapse within the cardiac cycle using of an electrocardiographic signal (ECG). We measured the left eyes of healthy subjects and determined the phases of vein collapse within the cardiac cycle using a principle of photoplethysmography and a semi-automatic image processing approach. We found that the time to vein collapse (Tvc) is between 60 ms and 220 ms after the R-wave of the ECG signal, which corresponds to 6% to 28% of the cardiac cycle. We found no correlation between Tvc and the duration of the cardiac cycle and only a weak correlation between Tvc and age (0.37, p = 0.20), and Tvc and systolic blood pressure (-0.33, p = 0.25). The Tvc values are comparable to those of previously published papers and can contribute to the studies that analyze vein pulsations.
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Affiliation(s)
- Radim Kolar
- Department of Biomedical Engineering, Faculty of Electrical Engineering and Communication, Brno University of Technology, Brno, Czech Republic
| | - Tomas Vicar
- Department of Biomedical Engineering, Faculty of Electrical Engineering and Communication, Brno University of Technology, Brno, Czech Republic
| | - Jiri Chmelik
- Department of Biomedical Engineering, Faculty of Electrical Engineering and Communication, Brno University of Technology, Brno, Czech Republic
| | - Roman Jakubicek
- Department of Biomedical Engineering, Faculty of Electrical Engineering and Communication, Brno University of Technology, Brno, Czech Republic
| | - Jan Odstrcilik
- Department of Biomedical Engineering, Faculty of Electrical Engineering and Communication, Brno University of Technology, Brno, Czech Republic
| | - Eva Valterova
- Department of Biomedical Engineering, Faculty of Electrical Engineering and Communication, Brno University of Technology, Brno, Czech Republic
| | - Michal Nohel
- Department of Biomedical Engineering, Faculty of Electrical Engineering and Communication, Brno University of Technology, Brno, Czech Republic
| | - Karolina Skorkovska
- Deparment of Ophthalmology and Optometry, St. Ann University Hospital, Brno, Czech Republic
- Department of Ophthalmology and Optometry, Masaryk University, Brno, Czech Republic
| | - Ralf P. Tornow
- Department of Ophthalmology, Friedrich-Alexander-University Erlangen–Nürnberg, Erlangen, Germany
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Abdul-Rahman A, Morgan W, Vukmirovic A, Mehnert A, Obreschow D, Yu DY. Empirical retinal venous pulse wave velocity using modified photoplethysmography. BMC Res Notes 2023; 16:48. [PMID: 37031176 PMCID: PMC10082983 DOI: 10.1186/s13104-023-06309-y] [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: 09/09/2022] [Accepted: 03/14/2023] [Indexed: 04/10/2023] Open
Abstract
OBJECTIVE Using the novel imaging method of high-speed modified photoplethysmography we measured the retinal venous pulse wave velocity in a single case. RESULTS A healthy 30-year-old subject underwent high-speed modified photoplethysmography (120 frames per second) with simultaneous ophthalmodynamometry at 26 Meditron units. A video of the optic nerve was analyzed using custom software. A harmonic regression model was fitted to each pixel in the time series and used to quantify the retinal vascular pulse wave parameters. Retinal venous pulsation at the optic disc was observed as a complex dynamic wall motion, whereas contraction commenced at a point in the vein at the center of the optic disc, and progressed centrifugally. The empirically estimated retinal venous pulse wave velocity at this segment was approximately 22.24694 mm/s. This measurement provides an estimate for future studies in the field.
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Affiliation(s)
- Anmar Abdul-Rahman
- Department of Ophthalmology, Counties Manukau DHB, Auckland, New Zealand.
| | - William Morgan
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
- Lions Eye Institute, University of Western Australia, Perth, Australia
| | - Aleksandar Vukmirovic
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
- Lions Eye Institute, University of Western Australia, Perth, Australia
| | - Andrew Mehnert
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
- Lions Eye Institute, University of Western Australia, Perth, Australia
| | - Danail Obreschow
- International Centre for Radio Astronomy Research (ICRAR), University of Western Australia, Perth, Australia
- International Space Centre, University of Western Australia, Perth, Australia
| | - Dao-Yi Yu
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
- Lions Eye Institute, University of Western Australia, Perth, Australia
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Morgan WH, Khoo J, Vukmirovic A, Abdul-Rahman A, An D, Mehnert A, Obreschkow D, Chowdhury E, Yu DY. Correlation between retinal vein pulse amplitude, estimated intracranial pressure, and postural change. NPJ Microgravity 2023; 9:28. [PMID: 37002218 PMCID: PMC10066386 DOI: 10.1038/s41526-023-00269-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 03/13/2023] [Indexed: 04/03/2023] Open
Abstract
Spaceflight associated neuro-ocular syndrome (SANS) is common amongst astronauts on long duration space missions and is associated with signs consistent with elevated cerebrospinal fluid (CSF) pressure. Additionally, CSF pressure has been found to be elevated in a significant proportion of astronauts in whom lumbar puncture was performed after successful mission completion. We have developed a retinal photoplethysmographic technique to measure retinal vein pulsation amplitudes. This technique has enabled the development of a non-invasive CSF pressure measurement apparatus. We tested the system on healthy volunteers in the sitting and supine posture to mimic the range of tilt table extremes and estimated the induced CSF pressure change using measurements from the CSF hydrostatic indifferent point. We found a significant relationship between pulsation amplitude change and estimated CSF pressure change (p < 0.0001) across a range from 2.7 to 7.1 mmHg. The increase in pulse amplitude was highest in the sitting posture with greater estimated CSF pressure increase (p < 0.0001), in keeping with physiologically predicted CSF pressure response. This technique may be useful for non-invasive measurement of CSF pressure fluctuations during long-term space voyages.
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Affiliation(s)
- W H Morgan
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, WA, Australia.
- International Space Centre, 35 Stirling Hwy, Crawley, WA, 6009, Australia.
| | - J Khoo
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, WA, Australia
| | - A Vukmirovic
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, WA, Australia
- International Space Centre, 35 Stirling Hwy, Crawley, WA, 6009, Australia
| | - A Abdul-Rahman
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, WA, Australia
- Department of Ophthalmology, Counties Manukau DHB, Auckland, New Zealand
| | - D An
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, WA, Australia
| | - A Mehnert
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, WA, Australia
- International Space Centre, 35 Stirling Hwy, Crawley, WA, 6009, Australia
| | - D Obreschkow
- International Space Centre, 35 Stirling Hwy, Crawley, WA, 6009, Australia
- International Centre for Radio Astronomy Research (ICRAR), M468, University of Western Australia, 35 Stirling Hwy, Crawley, WA, 6009, Australia
| | - E Chowdhury
- International Space Centre, 35 Stirling Hwy, Crawley, WA, 6009, Australia
- Information Technology, Murdoch University, 90 South Street, Murdoch, WA, 6150, Australia
| | - D Y Yu
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, WA, Australia
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Müller SJ, Henkes E, Gounis MJ, Felber S, Ganslandt O, Henkes H. Non-Invasive Intracranial Pressure Monitoring. J Clin Med 2023; 12:jcm12062209. [PMID: 36983213 PMCID: PMC10051320 DOI: 10.3390/jcm12062209] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/09/2023] [Accepted: 03/11/2023] [Indexed: 03/15/2023] Open
Abstract
(1) Background: Intracranial pressure (ICP) monitoring plays a key role in the treatment of patients in intensive care units, as well as during long-term surgeries and interventions. The gold standard is invasive measurement and monitoring via ventricular drainage or a parenchymal probe. In recent decades, numerous methods for non-invasive measurement have been evaluated but none have become established in routine clinical practice. The aim of this study was to reflect on the current state of research and shed light on relevant techniques for future clinical application. (2) Methods: We performed a PubMed search for “non-invasive AND ICP AND (measurement OR monitoring)” and identified 306 results. On the basis of these search results, we conducted an in-depth source analysis to identify additional methods. Studies were analyzed for design, patient type (e.g., infants, adults, and shunt patients), statistical evaluation (correlation, accuracy, and reliability), number of included measurements, and statistical assessment of accuracy and reliability. (3) Results: MRI-ICP and two-depth Doppler showed the most potential (and were the most complex methods). Tympanic membrane temperature, diffuse correlation spectroscopy, natural resonance frequency, and retinal vein approaches were also promising. (4) Conclusions: To date, no convincing evidence supports the use of a particular method for non-invasive intracranial pressure measurement. However, many new approaches are under development.
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Affiliation(s)
- Sebastian Johannes Müller
- Neuroradiologische Klinik, Klinikum Stuttgart, D-70174 Stuttgart, Germany
- Correspondence: ; Tel.: +49-(0)711-278-34501
| | - Elina Henkes
- Neuroradiologische Klinik, Klinikum Stuttgart, D-70174 Stuttgart, Germany
| | - Matthew J. Gounis
- New England Center for Stroke Research, Department of Radiology, University of Massachusetts, Worcester, MA 01655, USA
| | - Stephan Felber
- Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Stiftungsklinikum Mittelrhein, D-56068 Koblenz, Germany
| | - Oliver Ganslandt
- Neurochirurgische Klinik, Klinikum Stuttgart, D-70174 Stuttgart, Germany
| | - Hans Henkes
- Neuroradiologische Klinik, Klinikum Stuttgart, D-70174 Stuttgart, Germany
- Medizinische Fakultät, Universität Duisburg-Essen, D-47057 Duisburg, Germany
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Khoo YJ, Yu DY, Abdul-Rahman A, Balaratnasingam C, Chen FK, McAllister IL, Morgan WH. Vessel Pulse Amplitude Mapping in Eyes With Central and Hemi Retinal Venous Occlusion. Transl Vis Sci Technol 2023; 12:26. [PMID: 36692455 PMCID: PMC9896842 DOI: 10.1167/tvst.12.1.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Purpose The purpose of this study was to describe vessel pulse amplitude characteristics in eyes with central retinal vein occlusion (CRVO), hemiretinal vein occlusion (HVO), normal eyes (N1 N1), and the unaffected contralateral eyes of CRVO and HVO eyes (N1 CRVO and N1 HVO), as well as the unaffected hemivessels of HVO eyes (N2 HVO). Methods Ophthalmodynamometry estimates of blood column pulse amplitudes with modified photoplethysmography were timed against cardiac cycles. Harmonic analysis was performed on the vessel reflectance within 0.25 to 1 mm from the disc center to construct pulse amplitude maps. Linear mixed modeling was used to examine variable effects upon the log harmonic pulse amplitude. Results One hundred seven eyes were examined. Normal eyes had the highest mean venous pulse amplitude (2.08 ± 0.48 log u). CRVO had the lowest (0.99 ± 0.45 log u, P < 0.0001), followed by HVO (1.23 ± 0.46 log u, P = 0.0002) and N2 HVO (1.30 ± 0.59 log u, P = 0.0005). N1 CRVO (1.76 ± 0.34 log u, P = 0.52) and N1 HVO (1.33 ± 0.37 log u, P = 0.0101) had no significantly different mean amplitudes compared to N1 N1. Arterial amplitudes were lower than venous (P < 0.01) and reduced with venous occlusion (P < 0.01). Pulse amplitude versus amplitude over distance decreased along the N1 N1 vessels, with increasing slopes observed with CRVO (P < 0.01). Conclusions Pulse amplitude reduction and attenuation characteristics of arteries and veins in venous occlusion can be measured and are consistent with reduced vessel wall compliance and pulse wave transmission. Translational Relevance Retinal vascular pulse amplitudes can be measured, revealing occlusion induced changes, suggesting a role in evaluating the severity and progression of venous occlusion.
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Affiliation(s)
- Ying J. Khoo
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Western Australia, Australia,Lions Eye Institute, Nedlands, Western Australia, Australia
| | - Dao-Yi Yu
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Western Australia, Australia,Lions Eye Institute, Nedlands, Western Australia, Australia
| | - Anmar Abdul-Rahman
- Lions Eye Institute, Nedlands, Western Australia, Australia,Department of Ophthalmology, Counties Manukau District Health Board, Auckland, New Zealand
| | - Chandra Balaratnasingam
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Western Australia, Australia,Lions Eye Institute, Nedlands, Western Australia, Australia
| | - Fred K. Chen
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Western Australia, Australia,Lions Eye Institute, Nedlands, Western Australia, Australia,Ophthalmology Department, Royal Perth Hospital, Perth, Western Australia, Australia,Ophthalmology, Department of Surgery, The University of Melbourne, East Melbourne, Victoria, Australia,Centre for Eye Research Australia, The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Ian L. McAllister
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Western Australia, Australia,Lions Eye Institute, Nedlands, Western Australia, Australia
| | - William H. Morgan
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Western Australia, Australia,Lions Eye Institute, Nedlands, Western Australia, Australia,Ophthalmology Department, Royal Perth Hospital, Perth, Western Australia, Australia
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Abdul-Rahman A, Morgan W, Yu DY. A machine learning approach in the non-invasive prediction of intracranial pressure using Modified Photoplethysmography. PLoS One 2022; 17:e0275417. [PMID: 36174066 PMCID: PMC9521929 DOI: 10.1371/journal.pone.0275417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 09/16/2022] [Indexed: 11/19/2022] Open
Abstract
The ideal Intracranial pressure (ICP) estimation method should be accurate, reliable, cost-effective, compact, and associated with minimal morbidity/mortality. To this end several described non-invasive methods in ICP estimation have yielded promising results, however the reliability of these techniques have yet to supersede invasive methods of ICP measurement. Over several publications, we described a novel imaging method of Modified Photoplethysmography in the evaluation of the retinal vascular pulse parameters decomposed in the Fourier domain, which enables computationally efficient information filtering of the retinal vascular pulse wave. We applied this method in a population of 21 subjects undergoing lumbar puncture manometry. A regression model was derived by applying an Extreme Gradient Boost (XGB) machine learning algorithm using retinal vascular pulse harmonic regression waveform amplitude (HRWa), first and second harmonic cosine and sine coefficients (an1,2, bn1,2) among other features. Gain and SHapley Additive exPlanation (SHAP) values ranked feature importance in the model. Agreement between the predicted ICP mean, median and peak density with measured ICP was assessed using Bland-Altman bias±standard error. Feature gain of intraocular pressure (IOPi) (arterial = 0.6092, venous = 0.5476), and of the Fourier coefficients, an1 (arterial = 0.1000, venous = 0.1024) ranked highest in the XGB model for both vascular systems. The arterial model SHAP values demonstrated the importance of the laterality of the tested eye (1.2477), which was less prominent in the venous model (0.8710). External validation was achieved using seven hold-out test cases, where the median venous predicted ICP showed better agreement with measured ICP. Although the Bland-Altman bias from the venous model (0.034±1.8013 cm water (p<0.99)) was lower compared to that of the arterial model (0.139±1.6545 cm water (p<0.94)), the arterial model provided a potential avenue for internal validation of the prediction. This approach can potentially be integrated into a neurological clinical decision algorithm to evaluate the indication for lumbar puncture.
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Affiliation(s)
- Anmar Abdul-Rahman
- Department of Ophthalmology, Counties Manukau District Health Board, Auckland, New Zealand
- * E-mail:
| | - William Morgan
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
- Lions Eye Institute, University of Western Australia, Perth, Australia
| | - Dao-Yi Yu
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
- Lions Eye Institute, University of Western Australia, Perth, Australia
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Dong J, Li Q, Wang X, Fan Y. A Review of the Methods of Non-Invasive Assessment of Intracranial Pressure through Ocular Measurement. Bioengineering (Basel) 2022; 9:bioengineering9070304. [PMID: 35877355 PMCID: PMC9312000 DOI: 10.3390/bioengineering9070304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 01/19/2023] Open
Abstract
The monitoring of intracranial pressure (ICP) is essential for the detection and treatment of most craniocerebral diseases. Invasive methods are the most accurate approach to measure ICP; however, these methods are prone to complications and have a limited range of applications. Therefore, non-invasive ICP measurement is preferable in a range of scenarios. The current non-invasive ICP measurement methods comprise fluid dynamics, and ophthalmic, otic, electrophysiological, and other methods. This article reviews eight methods of non-invasive estimation of ICP from ocular measurements, namely optic nerve sheath diameter, flash visual evoked potentials, two-depth transorbital Doppler ultrasonography, central retinal venous pressure, optical coherence tomography, pupillometry, intraocular pressure measurement, and retinal arteriole and venule diameter ratio. We evaluated and presented the indications and main advantages and disadvantages of these methods. Although these methods cannot completely replace invasive measurement, for some specific situations and patients, non-invasive measurement of ICP still has great potential.
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