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Kamalipour A, Moghimi S, Eslani M, Nishida T, Mohammadzadeh V, Micheletti E, Girkin CA, Fazio MA, Liebmann JM, Zangwill LM, Weinreb RN. A Prospective Longitudinal Study to Investigate Corneal Hysteresis as a Risk Factor of Central Visual Field Progression in Glaucoma. Am J Ophthalmol 2022; 240:159-169. [PMID: 35278360 PMCID: PMC10249485 DOI: 10.1016/j.ajo.2022.02.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/07/2022] [Accepted: 02/27/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE To evaluate the role of corneal hysteresis (CH) as a risk factor of central visual field (VF) progression in a cohort of glaucoma suspect and glaucoma patients. DESIGN Prospective cohort study. METHODS Two hundred forty-eight eyes of 143 subjects who were followed for an average of 4.8 years with a minimum of 5 visits with 10-2 and 24-2 VF tests were included. Univariable and multivariable linear mixed-effects models were used to identify characteristics associated with the rate of change over time in 10-2 and 24-2 mean deviation (MD). Mixed-effects logistic regression was used to evaluate characteristics associated with an increased likelihood of event-based 10-2 VF progression based on the clustered pointwise linear regression criterion. RESULTS CH was significantly associated with 10-2 and 24-2 VF progression in the univariable trend-based analysis. In multivariable trend-based analyses, lower CH was associated with a faster rate of decline in 10-2 MD (0.07 dB/y per 1 mm Hg, P < .001) but not with 24-2 MD (P = .490). In multivariable event-based analysis, lower CH was associated with an increased likelihood of 10-2 VF progression (odds ratio = 1.35 per 1 mm Hg lower, P = .025). Similar results were found in eyes with early glaucomatous damage at the baseline (baseline: 24-2 MD ≥ -6 dB). CONCLUSIONS Lower CH was associated with a statistically significant, but relatively small, increased risk of central VF progression on the 10-2 test grid. Given the substantial influence of central VF impairment on the quality of life, clinicians should consider using CH to assess the risk of progression in patients with primary open-angle glaucoma including those with early disease.
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Affiliation(s)
- Alireza Kamalipour
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Medi Eslani
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Vahid Mohammadzadeh
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Eleonora Micheletti
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | | | - Massimo A Fazio
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California; Department of Ophthalmology and Visual Sciences, Heersink School of Medicine; Department of Biomedical Engineering, School of Engineering
| | - Jeffrey M Liebmann
- University of Alabama at Birmingham, Alabama, and Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York, USA
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California.
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Danielewska ME, Kicińska AK, Placek MM, Lewczuk K, Rękas M. Changes in spectral parameters of corneal pulse following canaloplasty. Graefes Arch Clin Exp Ophthalmol 2019; 257:2449-2459. [PMID: 31377849 DOI: 10.1007/s00417-019-04433-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/09/2019] [Accepted: 07/23/2019] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To ascertain whether changes in the spectral content of the corneal pulse (CP) signal, measured in vivo in primary open-angle glaucoma (POAG) patients, indirectly reflect changes in corneal biomechanics after canaloplasty. METHODS Fifteen eyes of 15 POAG patients who underwent canaloplasty combined with phacoemulsification were enrolled. Standard ophthalmic examinations were conducted before washout, pre-operatively, at days 1, 7, and 1, 3, 6, and 12 months after surgery. Non-contact measurements of the CP signal were performed at pre-washout, pre-operatively, and at 3, 6, and 12 months post-operatively. Then, amplitudes of the CP first five harmonics associated with the heart rate were estimated. Temporal changes of all considered parameters were tested at a Bonferroni-adjusted significance level set to 0.005. RESULTS A decrease in the amplitude of the first harmonic and an increase in the normalized amplitude of the third harmonic (ACP3n) of the CP signal were noticed between the pre-washout and the pre-operative stages (p = 0.003 and p = 0.004, respectively). This corresponds to an increase in median intraocular pressure (IOP) values by 6.0 mmHg (p = 0.0045). After surgery, ACP3n reached the highest value at 3 months post-operatively, compared with pre-washout level (p = 0.0045). CONCLUSIONS Alterations in corneoscleral stiffness caused by surgery are reflected in changes in the ACP3n value. Hence, post-operative corneal biomechanics could be monitored indirectly by this supporting indicator that can be used to estimate the time at which measures of IOP are no longer biased by the changed cornea boundary conditions caused by canaloplasty. CLINICAL TRIALS REGISTRATION NCT02908633.
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Affiliation(s)
- Monika E Danielewska
- Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wrocław University of Science and Technology, Wybrzeże Wyspiańskiego 27, 50-370, Wrocław, Poland.
| | - Aleksandra K Kicińska
- Department of Ophthalmology, Military Institute of Medicine, ul. Szaserów 128, 04-141, Warsaw, Poland
| | - Michał M Placek
- Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wrocław University of Science and Technology, Wybrzeże Wyspiańskiego 27, 50-370, Wrocław, Poland
| | - Katarzyna Lewczuk
- Department of Ophthalmology, Military Institute of Medicine, ul. Szaserów 128, 04-141, Warsaw, Poland
| | - Marek Rękas
- Department of Ophthalmology, Military Institute of Medicine, ul. Szaserów 128, 04-141, Warsaw, Poland
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Sánchez-Barahona C, Bolívar G, Mikropoulos DG, Konstas AG, Teus MA. Effect of Acute Increases in Intraocular Pressure on Corneal Pachymetry in Rabbit Eyes Treated with Timolol Maleate. Open Ophthalmol J 2018. [DOI: 10.2174/1874364101812010314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective:
To evaluate in an in vivo rabbit model, the effect of topical timolol maleate therapy on the central corneal thickness response to acute intraocular pressure increases.
Method:
In this prospective and interventional controlled study, the central corneal thickness and intraocular pressure were measured in vivo in 12 rabbit eyes treated with topical timolol maleate for 1 month and in 12 controls at baseline, and after the intraocular pressure (measured by direct cannulation of the anterior chamber) was increased to 15 and 30 mmHg using a forced saline infusion into the anterior chamber.
Results:
There were no significant differences in the basal central corneal thickness values (control group, 373.2±12.9 µm; study group, 377.5±19.2 µm, p=0.5) or the central corneal thickness values when the intraocular pressure was increased to 15 mmHg (control group, 335.2±14.3 µm; study group, 330.0±32.1 µm, p=0.6) and to 30 mmHg (study group, 318.8±25.3 µm; control group, 329.8±21.0 µm, p=0.3).
Conclusion:
Rabbit corneas treated with topical timolol maleate for 1 month did not show a strain response to acute intraocular pressure increases that differed from control eyes. This is in contrast to a previous finding in which rabbit eyes treated with prostaglandin analogues had a greater decrease in central corneal thickness in response to a sudden intraocular pressure increase compared with untreated corneas.
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Park YM, Hwang SH, Lee JW, Lee JS. Effects of Topical Brinzolamide/Timolol on Refractive Outcomes
in Eyes with Myopic Regression after Corneal Refractive Surgeries. INT J PHARMACOL 2016. [DOI: 10.3923/ijp.2016.556.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Bolívar G, Sánchez-Barahona C, Teus M, Castejón MA, Paz-Moreno-Arrones J, Gutiérrez-Ortiz C, Mikropoulos DG. Effect of topical prostaglandin analogues on corneal hysteresis. Acta Ophthalmol 2015; 93:e495-8. [PMID: 25722009 DOI: 10.1111/aos.12689] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 01/17/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate possible changes in corneal hysteresis (CH) after topical treatment with a prostaglandin analogue in medication-naïve eyes. METHODS This was a prospective, observational cohort study. Sixty-eight eyes of 68 patients were prospectively included who were newly diagnosed with primary open-angle glaucoma or ocular hypertension in our institution. All patients were treatment-naïve. Patients were evaluated at baseline and after 6 months of treatment with latanoprost in the eye with the lower intraocular pressure (IOP) measured by Goldmann applanation tonometry (GAT). The ocular response analyzer was used to measure CH. RESULTS CH increased significantly (p = 0.0001) from 8.96 ± 2.3 mmHg to 9.79 ± 1.97 mmHg, and this increase was correlated significantly (p = 0.0001, r = 0.64, r(2) = 0.41) with the basal CH. We identified a weak but significant (r(2) = 0.06, p = 0.01) relationship between the basal CH and the drug-induced reduction of the GAT IOP. Nevertheless, the increase in the drug-induced CH was not correlated with the decrease in the GAT IOP. CONCLUSION Treatment with latanoprost increases CH. The CH increase was not correlated with the drug-induced decrease in the GAT IOP, which suggested a direct effect of latanoprost on the viscoelastic corneal properties.
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Affiliation(s)
- Gema Bolívar
- Universitary Hospital “Príncipe de Asturias”; Alcalá de Henares Madrid Spain
| | | | - Miguel Teus
- Universitary Hospital “Príncipe de Asturias”; Alcalá de Henares Madrid Spain
- University of Alcalá; Alcalá de Henares Madrid Spain
| | - Miguel A. Castejón
- Universitary Hospital “Príncipe de Asturias”; Alcalá de Henares Madrid Spain
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Bolívar G, Teus M, Arranz-Marquez E. Effect of acute increases of intraocular pressure on corneal pachymetry in eyes treated with travoprost: an animal study. Curr Eye Res 2011; 36:1014-9. [PMID: 21942300 DOI: 10.3109/02713683.2011.608239] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To evaluate "in vivo" the effect of topical travoprost on the central corneal thickness (CCT) of rabbit eyes, and the changes in the CCT after acute increases of intraocular pressure (IOP) in these eyes. MATERIALS AND METHODS This is an interventional, prospective, case-control, masked study. Topical travoprost was applied once daily for one month to the right eye of six New Zealand male rabbits, the left eye of each animal served as control. The baseline CCT and IOP were measured under general anesthesia. After the IOP was stabilized at 15 and 30 mmHg, as registered by direct cannulation of the anterior chamber, CCT measurements were measured again at both pressure levels. RESULTS The baseline CCT was thicker in eyes previously treated with travoprost (study group) than in control eyes (p < 0.01). The CCT decreased in both groups when IOP was raised to 15 and 30 mmHg, and there were no statistically significant difference in absolute CCT values between study and control eyes at any of the IOP levels (p = 0.5). However, the amount of CCT decrease from baseline values was greater in eyes previously treated with travoprost (study group) than in control ones, at both 15 and 30 mmHg IOP levels (p = 0.01 and 0.02, respectively). CONCLUSIONS Rabbit corneas treated with topical travoprost show a different strain response to acute increases in IOP than control eyes.
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Affiliation(s)
- Gema Bolívar
- Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.
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Bolívar G, Teus MA, Hernández-Verdejo JL. Short-term effect of topical brimonidine tartrate on intrastromal corneal pressure in rabbits. J Refract Surg 2011; 26:533-5. [PMID: 20349857 DOI: 10.3928/1081597x-20100310-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2009] [Accepted: 02/04/2010] [Indexed: 11/20/2022]
Abstract
PURPOSE Because topical brimonidine tartrate has been reported to decrease flap adherence in the early postoperative period after LASIK, its effect on the intrastromal corneal pressure (ICP) was evaluated. METHODS An interventional, prospective, animal study was performed. Intrastromal corneal pressure was recorded for 45 minutes in eight eyes of rabbits treated with topical brimonidine tartrate three times daily for 3 consecutive days (study group); eight contralateral eyes were treated with artificial tears (control group). All measurements were performed by the same, masked investigator. RESULTS Mean ICP was -4.00 +/- 2.90 mmHg, -6.70 +/- 3.00 mmHg, and -9.00 +/- 4.50 mmHg at 15, 30, and 45 minutes, respectively, in the control group. In the study group (brimonidine-treated eyes), the ICP readings were +2.75 +/- 2.90 mmHg, -2.50 +/- 13.00 mmHg, and -8.50 +/- 5.00 mmHg at the same time points, respectively. The differences in the ICP between both groups were statistically significant at 15 minutes (P = .01), but no significant difference was found at 30 or 45 minutes (P = .20 and P = .80, respectively). CONCLUSIONS Topical treatment with brimonidine tartrate induces a significant decrease in ICP at 15 minutes. This effect on ICP may explain the decreased corneal flap adherence reported in eyes treated with this drug.
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Affiliation(s)
- Gema Bolívar
- Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.
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