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Shajiei TD, Iadanza S, Bachmann LM, Kniestedt C. Inventory of Ocular Pulse Amplitude Values in Healthy Subjects and Patients With Ophthalmologic Illnesses: Systematic Review and Meta-analysis. Am J Ophthalmol 2024; 259:151-165. [PMID: 37898282 DOI: 10.1016/j.ajo.2023.10.014] [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: 05/23/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE Many studies have examined the ocular pulse amplitude (OPA) to better understand its physiology and clinical relevance, but the papers are scattered, not consistently indexed, and sometimes difficult to locate. We aimed to identify and summarize the relevant published evidence on OPA and, in a meta-analysis, outline specific differences of this parameter between healthy individual, primary open-angle glaucoma, normal-tension glaucoma, ocular hypertension, and cataract patients. DESIGN Systematic review and meta-analysis. METHODS A thorough literature search and data extraction were conducted by 2 reviewers independently. Reports on OPA measured by the dynamic contour tonometry in conjunction with different ocular and systemic diseases or potential influencing factors were included. RESULTS Of the 527 initially found reports, 97 met the inclusion criteria assessing 31 clinical conditions. A meta-analysis based on 6850 eyes and 106 study arms (68.8%) revealed differences in mean OPA values in millimeters of mercury between various entities. Among healthy eyes, the OPA was 2.58 mm Hg (95% CI: 2.45-2.71), whereas OPA values were higher in glaucoma (unspecified glaucoma 2.73 mm Hg, 95% CI: 2.38-3.08; normal-tension glaucoma 2.66 mm Hg, 95% CI: 2.36-2.97; and primary open-angle glaucoma 2.92 mm Hg, 95% CI: 2.75-3.08). Although ocular hypertension showed the highest OPA values (3.53 mm Hg, 95% CI: 3.05-4.01), the lowest values were found in cataract eyes (2.26 mm Hg, 95% CI: 1.57-2.94). CONCLUSION We found different OPA values characteristic of different clinical entities, with above-normal values in glaucoma and ocular hypertension and lower values in cataract patients. Our work is intended for clinicians and researchers who want to get a quick overview of the available evidence or who need statistical data on OPA distributions in individual diseases.
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Affiliation(s)
- Tania D Shajiei
- From the Talacker Augen Zentrum Zürich (TAZZ), Department of Ophthalmology, University Hospital Zurich (T.D.S.), Zurich, Switzerland
| | - Sandro Iadanza
- Talacker Augen Zentrum Zürich (S.I., C.K.), Zurich, Switzerland
| | - Lucas M Bachmann
- Medignition Inc, Research Consultants (L.M.B.), Zurich, Switzerland.
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Raphtis VA, Sharma D, Wang S, Kim JY, Jacobson AL, Harman CD, Komáromy AM. Ocular pulse amplitude (OPA) in canine ADAMTS10-open-angle glaucoma ( ADAMTS10-OAG). Front Bioeng Biotechnol 2023; 11:1242166. [PMID: 38130820 PMCID: PMC10733518 DOI: 10.3389/fbioe.2023.1242166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction: The role of ocular rigidity and biomechanics remains incompletely understood in glaucoma, including assessing an individual's sensitivity to intraocular pressure (IOP). In this regard, the clinical assessment of ocular biomechanics represents an important need. The purpose of this study was to determine a possible relationship between the G661R missense mutation in the ADAMTS10 gene and the ocular pulse amplitude (OPA), the difference between diastolic and systolic intraocular pressure (IOP), in a well-established canine model of open-angle glaucoma (OAG). Methods: Animals studied included 39 ADAMTS10-mutant dogs with different stages of OAG and 14 unaffected control male and female dogs between 6 months and 12 years (median: 3.2 years). Dogs were sedated intravenously with butorphanol tartrate and midazolam HCl, and their IOPs were measured with the Icare® Tonovet rebound tonometer. The Reichert Model 30™ Pneumotonometer was used to measure OPA. Central corneal thickness (CCT) was measured via Accutome® PachPen, and A-scan biometry was assessed with DGH Technology Scanmate. All outcome measures of left and right eyes were averaged for each dog. Data analysis was conducted with ANOVA, ANCOVA, and regression models. Results: ADAMTS10-OAG-affected dogs displayed a greater IOP of 23.0 ± 7.0 mmHg (mean ± SD) compared to 15.3 ± 3.6 mmHg in normal dogs (p < 0.0001). Mutant dogs had a significantly lower OPA of 4.1 ± 2.0 mmHg compared to 6.5 ± 2.8 mmHg of normal dogs (p < 0.01). There was no significant age effect, but OPA was correlated with IOP in ADAMTS10-mutant dogs. Conclusion: The lower OPA in ADAMTS10-mutant dogs corresponds to the previously documented weaker and biochemically distinct posterior sclera, but a direct relationship remains to be confirmed. The OPA may be a valuable clinical tool to assess ocular stiffness and an individual's susceptibility to IOP elevation.
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Affiliation(s)
- Vanessa A. Raphtis
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States
| | - Dhruv Sharma
- Center for Statistical Training and Consulting, Michigan State University, East Lansing, MI, United States
| | - Sichao Wang
- Center for Statistical Training and Consulting, Michigan State University, East Lansing, MI, United States
| | - Jae Y. Kim
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States
| | - Amanda L. Jacobson
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States
| | - Christine D. Harman
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States
| | - András M. Komáromy
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States
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Yaïci R, Geerling G. [Tonometry: Review and Perspectives]. Klin Monbl Augenheilkd 2023. [PMID: 36827998 DOI: 10.1055/a-2022-0624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Reliable and repeated IOP measurement are essential in the diagnosis and treatment of glaucoma. In this second part, the other contact tonometry and non-contact tonometry are presented. The clinical value of the different methods and the value of multimodality in tonometry will be discussed based on a review of the literature, and the latest innovations with telemetric IOP sensors will be introduced.
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The Effect of the Water Drinking Test on Ocular Parameters and Choroidal Thickness in Glaucoma Suspects. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020381. [PMID: 36837582 PMCID: PMC9964822 DOI: 10.3390/medicina59020381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/02/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023]
Abstract
Background and objectives: We aimed to evaluate the effects of the water drinking test (WDT) on several systemic and ocular parameters, including choroidal thickness, which was assessed through optical coherence tomography angiography (OCTA), in glaucoma suspects. Materials and Methods: A total of 40 eyes from 20 glaucoma suspects without any systemic or ocular diseases were included in this prospective observational study. All the participants undertook the WDT, which required the drinking of 1 L of table water in 5 min. The outcome measures included IOP, systolic and diastolic blood pressure (SBP and DBP), mean arterial pressure (MAP), mean ocular perfusion pressure (MOPP), ocular pulse amplitude (OPA), and subfoveal and peripapillary choroidal thickness, which were assessed at baseline and at four 15 min intervals after the WDT. Generalized least squares models and mixed model analyses that take into account repeated measurements were used to assess the changes over time of these parameters. Results: All the ocular and systemic parameters showed statistically significant changes at all time points compared to baseline apart from choroidal thickness. The peak changes were an IOP of 20.1 mmHg versus 17.3 mmHg at 45 min, an SBP of 137.6 mmHg versus 125 mmHg at 30 min, a DBP of 95.9 mmHg versus 85.7 mmHg at 15 min, and an MOP of 53.51 mmHg versus 48.89 mmHg at 15 min. Conclusions: Despite elevations in IOP and significant changes in all the assessed systemic parameters, the WDT was not associated with changes in choroidal thickness in glaucoma suspects.
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Abstract
ZusammenfassungIn 2. Teil des Beitrags werden die sonstigen Kontakttonometer und die Nonkontakttonometrie präsentiert. Es wird anhand einer Revue der Literatur über den klinischen Wert der verschiedenen Methoden und den Wert der Multimodalität in der Tonometrie diskutiert; ferner werden die letzten Innovationen mit den telemetrischen IOD-Sensoren eingeführt.
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Lan G, Aglyamov SR, Larin KV, Twa MD. In Vivo Human Corneal Shear-wave Optical Coherence Elastography. Optom Vis Sci 2021; 98:58-63. [PMID: 33394932 PMCID: PMC7774819 DOI: 10.1097/opx.0000000000001633] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/24/2020] [Indexed: 01/01/2023] Open
Abstract
SIGNIFICANCE A novel imaging technology, dynamic optical coherence elastography (OCE), was adapted for clinical noninvasive measurements of corneal biomechanics. PURPOSE Determining corneal biomechanical properties is a long-standing challenge. Elasticity imaging methods have recently been developed and applied for clinical evaluation of soft tissues in cancer detection, atherosclerotic plaque evaluation, surgical guidance, and more. Here, we describe the use of dynamic OCE to characterize mechanical wave propagation in the human cornea in vivo, thus providing a method for clinical determination of corneal biomechanical properties. METHODS High-resolution phase-sensitive optical coherence tomography imaging was combined with microliter air-pulse tissue stimulation to perform dynamic elasticity measurements in 18 eyes of nine participants. Low-pressure (0.1 mmHg), spatiotemporally discreet (150 μm, 800 μs) tissue stimulation produced submicron-scale tissue deformations that were measured at multiple positions over a 1-mm2 area. Surface wave velocity was measured and used to determine tissue stiffness. Elastic wave propagation velocity was measured and evaluated as a function of IOP and central corneal thickness. RESULTS Submicron corneal surface displacement amplitude (range, 0.005 to 0.5 μm) responses were measured with high sensitivity (0.24 nm). Corneal elastic wave velocity ranged from 2.4 to 4.2 m/s (mean, 3.5; 95% confidence interval, 3.2 to 3.8 m/s) and was correlated with central corneal thickness (r = 0.64, P < .001) and IOP (r = 0.52, P = .02). CONCLUSIONS Phase-sensitive optical coherence tomography imaging combined with microliter air-pulse mechanical tissue stimulation has sufficient detection sensitivity to observe submicron elastic wave propagation in corneal tissue. These measurements enable in vivo corneal stiffness determinations that will be further studied for use with disease detection and for monitoring clinical interventions.
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Affiliation(s)
- Gongpu Lan
- School of Physics and Optoelectronic Engineering, Foshan University, Foshan, Guangdong, China
- University of Houston College of Optometry, Houston, Texas
| | | | - Kirill V. Larin
- Department of Biomedical Engineering, University of Houston, Houston, Texas
| | - Michael D. Twa
- University of Houston College of Optometry, Houston, Texas
- School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama
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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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Danielewska ME, Messner A, Werkmeister RM, Placek MM, Aranha Dos Santos V, Rękas M, Schmetterer L. Relationship Between the Parameters of Corneal and Fundus Pulse Signals Acquired With a Combined Ultrasound and Laser Interferometry Technique. Transl Vis Sci Technol 2019; 8:15. [PMID: 31388467 PMCID: PMC6675519 DOI: 10.1167/tvst.8.4.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 06/10/2019] [Indexed: 01/16/2023] Open
Abstract
Purpose To estimate the relationship between the characteristics of the corneal pulse (CP) signal and those of the fundus pulse (FP) signal measured with a combined noncontact ultrasonic and laser interferometry technique in healthy subjects. Methods Twenty-two healthy subjects participated in experiments that included measurements of intraocular pressure, ocular pulse amplitude, ocular biometry, blood pressure, and heart rate. Additionally, simultaneous recordings of CP and FP signals were acquired with a noncontact ultrasonic device combined with laser interferometry. Subsequently, ocular perfusion pressure (OPP) and the time and spectral parameters of CP and FP signals were computed. A system model was proposed to relate the FP signal to the CP signal. Results The system model revealed that the eye globe transfers information between signals of the posterior and anterior eye, relatively amplifying higher spectral harmonics. The amplitude of the second CP harmonic is predicted by FPRMS and OPP (R2 = 0.468, P = 0.002). Partial correlation analysis showed that the CP signal parameters are statistically significantly correlated with those of the FP signal and OPP, after correcting for age and sex. Conclusions The eye globe can be viewed as a high pass filter, in which the CP characteristic changes in relation to the fundus pulsation. The FP signal and OPP have an impact on the variations of the CP signal morphology. Translational Relevance Investigation of differences between the characteristics of the anterior and posterior tissue movements is a promising method for evaluating the role of circulatory and biomechanical components in the pathophysiology of ocular diseases.
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Affiliation(s)
- Monika E Danielewska
- Wrocław University of Science and Technology, Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wrocław, Poland
| | - Alina Messner
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - René M Werkmeister
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Michał M Placek
- Wrocław University of Science and Technology, Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wrocław, Poland
| | | | - Marek Rękas
- Department of Ophthalmology, Military Institute of Medicine, Warsaw, Poland
| | - Leopold Schmetterer
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.,Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Academic Clinical Program, Duke-NUS Medical School, Singapore.,Department of Ophthalmology, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.,Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
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Poli M, Cornut PL, Nguyen AM, De Bats F, Denis P. Accuracy of peripapillary versus macular vessel density in diagnosis of early to advanced primary open angle glaucoma. J Fr Ophtalmol 2018; 41:619-629. [PMID: 30150018 DOI: 10.1016/j.jfo.2018.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 01/31/2018] [Accepted: 02/07/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE To evaluate macular and peripapillary vessel density (mVD, pVD) using optical coherence tomography angiography (OCT-A) in healthy subjects, patients with ocular hypertension (OHT) and primary open-angle glaucoma (POAG) patients. METHODS In this prospective observational study, OCT-A images were obtained from 60 eyes of 36 healthy, ocular hypertension (OHT), preperimetric glaucoma (PPG), early glaucoma (EG) and moderate and advanced POAG subjects. Superficial mVD was acquired over a 6×6-mm cube centered on the foveal avascular zone and pVD over a 4.5×4.5-mm cube centered on the optic disc. Peripapillary retinal nerve fiber layer (pRNFL) and ganglion cell complex (GCC) thickness was calculated using spectral-domain OCT. Correlations between vascular, structural and Humphrey VF indices were evaluated (Spearman's rank correlation coefficient). RESULTS Median pVD and mVD in the PPG eyes were lower than in healthy eyes (51.87% and 47.23% versus 55.70% and 53.61%, respectively; P<0.001 and P=0.003), but higher than in mild glaucoma eyes (46.21% and 41.98%, P<0.001 compared to normal eyes) and moderate to advanced glaucoma eyes (37.45% and 39.89%, P<0.0001 compared to normal eyes). The highest correlations were found between structural parameters and pVD (r=0.87 and 0.86 for pRNFL and GCC, P<0.0001), followed by mVD (r=0.69 for both pRNFL and GCC, P<0.0001). Correlations with mean VF sensitivity were similar for pVD and mVD (r=0.61 and 0.56) and for GCC and pRNFL (r=0.60 and 0.52, P<0.0001 for all). CONCLUSIONS VD measured with OCT-A shows reduction in POAG. Detection of this damage differentiates PPG from normal and perimetric POAG eyes with a high correlation with structural parameters. Peripapillary VD accuracy is higher than mVD in detecting the disease. These results suggest that OCT-A could improve POAG diagnosis and understanding of the pathophysiologic mechanisms behind glaucoma.
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Affiliation(s)
- M Poli
- Centre ophtalmologique, pôle vision Val d'Ouest, clinique du Val d'Ouest, 69130 Ecully, France; Department of ophthalmology, Lyon Sud University Hospital, 69310 Pierre-Bénite, France.
| | - P-L Cornut
- Centre ophtalmologique, pôle vision Val d'Ouest, clinique du Val d'Ouest, 69130 Ecully, France
| | - A-M Nguyen
- Centre ophtalmologique, pôle vision Val d'Ouest, clinique du Val d'Ouest, 69130 Ecully, France; Department of ophthalmology, Croix-Rousse University Hospital, 69004 Lyon, France
| | - F De Bats
- Centre ophtalmologique, pôle vision Val d'Ouest, clinique du Val d'Ouest, 69130 Ecully, France; Department of ophthalmology, Croix-Rousse University Hospital, 69004 Lyon, France
| | - P Denis
- Department of ophthalmology, Croix-Rousse University Hospital, 69004 Lyon, France
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Cheng L, Ding Y, Duan X, Wu Z. Ocular pulse amplitude in different types of glaucoma using dynamic contour tonometry: Diagnosis and follow-up of glaucoma. Exp Ther Med 2017; 14:4148-4152. [PMID: 29104631 PMCID: PMC5658696 DOI: 10.3892/etm.2017.5074] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 03/24/2017] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to compare the ocular pulse amplitude (OPA) in patients with different types of glaucoma using dynamic contour tonometry (DCT), to evaluate ocular and systemic factors associated with the OPA and to verify whether OPA measured by DCT is an independent predictor for glaucoma diagnosis. A total of 217 eyes of 217 participants in the following five groups were included in this cross-sectional study: Chronic angle closure glaucoma (CACG), primary open angle glaucoma, normal tension glaucoma (NTG), suspected open angle glaucoma (SOAG) and normal control (NC). The following tests were simultaneously performed during a single visit: Intra-ocular pressure (IOP), OPA, cup-to-disk (C/D) ratio, mean damage (MD) and loss variance (LV). OPAs were compared in each group. The association between OPA and IOP, age, C/D ratio, MD and LV was detected. OPA analysis prior to and after trabeculectomy was also performed to assess its prognostic value. Among the 217 individuals, the OPA was consistent with the IOP, both measured by DCT, along with the MD and LV. Patients with CACG and SOAG had higher OPA values than those with NTG and normal controls. Compared with patients aged >30 years, the OPA was significantly lower in younger patients, while they may not have been affected by different C/D ratios. After trabeculectomy, the OPA had significantly decreased compared with the values prior to surgery. In conclusion, the present study showed that the OPA is correlated with the IOP determined by DCT. CACG and SOAG patients had higher OPA values than patients with other types of glaucoma. OPA measured by DCT may be a predictor for glaucoma diagnosis and prognosis.
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Affiliation(s)
- Lingyan Cheng
- Department of Ophthalmology, Wuxi Second People's Hospital of Nanjing Medical University, Wuxi, Jiangsu 214000, P.R. China
| | - Yuzhi Ding
- Department of Ophthalmology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu 210009, P.R. China
| | - Xuanchu Duan
- Department of Ophthalmology, Xiangya No. 2 Hospital Affiliated to Central South University, Changsha, Hunan 410008, P.R. China
| | - Zhifeng Wu
- Department of Ophthalmology, Wuxi Second People's Hospital of Nanjing Medical University, Wuxi, Jiangsu 214000, P.R. China
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Rogala MM, Danielewska ME, Antończyk A, Kiełbowicz Z, Rogowska ME, Kozuń M, Detyna J, Iskander DR. In-vivo corneal pulsation in relation to in-vivo intraocular pressure and corneal biomechanics assessed in-vitro. An animal pilot study. Exp Eye Res 2017; 162:27-36. [PMID: 28689748 DOI: 10.1016/j.exer.2017.07.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 06/30/2017] [Accepted: 07/05/2017] [Indexed: 01/27/2023]
Abstract
The aim was to ascertain whether the characteristics of the corneal pulse (CP) measured in-vivo in a rabbit eye change after short-term artificial increase of intraocular pressure (IOP) and whether they correlate with corneal biomechanics assessed in-vitro. Eight New Zealand white rabbits were included in this study and were anesthetized. In-vivo experiments included simultaneous measurements of the CP signal, registered with a non-contact method, IOP, intra-arterial blood pressure, and blood pulse (BPL), at the baseline and short-term elevated IOP. Afterwards, thickness of post-mortem corneas was determined and then uniaxial tensile tests were conducted leading to estimates of their Young's modulus (E). At the baseline IOP, backward stepwise regression analyses were performed in which successively the ocular biomechanical, biometric and cardiovascular predictors were separately taken into account. Results of the analysis revealed that the 3rd CP harmonic can be statistically significantly predicted by E and central corneal thickness (Models: R2 = 0.662, p < 0.005 and R2 = 0.832, p < 0.001 for the signal amplitude and power, respectively). The 1st CP harmonic can be statistically significantly predicted by the amplitude and power of the 1st BPL harmonic (Models: R2 = 0.534, p = 0.015 and R2 = 0.509, p < 0.018, respectively). For elevated IOP, non-parametric analysis indicated significant differences for the power of the 1st CP harmonic (Kruskal-Wallis test; p = 0.031) and for the mean, systolic and diastolic blood pressures (p = 0.025, p = 0.019, p = 0.033, respectively). In conclusion, for the first time, the association between parameters of the CP signal in-vivo and corneal biomechanics in-vitro was confirmed. In particular, spectral analysis revealed that higher amplitude and power of the 3rd CP harmonic indicates higher corneal stiffness, while the 1st CP harmonic correlates positively with the corresponding harmonic of the BPL signal.
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Affiliation(s)
- Maja M Rogala
- Wroclaw University of Science and Technology, Department of Mechanics, Materials Science and Engineering, Faculty of Mechanical Engineering, ul. Smoluchowskiego 25, 50-370 Wroclaw, Poland.
| | - Monika E Danielewska
- Wroclaw University of Science and Technology, Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wybrzeze Wyspianskiego 27, 50-370 Wroclaw, Poland.
| | - Agnieszka Antończyk
- Wroclaw University of Environmental and Life Sciences, Department of Surgery, Faculty of Veterinary Medicine, pl. Grunwaldzki 51, 50-366 Wroclaw, Poland.
| | - Zdzisław Kiełbowicz
- Wroclaw University of Environmental and Life Sciences, Department of Surgery, Faculty of Veterinary Medicine, pl. Grunwaldzki 51, 50-366 Wroclaw, Poland.
| | - Marta E Rogowska
- Wroclaw University of Science and Technology, Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wybrzeze Wyspianskiego 27, 50-370 Wroclaw, Poland.
| | - Marta Kozuń
- Wroclaw University of Science and Technology, Department of Biomedical Engineering, Mechatronics and Theory of Mechanisms, Faculty of Mechanical Engineering, ul. Lukasiewicza 7/9, 50-371 Wroclaw, Poland.
| | - Jerzy Detyna
- Wroclaw University of Science and Technology, Department of Mechanics, Materials Science and Engineering, Faculty of Mechanical Engineering, ul. Smoluchowskiego 25, 50-370 Wroclaw, Poland.
| | - D Robert Iskander
- Wroclaw University of Science and Technology, Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wybrzeze Wyspianskiego 27, 50-370 Wroclaw, Poland.
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Abegão Pinto L, Willekens K, Van Keer K, Shibesh A, Molenberghs G, Vandewalle E, Stalmans I. Ocular blood flow in glaucoma - the Leuven Eye Study. Acta Ophthalmol 2016; 94:592-8. [PMID: 26895610 DOI: 10.1111/aos.12962] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 11/24/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE Elevated intra-ocular pressure (IOP) has been identified as a major risk factor for glaucoma. Additionally, extensive literature depicts a vascular dysfunction to exist in these patients. However, a large ocular blood flow-oriented trial to integrate these findings in the clinical setting is lacking. This study would likely help to identify which of these vascular data can be used as a clinical tool for screening and disease stratification. METHOD Prospective, cross-sectional, case-control hospital-based study. Patients with primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), ocular hypertension (OHT), glaucoma suspects and healthy volunteers were recruited. In addition to a comprehensive ophthalmological examination, a vascular-oriented questionnaire was completed and ocular blood flow assessment (colour Doppler imaging of retrobulbar vessels, retinal oximetry, dynamic contour tonometry, optical coherent tomography enhanced-depth imaging of the choroid) were performed. Statistical analysis was based on multiple imputation to account for missingness. RESULTS A total of 614 subjects (291 males) were recruited between March and December 2013 (POAG: 214, NTG: 192; OHT: 27; glaucoma suspect: 41; healthy controls: 140). Glaucoma groups (NTG and POAG) were age and gender matched with the control group (p > 0.05). Glaucoma groups were paired in terms of functional and structural parameters (p > 0.08). Mean ocular perfusion pressure was higher in the glaucoma groups than in controls (p < 0.001). Glaucoma groups had lower retrobulbar velocities, higher retinal venous saturation and choroidal thickness asymmetries when compared to the healthy group, in line with the current literature. CONCLUSIONS The Leuven Eye Study stands as one of the largest clinical trials on ocular blood flow in glaucoma. The creation of this vast database may help integrate the vascular aspects of glaucoma into the clinical practice of glaucoma.
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Affiliation(s)
- Luís Abegão Pinto
- Department of Ophthalmology; University Hospitals Leuven; Leuven Belgium
- Visual Sciences Study Center; Faculty of Medicine of Lisbon University; Lisbon Portugal
| | - Koen Willekens
- Department of Ophthalmology; University Hospitals Leuven; Leuven Belgium
| | - Karel Van Keer
- Department of Ophthalmology; University Hospitals Leuven; Leuven Belgium
| | | | - Geert Molenberghs
- I-BioStat; KU Leuven; Leuven Belgium
- I-BioStat; Hasselt University; Hasselt Belgium
| | - Evelien Vandewalle
- Department of Ophthalmology; University Hospitals Leuven; Leuven Belgium
| | - Ingeborg Stalmans
- Department of Ophthalmology; University Hospitals Leuven; Leuven Belgium
- Department of Ophthalmology Neurosciences; Laboratory of Ophthalmology; KU Leuven; Leuven Belgium
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Relationship Between Subfoveal Choroidal Thickness, Ocular Pulse Amplitude, and Intraocular Pressure in Healthy Subjects. J Glaucoma 2016; 25:613-7. [DOI: 10.1097/ijg.0000000000000401] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Willekens K, Rocha R, Van Keer K, Vandewalle E, Abegão Pinto L, Stalmans I, Marques-Neves C. Review on Dynamic Contour Tonometry and Ocular Pulse Amplitude. Ophthalmic Res 2015; 55:91-8. [PMID: 26650248 DOI: 10.1159/000441796] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 10/19/2015] [Indexed: 11/19/2022]
Abstract
Intraocular pressure (IOP) measurement is the cornerstone of the management of glaucoma patients. The gold standard for assessing IOP is Goldmann applanation tonometry (GAT). Recently, the dynamic contour tonometer (DCT) has become available. While both devices provide reliable IOP measurements, the results are not interchangeable. DCT has the advantage of measuring an additional parameter: ocular pulse amplitude (OPA). OPA is defined as the difference between systolic and diastolic IOP and represents the pulsatile wave front produced by the varying amount of blood in the eye during the cardiac cycle. It has been shown to vary with ocular structural parameters, such as axial length, corneal thickness, and ocular rigidity, as well as with systemic variables like heart rate, blood pressure, and left ventricular ejection fraction. Although the existence of some of these associations is still controversial, the clinical relevance of OPA has been consistently suggested, especially in glaucoma. Further research on this intriguing parameter could not only provide insight into glaucoma pathophysiology but also help integrate this variable into clinical practice.
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Affiliation(s)
- Koen Willekens
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
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Comparison of Ocular Pulse Amplitude Lowering Effects of Preservative-Free Tafluprost and Preservative-Free Dorzolamide-Timolol Fixed Combination Eyedrops. BIOMED RESEARCH INTERNATIONAL 2015; 2015:435874. [PMID: 26557671 PMCID: PMC4628750 DOI: 10.1155/2015/435874] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 05/29/2015] [Accepted: 05/31/2015] [Indexed: 11/28/2022]
Abstract
Purpose. To compare the ocular pulse amplitude (OPA) lowering effects of preservative-free tafluprost and dorzolamide-timolol fixed combination (DTFC) using dynamic contour tonometry. Methods. In total, 66 eyes of 66 patients with normal tension glaucoma (NTG) (n = 34) or primary open angle glaucoma (POAG) (n = 32) were included. Patients were divided into two groups: the preservative-free tafluprost-treated group (n = 33) and the preservative-free DTFC-treated group (n = 33). Intraocular pressure (IOP) was measured using Goldmann applanation tonometry (GAT). OPA was measured using dynamic contour tonometry; corrected OPA (cOPA) was calculated at baseline and at 1 week and 1, 3, and 6 months after treatment. Results. After 6 months of treatment, tafluprost significantly reduced IOP (P < 0.001). The OPA lowering effects differed significantly between the two treatment groups (P = 0.003). The cOPA-lowering effect of tafluprost (1.09 mmHg) was significantly greater than that of DTFC (0.36 mmHg) after 6 months of treatment (P = 0.01). Conclusions. Tafluprost and DTFC glaucoma treatments provided marked OPA and IOP lowering effects. Tafluprost had a greater effect than DTFC; thus, this drug is recommended for patients at risk of glaucoma progression, due to the high OPA caused by large fluctuations in IOP.
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Park SH, Yoo SH, Ha SJ. Comparison of Ocular Pulse Amplitude-Lowering Effects of Tafluprost and Latanoprost by Dynamic Contour Tonometry. J Ocul Pharmacol Ther 2015; 31:617-22. [PMID: 26348718 DOI: 10.1089/jop.2014.0122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE A prospective study was performed to compare the ocular pulse amplitude (OPA)-lowering effects of tafluprost and latanoprost, used in the treatment of glaucoma, using dynamic contour tonometry. METHODS The study population consisted of patients with normal-tension glaucoma (NTG) (n = 27) or primary open-angle glaucoma (POAG) (n = 14) treated with tafluprost and latanoprost. All patients were newly diagnosed with NTG and POAG and had undergone no previous treatment. Intraocular pressure (IOP) was measured by Goldmann applanation tonometry (GAT), OPA was measured by dynamic contour tonometry, and corrected OPA (cOPA) was calculated before and after 1 week, 1-3 months of treatment. RESULTS Initial IOP and OPA were 17.12 ± 3.75, 2.30 ± 0.56 mmHg and 17.53 ± 2.87, 2.65 ± 0.94 mmHg in the tafluprost and latanoprost groups, respectively. After 3 months of treatment, IOP and OPA were 13.00 ± 2.04 mmHg (24.1%) and 1.51 ± 0.30 mmHg (34.3%), respectively, in the tafluprost group. These values were 15.40 ± 2.32 mmHg (12.2%) and 2.08 ± 0.83 mmHg (21.5%), respectively, in the latanoprost group. Therefore, tafluprost significantly reduced IOP (P = 0.01), but OPA-lowering effects did not differ significantly between the 2 groups (P = 0.17). However, the cOPA-lowering effect of tafluprost (1.27 mmHg, 55.2%) was significantly greater than that of latanoprost (0.84 mmHg, 31.7%) after 3 months of treatment (P < 0.001). CONCLUSIONS Tafluprost and latanoprost, used to treat glaucoma, have marked OPA-lowering effects as well as IOP-lowering effects. Moreover, tafluprost has a greater effect than latanoprost. Therefore, it can be used for patients in need of IOP reduction and at risk of glaucoma progression.
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Affiliation(s)
- Sun Ho Park
- Department of Ophthalmology, Soonchunhyang University College of Medicine, Soonchunhyang University Seoul Hospital , Seoul, Republic of Korea
| | - Seung Hoon Yoo
- Department of Ophthalmology, Soonchunhyang University College of Medicine, Soonchunhyang University Seoul Hospital , Seoul, Republic of Korea
| | - Seung Joo Ha
- Department of Ophthalmology, Soonchunhyang University College of Medicine, Soonchunhyang University Seoul Hospital , Seoul, Republic of Korea
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Lemos V, Cabugueira A, Noronha M, Abegão Pinto L, Reina M, Branco J, Gomes T. Intraocular Pressure in Eyes Receiving Intravitreal Antivascular Endothelial Growth Factor Injections. Ophthalmologica 2015; 233:162-8. [DOI: 10.1159/000369478] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 10/28/2014] [Indexed: 11/19/2022]
Abstract
Purpose: The aim of the this study was to determine the effect of intravitreal antivascular endothelial growth factor injections on intraocular pressure (IOP) and identify possible risk factors for the development of increased IOP. Materials and Methods: This prospective study included a total of 106 eyes receiving intravitreal injection of bevacizumab as treatment for macular edema or active choroidal neovascularization. IOP was measured by Goldmann applanation tonometry immediately before the intravitreal injection and 5 min, 1 h and 15 days after the procedure. The records of the study patients were reviewed for age, gender, history of glaucoma, diabetes mellitus, phakic status, systemic and topical medication and number of previous injections. Subconjunctival reflux was registered. IOP elevation was defined as IOP ≥21 mm Hg and/or a change from baseline of ≥5 mm Hg recorded at least on two or more measurements on the same visit. Results: Mean preoperative IOP was 15.31 ± 3.90 mm Hg and postoperative IOP values were 27.27 ± 11.87 mm Hg (after 5 min), 17.59 ± 6.24 mm Hg (after 1 h) and 16.86 ± 3.62 mm Hg (after 15 days). The IOP variation was statistically significant between pre- and postoperative measurements (p < 0.05). Subconjunctival reflux was recorded in 11.3%, and in this subgroup the IOP at 5 min and at 1 h was lower than preoperative IOP (p < 0.05). Conclusions: More than one third of the eyes achieved IOPs >30 mm Hg 5 min after injection. Subconjunctival reflux contributed to a lower mean postoperative IOP (p < 0.05). Considerations for the management include prophylactic IOP lowering with medical therapy and/or preinjection ocular decompression for patients with a history of glaucoma or ocular hypertension and switching to an as-needed injection protocol in patients suffering a marked IOP rise in previous injections.
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Ahn JH, Kil HK, Lee MV. Positional Change of Intraocular Pressure and Its Relationship to Ocular Pulse Amplitude. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.2.234] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jae Hong Ahn
- Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea
| | - Hyun Kyung Kil
- Department of Ophthalmology, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Mar Vin Lee
- Department of Ophthalmology, Bundang Jesaeng General Hospital, Seongnam, Korea
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Pekel G, Kılıç ID, Alihanoğlu Yİ, Acer S, Yağcı R, Kaya H, Alur İ. Effects of coronary artery bypass grafting surgery on retinal vascular caliber, ocular pulse amplitude and retinal thickness measurements. Perfusion 2014; 30:312-7. [DOI: 10.1177/0267659114547249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: The retina and ocular vasculature are vulnerable to alterations in systemic hemodynamics, such as in open heart surgeries. Our aim was to investigate retinal vascular caliber (RVC), ocular pulse amplitude (OPA), peripapillary retinal nerve fiber layer (RNFL) and macular thickness in coronary artery bypass grafting (CABG) surgery patients. Methods: Twenty-six patients who had a history of CABG surgery and 26 age-sex-matched healthy participants were recruited for this prospective, cross-sectional and comparative study. The RVC, peripapillary RNFL and macular thickness measurements were taken with spectral-domain optical coherence tomography. The OPA, a surrogate of pulsatile ocular blood flow, was measured with the Pascal dynamic contour tonometer. Results: There were no statistically significant differences between the CABG surgery patients and the controls with regard to RVC, OPA, peripapillary RNFL thickness and macular thickness measurements (p>0.05). Conclusions: CABG surgery does not affect retinal structures and pulsatile ocular blood flow in the long-term follow-up.
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Affiliation(s)
- G Pekel
- Ophthalmology Department, Pamukkale University, Denizli, Turkey
| | - ID Kılıç
- Cardiology Department, Pamukkale University, Denizli, Turkey
| | - Yİ Alihanoğlu
- Cardiology Department, Pamukkale University, Denizli, Turkey
| | - S Acer
- Ophthalmology Department, Pamukkale University, Denizli, Turkey
| | - R Yağcı
- Ophthalmology Department, Pamukkale University, Denizli, Turkey
| | - H Kaya
- Ophthalmology Department, Pamukkale University, Denizli, Turkey
| | - İ Alur
- Cardiovascular Surgery Department, Pamukkale University, Denizli, Turkey
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Abegão Pinto L, Vandewalle E, Willekens K, Marques-Neves C, Stalmans I. Ocular pulse amplitude and Doppler waveform analysis in glaucoma patients. Acta Ophthalmol 2014; 92:e280-5. [PMID: 24456194 DOI: 10.1111/aos.12340] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Accepted: 11/21/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE To determine the correlation between ocular blood flow velocities and ocular pulse amplitude (OPA) in glaucoma patients using colour Doppler imaging (CDI) waveform analysis. METHOD A prospective, observer-masked, case-control study was performed. OPA and blood flow variables from central retinal artery and vein (CRA, CRV), nasal and temporal short posterior ciliary arteries (NPCA, TPCA) and ophthalmic artery (OA) were obtained through dynamic contour tonometry and CDI, respectively. Univariate and multiple regression analyses were performed to explore the correlations between OPA and retrobulbar CDI waveform and systemic cardiovascular parameters (blood pressure, blood pressure amplitude, mean ocular perfusion pressure and peripheral pulse). RESULTS One hundred and ninety-two patients were included [healthy controls: 55; primary open-angle glaucoma (POAG): 74; normal-tension glaucoma (NTG): 63]. OPA was statistically different between groups (Healthy: 3.17 ± 1.2 mmHg; NTG: 2.58 ± 1.2 mmHg; POAG: 2.60 ± 1.1 mmHg; p < 0.01), but not between the glaucoma groups (p = 0.60). Multiple regression models to explain OPA variance were made for each cohort (healthy: p < 0.001, r = 0.605; NTG: p = 0.003, r = 0.372; POAG: p < 0.001, r = 0.412). OPA was independently associated with retrobulbar CDI parameters in the healthy subjects and POAG patients (healthy CRV resistance index: β = 3.37, CI: 0.16-6.59; healthy NPCA mean systolic/diastolic velocity ratio: β = 1.34, CI: 0.52-2.15; POAG TPCA mean systolic velocity: β = 0.14, CI 0.05-0.23). OPA in the NTG group was associated with diastolic blood pressure and pulse rate (β = -0.04, CI: -0.06 to -0.01; β = -0.04, CI: -0.06 to -0.001, respectively). CONCLUSIONS Vascular-related models provide a better explanation to OPA variance in healthy individuals than in glaucoma patients. The variables that influence OPA seem to be different in healthy, POAG and NTG patients.
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Affiliation(s)
- Luís Abegão Pinto
- Department of Ophthalmology; Centro Hospitalar Lisboa Central; Lisbon Portugal
- Department of Pharmacology and Neurosciences; Faculty of Medicine; Lisbon University; Lisbon Portugal
| | - Evelien Vandewalle
- Department of Ophthalmology; University Hospitals Leuven (UZ Leuven); Leuven Belgium
| | - Koen Willekens
- Department of Ophthalmology; University Hospitals Leuven (UZ Leuven); Leuven Belgium
| | | | - Ingeborg Stalmans
- Department of Ophthalmology; University Hospitals Leuven (UZ Leuven); Leuven Belgium
- Department of Neurosciences; Laboratory of Ophthalmology; Catholic University Leuven (KU Leuven); Leuven Belgium
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Siesky BA, Harris A, Amireskandari A, Marek B. Glaucoma and ocular blood flow: an anatomical perspective. EXPERT REVIEW OF OPHTHALMOLOGY 2014. [DOI: 10.1586/eop.12.41] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Bochmann F, Kaufmann C, Thiel MA. Dynamic contour tonometry versus Goldmann applanation tonometry: challenging the gold standard. EXPERT REVIEW OF OPHTHALMOLOGY 2014. [DOI: 10.1586/eop.10.68] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Jang SR, Lee MV, Ahn JH. Comparison of Dorzolamide-Timolol Fixed Combination and Latanoprost, Effects on Intraocular Pressure and Ocular Pulse Amplitude. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2014. [DOI: 10.3341/jkos.2014.55.6.854] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Se Ran Jang
- Department of Ophthalmology, Ajou University Medical Center, Ajou University School of Medicine, Suwon, Korea
| | - Mar Vin Lee
- Department of Ophthalmology, DMC BunDang Jesaeng General Hospital, Seongnam, Korea
| | - Jae Hong Ahn
- Department of Ophthalmology, Ajou University Medical Center, Ajou University School of Medicine, Suwon, Korea
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Does fundus fluorescein angiography procedure affect ocular pulse amplitude? J Ophthalmol 2013; 2013:942972. [PMID: 23984045 PMCID: PMC3745956 DOI: 10.1155/2013/942972] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 06/02/2013] [Accepted: 06/02/2013] [Indexed: 11/18/2022] Open
Abstract
Purpose. This study examines the effects of fundus fluorescein angiography (FFA) procedure on ocular pulse amplitude (OPA) and intraocular pressure (IOP). Materials and Methods. Sixty eyes of 30 nonproliferative diabetic retinopathy patients (15 males, 15 females) were included in this cross-sectional case series. IOP and OPA were measured with the Pascal dynamic contour tonometer before and after 5 minutes of intravenous fluorescein dye injection. Results. Pre-FFA mean OPA value was 3.05 ± 1.36 mmHg and post-FFA mean OPA value was 2.93 ± 1.28 mmHg (P = 0.071). Pre-FFA mean IOP value was 17.97 ± 1.99 mmHg and post-FFA mean IOP value was 17.81 ± 2.22 mmHg (P = 0.407). Conclusion. Although both mean OPA and IOP values were decreased after FFA procedure, the difference was not statistically significant. This clinical trial is registered with Australian New Zealand Clinical Trials Registry number ACTRN12613000433707.
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Moghimi S, Torabi H, Fakhraie G, Nassiri N, Mohammadi M. Dynamic contour tonometry in primary open angle glaucoma and pseudoexfoliation glaucoma: factors associated with intraocular pressure and ocular pulse amplitude. Middle East Afr J Ophthalmol 2013; 20:158-62. [PMID: 23741135 PMCID: PMC3669493 DOI: 10.4103/0974-9233.110606] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose: To compare the intraocular pressures (IOP) and ocular pulse amplitudes (OPAs) in patients with primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PXG), and to evaluate ocular and systemic factors associated with the OPA. Materials and Methods: In this prospective study, on 28 POAG and 30 PXG patients, IOP was measured with the Goldmann applanation tonometry (GAT) and the Pascal dynamic contour tonometry (DCT). Other measurements included central corneal thickness (CCT), vertical cup-to-disc ratio (CDR), and systolic and diastolic blood pressure. Statistical significance was defined as P < 0.05. Results: In each of the POAG and PXG groups, GAT IOP was correlated with CCT (r = 0.40, P = 0.03 and r = 0.35, P = 0.05, respectively), whereas DCT IOP and CCT were not correlated. In all patients and in the POAG group, OPA was positively correlated with DCT IOP (r = 0.39, P = 0.002). OPA was not correlated with CCT in the POAG (P = 0.80), nor in the PXG (P = 0.20) group, after adjusting for DCT IOP. When corrected for DCT IOP and CCT, there was a significant negative correlation between OPA and vertical CDR in all patients (r = −0.41, P = 0.002). There was no significant difference in OPA between groups (P = 0.55), even when OPA was adjusted for IOP and systolic and diastolic pressure (P = 0.40), in a linear regression model. Conclusion: DCT IOP and OPA are not correlated with CCT. There is no significant difference between the OPA of PXG and POAG eyes. OPA is correlated with DCT IOP, and is lower in eyes with more advanced glaucomatous cupping.
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Affiliation(s)
- Sasan Moghimi
- Department of Ophthalmology, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Lee M, Cho EH, Lew HM, Ahn J. Relationship between ocular pulse amplitude and glaucomatous central visual field defect in normal-tension glaucoma. J Glaucoma 2013; 21:596-600. [PMID: 22366705 DOI: 10.1097/ijg.0b013e31824cfbf7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate the relationship between central visual field (VF) defects and ocular pulse amplitude (OPA) in early normal-tension glaucoma (NTG). PATIENTS AND METHODS This retrospective study included 100 eyes of 100 subjects: 54 NTG patients whose mean deviations were better than -7.00 dB and 46 normal subjects. OPA was measured by dynamic contour tonometry. NTG patients were divided into 2 subgroups according to VF tests: the central VF-invading and the central VF-sparing groups. Ocular parameters including OPA, intraocular pressure (IOP), and indices of VF tests were analyzed in glaucoma patients and normal subjects. RESULTS There was no difference in the OPA between the NTG and normal groups. However, IOP and OPA of the central VF-invading group (14.4 ± 2.87 and 2.9 ± 0.78 mm Hg) were higher than those of the central VF-sparing group (12.7 ± 2.52 and 2.0 ± 0.80 mm Hg; P = 0.025 and P < 0.001, respectively). OPA, but not IOP, showed a positive correlation with the VF test indices that represented central field defects (r = 0.494, P < 0.001). CONCLUSIONS Increased OPA was related to more centrally located VF defects in NTG patients with mild VF defects.
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Affiliation(s)
- Marvin Lee
- Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea
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Moon DRC, Ha SJ. Analysis of Clinical Effectiveness of Tafluprost by Ocular Pulse Amplitude. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.2.303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Da Ru Chi Moon
- Department of Ophthalmology, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Seung Joo Ha
- Department of Ophthalmology, Soonchunhyang University College of Medicine, Seoul, Korea
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Jiwani AZ, Rhee DJ, Brauner SC, Gardiner MF, Chen TC, Shen LQ, Chen SH, Grosskreutz CL, Chang KK, Kloek CE, Greenstein SH, Borboli-Gerogiannis S, Pasquale DL, Chaudhry S, Loomis S, Wiggs JL, Pasquale LR, Turalba AV. Effects of caffeinated coffee consumption on intraocular pressure, ocular perfusion pressure, and ocular pulse amplitude: a randomized controlled trial. Eye (Lond) 2012; 26:1122-30. [PMID: 22678051 DOI: 10.1038/eye.2012.113] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To examine the effects of caffeinated coffee consumption on intraocular pressure (IOP), ocular perfusion pressure (OPP), and ocular pulse amplitude (OPA) in those with or at risk for primary open-angle glaucoma (POAG). METHODS We conducted a prospective, double-masked, crossover, randomized controlled trial with 106 subjects: 22 with high tension POAG, 18 with normal tension POAG, 20 with ocular hypertension, 21 POAG suspects, and 25 healthy participants. Subjects ingested either 237 ml of caffeinated (182 mg caffeine) or decaffeinated (4 mg caffeine) coffee for the first visit and the alternate beverage for the second visit. Blood pressure (BP) and pascal dynamic contour tonometer measurements of IOP, OPA, and heart rate were measured before and at 60 and 90 min after coffee ingestion per visit. OPP was calculated from BP and IOP measurements. Results were analysed using paired t-tests. Multivariable models assessed determinants of IOP, OPP, and OPA changes. RESULTS There were no significant differences in baseline IOP, OPP, and OPA between the caffeinated and decaffeinated visits. After caffeinated as compared with decaffeinated coffee ingestion, mean mm Hg changes (± SD) in IOP, OPP, and OPA were as follows: 0.99 (± 1.52, P<0.0001), 1.57 (± 6.40, P=0.0129), and 0.23 (± 0.52, P<0.0001) at 60 min, respectively; and 1.06 (± 1.67, P<0.0001), 1.26 (± 6.23, P=0.0398), and 0.18 (± 0.52, P=0.0006) at 90 min, respectively. Regression analyses revealed sporadic and inconsistent associations with IOP, OPP, and OPA changes. CONCLUSION Consuming one cup of caffeinated coffee (182 mg caffeine) statistically increases, but likely does not clinically impact, IOP and OPP in those with or at risk for POAG.
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Affiliation(s)
- A Z Jiwani
- Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA
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Kim MH, Yang HS, Lee MV, Ahn JH. The Effect of Cataract Surgery on Ocular Pulse Amplitude. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2012. [DOI: 10.3341/jkos.2012.53.12.1828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Min Ho Kim
- Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea
| | - Hong Seok Yang
- Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea
| | - Mar Vin Lee
- Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea
| | - Jae Hong Ahn
- Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea
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Robert YCA, Wild A, Kessels AG, Backes WH, Zollinger A, Bachmann LM. Discrimination of healthy and glaucomatous eyes based on the ocular pulse amplitude: a diagnostic case-control study. Ophthalmic Res 2011; 48:1-5. [PMID: 22205259 DOI: 10.1159/000334616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Accepted: 10/03/2011] [Indexed: 11/19/2022]
Abstract
By measuring the ocular pulse amplitude (OPA), the dynamic contour tonometer (DCT) assesses intraocular pressure (IOP). Hypothesizing that OPA is characteristic for the IOP when considered with the systemic arterial blood pressure, we assumed the ratio of ocular and arterial pulsation amplitudes is larger in glaucoma patients. Bi-ocular DCT-OPA assessment was synchronized with arterial pulsations using Finapres® technology, thereby enabling blood pressure determination for each corresponding IOP value every 0.01 s for 12 s. Based on measurements and calculations in 10 healthy subjects and 11 glaucoma patients, we conclude that the ratio of the OPA and blood pressure variances is a strong glaucoma diagnostic indicator, thereby justifying further investigation.
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Decreased ocular pulse amplitude associated with functional and structural damage in open-angle glaucoma. Eur J Ophthalmol 2011; 22:111-6. [PMID: 22167550 DOI: 10.5301/ejo.5000043] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2011] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess the relationship of ocular pulse amplitude (OPA), as measured by dynamic contour tonometry (DCT), with structural and functional damage in patients with open-angle glaucoma (OAG). METHODS In this cross-sectional, observational study, 242 eyes of 139 patients with OAG underwent Goldmann applanation tonometry (GAT), DCT, central corneal thickness (CCT) measurement, visual fields examination (Octopus, Haag Streit), and complete ophthalmologic examination. Linear regression analysis was used to analyze the effect of OPA, DCT, GAT, and CCT to the mean defect (MD) of the visual fields and to the vertical cup to disc ratio (CDR). RESULTS Ocular pulse amplitude was the only variable that showed a significant association with MD (slope=-1.1, p=0.012), in contrast to GAT (p=0.98), DCT (p=0.32), and CCT (p=0.42). Ocular pulse amplitude was also negatively associated with CDR (slope=-0.028, p=0.0001). Additional multiple regression analysis revealed that OPA (R2=0.12, r=-0.25, slope=-0.02, p=0.033), GAT (r=-0.27, slope=-0.01, p=0.027), and CCT (r=-0.18, slope=-0.001, p=0.012) were statistically significantly correlated to CDR, while DCT was not (r=-0.20, slope=0.003, p=0.46). Ocular pulse amplitude did not differ statistically significantly (p=0.93) between eyes with (2.79 ± 1.42) and without (2.77 ± 1.21) prior trabeculectomy. No statistically significant difference of OPA was observed between diagnosis groups (p=0.255). CONCLUSIONS Decreased OPA seems to be correlated with increased glaucomatous functional and structural damage in OAG. Assessment of OPA by DCT could therefore serve as an important additional parameter in the evaluation of glaucoma patients.
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Knecht PB, Bosch MM, Michels S, Mannhardt S, Schmid U, Bosch MA, Menke MN. The ocular pulse amplitude at different intraocular pressure: a prospective study. Acta Ophthalmol 2011; 89:e466-71. [PMID: 21401909 DOI: 10.1111/j.1755-3768.2011.02141.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To investigate changes in ocular pulse amplitude (OPA) during a short-term increase in intraocular pressure (IOP) and to assess possible influences of biometrical properties of the eye, including central corneal thickness (CCT) and axial length. METHODS In a prospective, single centre study, OPA and IOP as measured by dynamic contour tonometry (DCT) were taken before baseline- and post-OPA (delta) intravitreal injection of 0.05 ml anti-vascular endothelial growth factor agents. Analysis was performed employing linear regression with baseline- and post (delta)-OPA differences as the dependent and post-IOP as well as delta IOP as the independent variable. A multilinear regression analysis with delta OPA as the dependent variable and baseline IOP, post-IOP, CCT and axial length as independent variables was conducted. RESULTS Forty eyes of 40 patients were included. IOP and OPA increased significantly after injection (IOP mean increase ± SD: 17.83 ± 9.83 mmHg, p < 0.001; OPA mean increase ± SD: 1.39 ± 1.16 mmHg, p < 0.001). For every mmHg increase in IOP, the OPA showed a linear increase of 0.05 mmHg (slope 0.05, 95% CI: 0.02-0.09, p = 0.003, r(2) = 0.20). Multiple regression analysis with delta OPA as the dependent variable revealed a partial correlation coefficient of 0.47 (p = 0.003) for post-IOP as the only significant contribution. CONCLUSION A clear positive relationship between OPA measurements and IOP levels was shown in a clinical routine setting using DCT focusing on baseline and postinterventional comparisons of OPA values after intravitreal injections in patients with exudative age related macular degeneration. When considering the OPA for diagnostic purposes, we recommend indication of corresponding IOP values.
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Affiliation(s)
- Pascal Bruno Knecht
- Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland.
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Kac MJ, Solari HP, Velarde GC, Brazuna R, Cardoso GP, Ventura MP. Ocular pulse amplitude in patients with asymmetric primary open-angle glaucoma. Curr Eye Res 2011; 36:727-32. [PMID: 21780922 DOI: 10.3109/02713683.2011.584652] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM To evaluate ocular pulse amplitude (OPA) using the dynamic contour tonometer (DCT) in patients with asymmetric primary open-angle glaucoma (POAG) and asymmetric intra-ocular pressure (IOP). METHODS The participants consisted of 48 patients (96 eyes) with asymmetric POAG. Three measurements of IOP and OPA were taken using DCT. The diagnosis of asymmetry required a difference of glaucomatous visual field loss greater than 6 dB in the global index MD and a difference of 5 mmHg in IOP measured by Goldmann tonometry between the more affected and the contra-lateral eye. All participants underwent full ophthalmologic clinical assessment including ultrasonic pachymetry and biometric measurements. Exclusion criteria were corneal diseases or scars, topical or systemic glaucomatous medications, and previous ocular surgery. RESULTS No difference (p = 0.142) was found between the axial length measurements of the better eyes group (22.95 ± 0.91 mm) and worse eyes group (22.85 ± 0.97 mm). There was a statistically significant difference (p = 0.011) between the central corneal thickness values of the better eyes group (537.08 ± 29.54 μm) and worse eyes group (534.40 ± 29.87 μm). The OPA values of the better eyes group (3.32 ± 1.14 mmHg) were significantly lower (p = 0.001) than those obtained in the worse eyes group (3.83 ± 1.27 mmHg). When correcting the OPA readings by the IOP there was no statistical difference between groups (p = 0.996). CONCLUSION Higher OPA values were found in eyes with higher IOP levels and advanced glaucoma's lesions in asymmetric hypertensive POAG patients. However, after the OPA correction by the IOP levels there was no more statistical difference between eyes.
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Affiliation(s)
- Marcelo Jarczun Kac
- Department of Ophthalmology, Hospital Universitario Antonio Pedro, Fluminense Federal University, Niteroi, Brazil.
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Tabuchi H, Kiuchi Y, Ohsugi H, Nakakura S, Han Z. Effects of corneal thickness and axial length on intraocular pressure and ocular pulse amplitude before and after cataract surgery. Can J Ophthalmol 2011; 46:242-6. [PMID: 21784209 DOI: 10.1016/j.jcjo.2011.05.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Revised: 10/08/2010] [Accepted: 11/02/2010] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To investigate the relationship between the biophysical properties of the cornea and eye on the intraocular pressure (IOP) and ocular pulse amplitude (OPA) before and after cataract surgery. DESIGN Intervention study. PARTICIPANTS The left eyes of 311 patients. METHODS The left eyes of 338 patients undergoing cataract surgery without other eye pathology were studied. IOP and OPA were recorded by dynamic contour tonometry (DCT) 1 week before and 14 weeks after cataract surgery. The axial length, corneal curvature, central corneal thickness, anterior chamber depth, and anterior chamber angle were measured 1 week before cataract surgery. Multiple regression analyses of these factors to the preoperative OPA were performed. The difference between the pre- and postoperative IOP and OPA were investigated by paired t tests. RESULTS Three hundred and eleven of 338 eyes were analyzed. The preoperative OPA was negatively correlated with axial length (β = -0.24, p < 0.0001) and positively correlated with the preoperative IOP (β = 0.13, p < 0.0001). The average OPA was significantly decreased after cataract surgery (p < 0.0001). The mean change in postoperative OPA was -0.45 ± 0.63 mm Hg (95% CI -0.52 to -0.38 mm Hg). CONCLUSIONS The preoperative OPA was negatively correlated with axial length as reported. A significant decrease in OPA was observed after the cataract surgery.
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Affiliation(s)
- Hitoshi Tabuchi
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, 68-1 Waku, Aboshi-ku, Himeji-City, Hyogo 671-1227, Japan.
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Insull E, Nicholas S, Ang GS, Poostchi A, Chan K, Wells A. Optic disc area and correlation with central corneal thickness, corneal hysteresis and ocular pulse amplitude in glaucoma patients and controls. Clin Exp Ophthalmol 2011; 38:839-44. [PMID: 20653690 DOI: 10.1111/j.1442-9071.2010.02373.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND To examine the relationships between optic disc area and parameters measured at the cornea; central corneal thickness (CCT), corneal hysteresis (CH) and ocular pulse amplitude (OPA) in glaucoma subjects and controls. METHODS In this prospective experimental study, patients underwent measurement of CCT, OPA, CH and optic disc imaging with the Heidelberg Retina Tomograph II (HRT-II). Pearson's correlation coefficient was calculated to assess the associations between optic disc area and CCT, OPA and CH. RESULTS A total of 100 patients, 38 with glaucoma and 62 controls were examined. In a univariate analysis of this group, CCT and CH were significantly lower in glaucoma patients (P = 0.01). CCT was inversely correlated with optic disc surface area (Pearson's correlation coefficient r = -0.200; P = 0.05). This inverse correlation did not achieve statistical significance when glaucoma patients and controls were analysed separately. There was no statistically significant association between optic disc area and OPA or CH. CONCLUSIONS There was an inverse relationship between CCT and optic disc area in this study group. No association was found between optic disc area and OPA or CH.
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Affiliation(s)
- Elizabeth Insull
- Wellington Eye Clinic, Capital and Coast District Health Board, Wellington, New Zealand
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Karadag R, Keskin UC, Koktener A, Selcoki Y, Hepsen IF, Kanbay M. Ocular pulse amplitude and retrobulbar blood flow change in dipper and non-dipper individuals. Eye (Lond) 2011; 25:762-6. [PMID: 21423136 DOI: 10.1038/eye.2011.50] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To evaluate ocular pulse amplitude (OPA), IOP values, and hemodynamic changes in the ophthalmic artery, central retinal artery, and short posterior ciliary artery in dipper and non-dipper patients. METHODS A total of 59 right eye measurements of healthy subjects with normotensive were included to the study. Ambulatory blood pressure (BP) monitoring measurement (ABPM), Doppler imaging, and OPA measurements were performed in the same day. The patients in which systolic BP decreased during the nocturnal time by 10% of the diurnal BP or more were called dippers. A patient whose nocturnal systolic BP fell by <10% or even rose was defined as non-dipper. Color Doppler imaging was used for blood flow velocity assessment of ophthalmic, central retinal, and posterior ciliary arteries. For each artery, peak systolic and end-diastolic velocities (PSV and EDV, respectively), resistive index (RI), and pulsalite index (PI) were automatically calculated by the machine. Mean IOP and OPA values were calculated after three consecutive measurements. RESULTS The mean OPA in non-dipper patients was significantly lower compared with that of dipper patients (P=0.011). There was no significant difference in IOP levels between groups. There was no significant difference in the PSV, EDV, RI, and PI in the ophthalmic, posterior ciliary, and central retinal arteries between the groups. CONCLUSION Our study demonstrated that OPA level in non-dippers is lower than dippers. This may give additional information about the effect of BP changes on OPA values.
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Affiliation(s)
- R Karadag
- Yuzuncu Yil University, Medical School, Department of Ophthalmology, Van, Turkey.
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Rechtman E, Stalmans I, Glovinsky J, Breusegem C, Moisseiev J, Van Calster J, Harris A. The effect of intravitreal bevacizumab (Avastin) on ocular pulse amplitude in neovascular age-related macular degeneration. Clin Ophthalmol 2011; 5:37-44. [PMID: 21386919 PMCID: PMC3048056 DOI: 10.2147/opth.s15810] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
PURPOSE To evaluate the effect of intravitreal (IVT) bevacizumab in neovascular age-related macular degeneration (AMD) on global choroidal hemodynamics, as measured by ocular pulse amplitude (OPA). METHODS This was a two-center prospective study (Sheba Medical Center, Israel, and University Hospitals Leuven, Belgium). AMD patients who required IVT bevacizumab (1.25 mg/0.05 mL; first or repeated) were examined three times: at days 0 (prior to injection), 7 (±3), and 28 (±7) postinjection. At each visit, OPAs of both eyes were measured using the Pascal dynamic contour tonometer (DCT). A paired t-test between preoperative and postoperative OPA was conducted. Pearson correlation was used to evaluate the influence of various measured parameters on DCT-OPA. RESULTS A total of 38 neovascular AMD patients were recruited, and 30 patients were included in the final analysis (18 females and 12 males; age 78.8 ± 5.82 years [mean ± standard deviation]). A good correlation was found throughout the study between the DCT-intraocular pressure (IOP) and Goldmann IOP and between DCT-IOP and DCT-OPA. No change in OPA of bevacizumab-treated eyes was found between the visits (2.24 ± 0.73, 2.2 ± 0.86, and 2.23 ± 0.73 mm Hg at visits 1, 2, and 3, respectively; paired t-test: P = 0.77 between visits 1 and 2, P = 0.98 between visits 1 and 3). No correlations were found between DCT-OPA and age, heart rate, systemic blood pressure, axial length, keratometry readings, and central corneal thickness. CONCLUSIONS OPA, an indirect measure of global choroidal hemodynamics, remains unchanged following IVT off-label bevacizumab. This finding adds to the growing evidence regarding the safety profile of bevacizumab in AMD treatment.
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Affiliation(s)
- Ehud Rechtman
- Goldschleger Eye Institute, Sheba Medical Center, Ramat Gan, Israel
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Berisha F, Findl O, Lasta M, Kiss B, Schmetterer L. A study comparing ocular pressure pulse and ocular fundus pulse in dependence of axial eye length and ocular volume. Acta Ophthalmol 2010; 88:766-72. [PMID: 20337602 DOI: 10.1111/j.1755-3768.2009.01577.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE There is a long-standing discussion about whether myopia is associated with decreased choroidal blood flow, as suggested by pneumotonometric measurements of pulsatile ocular blood flow (POBF). However, it has been noted previously that calculations of POBF depend on intraocular volume. METHODS In the present study we investigated this volume dependence through the comparison of ocular pressure pulse and ocular fundus pulse. Fifty-one healthy participants with different refractive errors participated in the study. Pulse amplitude (PA) and POBF were measured using pneumotonometry. Fundus pulsation amplitude (FPA) was measured with laser interferometry. Axial eye length (AEL) was measured with partial coherence interferometry. A mathematical model was used to calculate choroidal volume changes based on FPA. The ocular pressure pulse was converted into pulse volume (PV) according to the standard procedure used for pneumotonometry. RESULTS PA and POBF were found to decrease with increasing axial length (r = -0.55, p < 0.001 and r = -0.57, p < 0.001, respectively). A similar relationship existed for PV (r = -0.57, p < 0.001) and FPA (r = -0.46, p = 0.001). In addition, there was a significant association between PV and choroidal volume change during the cardiac cycle (r = 0.61, p < 0.001). CONCLUSION The present study confirms experimentally that PA, FPA and POBF are dependent on ocular volume and indicates that the pulsatile component of ocular blood flow is not reduced in myopic patients. Accordingly, the relationship between AEL and POBF described previously appears to be a consequence of different ocular volumes. Our findings have important implications for studies using PA or POBF.
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Affiliation(s)
- Fatmire Berisha
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
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Wasielica-Poslednik J, Berisha F, Aliyeva S, Pfeiffer N, Hoffmann EM. Reproducibility of ocular response analyzer measurements and their correlation with central corneal thickness. Graefes Arch Clin Exp Ophthalmol 2010; 248:1617-22. [PMID: 20697730 DOI: 10.1007/s00417-010-1471-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Revised: 06/11/2010] [Accepted: 07/17/2010] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND To evaluate the inter- and intraobserver variability of ocular response analyzer (ORA) measurements, namely corneal-compensated intraocular pressure (IOPcc), corneal resistance factor (CRF) and corneal hysteresis (CH). METHODS One randomly chosen eye of 46 healthy volunteers was included in this study. Three clinical observers performed three consecutive measurements using ORA, with an interval of 1-2 minutes between measurements. In all subjects, central corneal thickness (CCT) was measured. The inter- and intraobserver reproducibility for IOPcc, CRF and CH was assessed by ANOVA-based intraclass correlation coefficient (ICC) and coefficient of variation (CV). RESULTS The mean ICC for interobserver reproducibility was 0.94 for IOPcc, 0.90 for CRF, and 0.86 for CH. The corresponding CV values were 12.8%, 10.3%, and 13.6% respectively. The intraobserver ICC values for IOPcc were 0.86 for the first examiner, 0.84 for the second, and 0.89 for the third. CV was 11.7%, 11.9%, and 11.0% respectively. For CRF, the intraobserver ICC values were 0.69, 0.81, and 0.63, and corresponding CV values were 9.6%, 8.1, and 10.8%. The intraobserver ICC for CH was 0.66 for the first observer, 0.71 for the second, and 0.61 for the third examiner. The respective CV values were 12.7%, 11.8%, and 13.9%. There was a significant correlation between CCT and CRF (Rsq = 0.13, p = 0.02). The correlations of CCT with IOPcc and CH were not significant (p > 0.05). CONCLUSIONS The interobserver reproducibility of ORA measurements was almost perfect for IOPcc, CRF, and CH. The intraobserver short-term reproducibility was almost perfect for IOPcc and substantial for CRF and CH, for all observers. The significant correlation between CCT and CRF, and no association between IOPcc and CCT, are in agreement with previous studies. There was no significant correlation between CH and CCT in our study. This device might be useful in glaucoma diagnosis and management.
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Affiliation(s)
- Joanna Wasielica-Poslednik
- Department of Ophthalmology of the University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
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Ocular pulse amplitude and associated glaucomatous risk factors in a healthy Hispanic population. OPTOMETRY (ST. LOUIS, MO.) 2010; 81:408-13. [PMID: 20655499 DOI: 10.1016/j.optm.2010.02.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2009] [Revised: 02/05/2010] [Accepted: 02/12/2010] [Indexed: 11/21/2022]
Abstract
BACKGROUND With increasing evidence that vascular risk factors play a role in the development of glaucoma, it is critical to be familiar with factors related to intraocular blood flow, such as the ocular pulse amplitude (OPA). This study evaluates OPA and factors related to it in a healthy, Hispanic population. METHODS Refractive error, corneal curvature, Goldmann applanation tonometry (GAT), dynamic contour tonometry (DCT), OPA, axial length, and central corneal thickness (CCT) measurements were obtained on 104 Hispanic subjects recruited from the community. RESULTS OPA ranged from 0.7 to 4.7 mmHg (mean, 2.1 +/- 0.8 mmHg) and showed a significant correlation with refractive error, axial length, GAT, and DCT (r=0.250, -0.358, 0.460, 0.378; P=0.011, <0.001, <0.001, and <0.001, respectively). Mean intraocular pressure with GAT was 15.6 mmHg. Mean CCT was 541.2 microm. The average refractive error was 0.75 diopters (D) of myopia, with 25% having >1.00 D myopia. CONCLUSION Normal OPA values have not been studied in Hispanic populations. OPA is thought to provide information regarding ocular blood flow; however, more studies are needed to determine its significance in glaucoma treatment.
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Stalmans I, Harris A, Fieuws S, Zeyen T, Vanbellinghen V, McCranor L, Siesky B. Color Doppler imaging and ocular pulse amplitude in glaucomatous and healthy eyes. Eur J Ophthalmol 2009; 19:580-7. [PMID: 19551672 DOI: 10.1177/112067210901900410] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To determine factors influencing color Doppler imaging (CDI) measurements, to compare retrobulbar flow velocities between patients with glaucoma and healthy controls, and to describe the correlation between CDI and ocular pulse amplitude (OPA). METHODS Patients with normal tension (n=28) or primary open angle glaucoma (n=19) and healthy controls (n=22) underwent CDI and OPA measurements. Intraocular pressure, corneal thickness, blood pressure, and heart rate were also measured. Spearman correlations were used to explore relations among these variables. A regression model for repeated measures was applied to compare between diagnostic groups the flow velocity indices in the retrobulbar vessels. RESULTS Retrobulbar diastolic blood flow velocities correlated with diastolic blood pressure and perfusion pressure (range of Spearman rho [rho] coefficients=0.25-0.28; p=0.044-0.013 for the different vessels). Corneal thickness showed a positive correlation with systolic and diastolic flow velocities in the central retinal artery (rho=0.29 and 0.31; p=0.017 and 0.011 for peak systolic and end diastolic velocity, respectively). Systolic and diastolic blood flow velocities were reduced in the retrobulbar vessels of patients with normal tension glaucoma (P=0.0004) as well as primary open angle glaucoma (P=0.003) compared to healthy controls. A correlation was found between OPA and the resistive index in the retrobulbar vessels of the healthy controls (range rho=0.42-0.53; p=0.059-0.014). CONCLUSIONS Retrobulbar blood flow velocities are reduced in patients with primary open angle glaucoma and normal tension glaucoma. Blood pressure and corneal thickness may influence CDI measurements. OPA correlates with the resistive index in CDI.
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Affiliation(s)
- Ingeborg Stalmans
- Department of Ophthalmology, University Hospitals Leuven, Campus St Raphaël, Leuven - Belgium.
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Stalmans I, Siesky B, Zeyen T, Fieuws S, Harris A. Reproducibility of color Doppler imaging. Graefes Arch Clin Exp Ophthalmol 2009; 247:1531-8. [DOI: 10.1007/s00417-009-1178-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2008] [Revised: 10/16/2008] [Accepted: 08/12/2009] [Indexed: 10/20/2022] Open
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