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Dobberstein D, Seitz B, Viestenz A, Viestenz A. The Alteration of Intraocular Pressure and Ocular Pulse Amplitude by Retrobulbar Anaesthesia-A Search for Risk Factors for Serious Complications Due to Retrobulbar Anaesthesia. J Clin Med 2024; 13:5172. [PMID: 39274385 PMCID: PMC11395830 DOI: 10.3390/jcm13175172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Revised: 08/22/2024] [Accepted: 08/27/2024] [Indexed: 09/16/2024] Open
Abstract
Our goal was to assess the impact of retrobulbar anaesthesia on ocular pressure and perfusion development and to find out if there were systemic or biometric parameters of patients affecting them in order to understand the effect of retrobulbar anaesthesia better. Methods: Changes in intraocular pressure (IOP) and ocular pulse amplitude (OPA) using a dynamic contour tonometer (DCT) were noted before and after retrobulbar anaesthesia (RBA) in combination with five minutes of oculopression at 40 mmHg in 134 patients. Only results with a quality Q 1-3 were considered for further statistical analysis. Systemic and ophthalmic parameters were noted and their impact was tested using linear regression. Results: IOP decreased from 18.9 ± 7.2 mmHg to 15.4 ± 6.3 mmHg (n = 71, p = 0.001) after first RBA. The dosage of midazolam administered during premedication was found to increase IOP significantly after first RBA (B = 3.75; R2 = 0.38). Ocular pulse amplitude decreased significantly from 3.8 ± 1.7 mmHg to 3.0 ± 1.9 mmHg after first RBA (n = 72, p < 0.001). This change was found to be dependent on the presence of diabetes mellitus (n = 68, p = 0.048). Conclusions: IOP and OPA decrease after RBA and oculopression. Caution is needed with midazolam premedication due to potential IOP increase. Patients with diabetes and pre-existing retinal or optic nerve damage should consider alternative anaesthesia methods, such as eye drops or general anaesthesia, due to the observed decrease in OPA after RBA and oculopression.
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Affiliation(s)
- Deborah Dobberstein
- Department of Ophthalmology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Anja Viestenz
- Department of Ophthalmology, Saarland University Medical Center, 66421 Homburg, Germany
- Department of Ophthalmology, University Medicine Halle, Martin-Luther-University Halle-Wittenberg, 06120 Halle, Germany
| | - Arne Viestenz
- Department of Ophthalmology, Saarland University Medical Center, 66421 Homburg, Germany
- Department of Ophthalmology, University Medicine Halle, Martin-Luther-University Halle-Wittenberg, 06120 Halle, Germany
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Hemoglobin Video Imaging Detects Differences in Aqueous Outflow Between Eyes With and Without Glaucoma During the Water Drinking Test. J Glaucoma 2022; 31:511-522. [PMID: 35394459 DOI: 10.1097/ijg.0000000000002029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/22/2022] [Indexed: 01/31/2023]
Abstract
PRCIS Hemoglobin video imaging (HVI) demonstrates increased aqueous outflow (AO) in response to the water drinking test (WDT) in patients with and without glaucoma. In glaucomatous eyes, increased AO was not sustained, and characteristic flow patterns were seen. PURPOSE To observe how variations in intraocular pressure (IOP) correlate with the flow of aqueous in episcleral veins. DESIGN Prospective observational cohort study. PARTICIPANTS The WDT increased AO into the episcleral venous system in 30 eyes recruited from Sydney Eye Hospital. A comparison was made between glaucomatous (n=20) and nonglaucomatous eyes (n=10). METHODS Each patient had baseline IOP and HVI before drinking 10 mL/kg body weight of water. IOP and HVI were then repeated every 15 minutes for 1 hour. Aqueous column cross-sectional area (AqCA) of the most prominent nasal and temporal aqueous veins was used to semi-quantify conventional AO. MAIN OUTCOME MEASURES Change in IOP and AqCA from baseline during the WDT. Aqueous flow characteristics were also observed. RESULTS Peak IOP elevation above baseline was significantly higher in the glaucoma group, with an average IOP rise of 39.7% on 1.6 1.1 medications, compared with 22.9% in the control group ( P =0.04). AqCA significantly increased for glaucomatous and nonglaucomatous eyes in response to water ingestion ( P <0.05). AqCA fell by 50% in glaucomatous eyes ( P =0.003) and 33% in nonglaucomatous eyes ( P =0.08) at study completion compared with the peak measurement. IOP remained >30% elevated in 8 glaucomatous eyes (40%) after 60 minutes and no control eyes. Variations in qualitative aqueous flow patterns were observed in glaucomatous eyes but not in controls. CONCLUSIONS AO volume, estimated by AqCA, increases in response to IOP elevation induced by an ingested water bolus in patients with and without glaucoma. The increase in aqueous drainage was not sustained in glaucomatous eyes and may have led to incomplete recovery of IOP. Using HVI in combination with the WDT may assist with clinical decision-making and facilitate the monitoring of responses to treatment.
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van den Bosch JJON, Pennisi V, Invernizzi A, Mansouri K, Weinreb RN, Thieme H, Hoffmann MB, Choritz L. Implanted Microsensor Continuous IOP Telemetry Suggests Gaze and Eyelid Closure Effects on IOP-A Preliminary Study. Invest Ophthalmol Vis Sci 2021; 62:8. [PMID: 33956052 PMCID: PMC8107486 DOI: 10.1167/iovs.62.6.8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 03/15/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose To explore the effect of gaze direction and eyelid closure on intraocular pressure (IOP). Methods Eleven patients with primary open-angle glaucoma previously implanted with a telemetric IOP sensor were instructed to view eight equally-spaced fixation targets each at three eccentricities (10°, 20°, and 25°). Nine patients also performed eyelid closure. IOP was recorded via an external antenna placed around the study eye. Differences of mean IOP between consecutive gaze positions were calculated. Furthermore, the effect of eyelid closure on gaze-dependent IOP was assessed. Results The maximum IOP increase was observed at 25° superior gaze (mean ± SD: 4.4 ± 4.9 mm Hg) and maximum decrease at 25° inferonasal gaze (-1.6 ± 0.8 mm Hg). There was a significant interaction between gaze direction and eccentricity (P = 0.003). Post-hoc tests confirmed significant decreases inferonasally for all eccentricities (mean ± SEM: 10°: -0.7 ± 0.2, P = 0.007; 20°: -1.1 ± 0.2, P = 0.006; and 25°: -1.6 ± 0.2, P = 0.006). Eight of 11 eyes showed significant IOP differences between superior and inferonasal gaze at 25°. IOP decreased during eyelid closure, which was significantly lower than downgaze at 25° (mean ± SEM: -2.1 ± 0.3 mm Hg vs. -0.7 ± 0.2 mm Hg, P = 0.014). Conclusions Our data suggest that IOP varies reproducibly with gaze direction, albeit with patient variability. IOP generally increased in upgaze but decreased in inferonasal gaze and on eyelid closure. Future studies should investigate the patient variability and IOP dynamics.
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Affiliation(s)
| | - Vincenzo Pennisi
- Department of Ophthalmology, University Hospital Magdeburg, Germany
| | - Azzurra Invernizzi
- Laboratory for Experimental Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, Groningen, The Netherlands
| | - Kaweh Mansouri
- Glaucoma Research Center, Montchoisi Clinic, Swiss Visio, Lausanne, Switzerland
- Department of Ophthalmology, University of Colorado, Denver, Colorado, United States
| | - Robert N. Weinreb
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California, San Diego, La Jolla, California, United States
| | - Hagen Thieme
- Department of Ophthalmology, University Hospital Magdeburg, Germany
| | - Michael B. Hoffmann
- Department of Ophthalmology, University Hospital Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Lars Choritz
- Department of Ophthalmology, University Hospital Magdeburg, Germany
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Borroni D, Gadhvi KA, Hristova R, McLean K, Rocha de Lossada C, Romano V, Kaye S. Influence of Corneal Visualization Scheimpflug Technology Tonometry on Intraocular Pressure. OPHTHALMOLOGY SCIENCE 2021; 1:100003. [PMID: 36246003 PMCID: PMC9562332 DOI: 10.1016/j.xops.2021.100003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/28/2020] [Accepted: 01/07/2021] [Indexed: 11/25/2022]
Abstract
Purpose To investigate the effect of Corneal Visualization Scheimpflug Technology tonometry (CST) on intraocular pressure (IOP). Design Cohort study. Participants Patients with and without primary open-angle glaucoma (POAG) were included. Methods Intraocular pressure was measured using the Icare rebound tonometer (ICRT; Icare Finland Oy) and the biomechanically corrected IOP (bIOP) using the CST. Intraocular pressure was measured at baseline with ICRT, followed by a CST measurement in one eye with the fellow eye acting as a control. Icare measurements were repeated at 10 seconds and 1, 2, 4, 8, 15, 30, and 60 minutes in both eyes. The ratio of test eye IOP to fellow eye IOP was used to control for intrasubject variation. Main Outcome Measures Intraocular pressure change following Corneal Visualization Scheimflug Technology tonometry. Results Forty participants (mean age, 54.09 ± 20.08 years) were included comprising 20 patients with POAG and 20 patients with no ocular abnormalities other than cataract. Mean central corneal thickness was similar in those without POAG (547.4 ± 55.05 μm) and with POAG (520.22 ± 37.59 μm; P = 0.14). No significant change was found in IOP measured with the ICRT in the fellow eye versus the 1-hour period in either the healthy (P = 0.87) or POAG (P = 0.92) group. Significant changes were found in IOP after CST measurement for both healthy (P < 0.01) and glaucomatous (P < 0.01) eyes. After the CST measurement, the IOP reduced continuously from a mean of 13.75 mmHg to 10.84 mmHg at 4 minutes for healthy eyes and from 13.28 mmHg to 11.11 mmHg at 8 minutes for glaucomatous eyes before approaching (83% for healthy eyes and 92% POAG eyes) the pre-CST measurement at 1 hour. Conclusions Corneal Visualization Scheimpflug Technology tonometry causes a significant reduction in IOP in both glaucomatous and healthy eyes that lasts for at least 1 hour afterward.
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Molero-Senosiaín M, Morales-Fernández L, Saenz-Francés F, García-Feijoo J, Martínez-de-la-Casa JM. Analysis of reproducibility, evaluation, and preference of the new iC100 rebound tonometer versus iCare PRO and Perkins portable applanation tonometry. Eur J Ophthalmol 2019; 30:1349-1355. [DOI: 10.1177/1120672119878017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: To analyze the reproducibility of the new iC100 rebound tonometer, to compare its results with the applanation tonometry and iCare PRO and to evaluate the preference between them. Materials and methods: For the study of reproducibility, 15 eyes of 15 healthy Caucasian subjects were included. Three measurements were taken each day in three separate sessions. For the comparative study, 150 eyes of 150 Caucasian subjects were included (75 normal subjects and 75 patients with glaucoma). Three consecutive measurements were collected with each tonometer, randomizing the order of use. The discomfort caused by each tonometer was evaluated using the visual analogue scale. Results: No statistically significant differences were detected between sessions. In the comparison between tonometers, the measurements with iC100 were statistically lower than those of Perkins (−1.35 ± 0.417, p = 0.004) and that iCare PRO (−1.41 ± 0.417, p = 0.002). The difference between PRO and Perkins was not statistically significant ( p = 0.990). The mean time of measurement (in seconds) with iC100 was significantly lower than with Perkins (6.74 ± 1.46 vs 15.53 ± 2.01, p < 0.001) and that PRO (6.74 ± 1.46 vs 11.53 ± 1.85, p < 0.001). Visual analogue scale score with iC100 was lower than Perkins (1.33 ± 0.99 vs 1.73 ± 1.10, p < 0.05). In total, 61.7% preferred iC100 against Perkins. Conclusion: The reproducibility of this instrument has been proven good. iC100 underestimates intraocular pressure compared to applanation tonometry at normal values and tends to overestimate it in high intraocular pressure values. Most of the subjects preferred iC100 tonometer.
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Affiliation(s)
| | | | | | - Julian García-Feijoo
- Department of Ophthalmology, Hospital Clinico Universitario San Carlos, Madrid, Spain
- Instituto de Investigaciones Oftalmologicas Ramon Castroviejo, Universidad Complutense Madrid, Madrid, Spain
| | - Jose María Martínez-de-la-Casa
- Department of Ophthalmology, Hospital Clinico Universitario San Carlos, Madrid, Spain
- Instituto de Investigaciones Oftalmologicas Ramon Castroviejo, Universidad Complutense Madrid, Madrid, Spain
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Pandya J, Schardt M, Yu D, Henderer JD. A Pilot Study on the Effect of Alternate Nostril Breathing and Foot Reflexology on Intraocular Pressure in Ocular Hypertension. J Altern Complement Med 2019; 25:824-826. [PMID: 31180234 DOI: 10.1089/acm.2019.0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study is to investigate the effects of alternate nostril breathing (ANB) and foot reflexology (FR) on lower intraocular pressure (IOP) in patients with ocular hypertension (OHTN). This prospective pilot study recruited 11 patients from 2014 to 2016 from Temple opthamology outpatient clinic. Patients had OHTN with ages of 48-78 years. Patients were excluded if they currently performed ANB or FR, were unable to perform the task, had previous eye surgery or laser, were receiving other complementary and alternative medicine for OHTN, or were unable to complete drug washout period. After a 30-day drug washout, patients were randomly assigned to complete either ANB or FR for 5 min. After instruction, patients completed either ANB or FR, and completed the alternate task 2 weeks later. IOP was measured before the task, immediately after the task, and then every 30 min for 2 h. Decrease in IOP compared with baseline IOP was significant for ANB and FR at all time points. Baseline IOP was 25.86 ± 3.19 mmHg for ANB and 25.41 ± 3.54 mmHg for FR (N = 22 eyes). There was only one significant difference between IOP for the right and left eyes for FR at 120 min. Otherwise, there was no difference between eyes for both ANB and FR. There was a significant decrease in IOP at 30 min post task with IOP decrease of 1.98 ± 1.70 mmHg for ANB and 3.59 ± 1.89 mmHg for FR (both p < 0.0001) and at 60 min post task with IOP decrease of 2.39 ± 2.05 mmHg for ANB and 3.86 ± 1.89 mmHg for FR (both p < 0.0001). The decrease in IOP at 90 and 120 min post task was less but remained significant (p < 0.0001). Both FR and ANB had a small but significant IOP lowering effect. These alternative therapies could serve as possible adjunctive treatments for lowering IOP.
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Affiliation(s)
- Jui Pandya
- 1Department of Ophthalmology, Temple University Hospital, Philadelphia, PA
| | - Martin Schardt
- 1Department of Ophthalmology, Temple University Hospital, Philadelphia, PA
| | - Daohai Yu
- 2Department of Research, Temple University School of Medicine, Philadelphia, PA
| | - Jeffrey D Henderer
- 1Department of Ophthalmology, Temple University Hospital, Philadelphia, PA.,2Department of Research, Temple University School of Medicine, Philadelphia, PA
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Comparison of Disposable Goldmann Applanation Tonometer, ICare ic100, and Tonopen XL to Standards of Care Goldmann Nondisposable Applanation Tonometer for Measuring Intraocular Pressure. J Glaucoma 2018; 27:1119-1124. [DOI: 10.1097/ijg.0000000000001059] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Erdogan H, Akingol Z, Cam O, Sencan S. A comparison of NCT, Goldman application tonometry values with and without fluorescein. Clin Ophthalmol 2018; 12:2183-2188. [PMID: 30464378 PMCID: PMC6211304 DOI: 10.2147/opth.s177870] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose The aim of the study was to statistically compare intraocular pressure (IOP) values measured using noncontact tonometer (NCT), Goldmann applanation tonometry (GAT) with fluorescein (fGAT), and GAT without fluorescein (nGAT). The study was also performed to test whether the values obtained using each technique change in accordance with the central corneal thickness (CCT) and refractive and keratometric values. Study design This study was a prospective study of 188 eyes of 94 healthy volunteers. Methods: IOP was measured using fGAT, nGAT and NCT. CCT, refractive values, and keratometric values were measured, and the correlations and differences in the IOP for each tonometer were investigated. Results The mean IOP values obtained with the NCT, nGAT, and fGAT were 17.5±3.7, 12.3±2.7, and 12.5±2 mmHg. The mean CCT was 538.2±34.4 µm, the mean refractive value was 0.9±1.2 D, and the mean keratometric value was 43.5±1.5 D. NCT was positively correlated with fGAT and GAT values and was significantly higher than both the values. There were no differences between fGAT and GAT values. No correlation was observed between the CCT and keratometric and refractive values and the difference between NCT and nGAT or fGAT. Conclusion Differences in the measurements obtained using nGAT and fGAT were insignificant (P>0.05). Both values were positively correlated with NCT measurements (r =0.354, P<0.05) and were independent of CCT, keratometry, and refraction values. nGAT appears to be suitable for use in routine clinic practice.
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Affiliation(s)
- Hakika Erdogan
- Department of Ophthalmology, Faculty of Medicine, Maltepe University, Maltepe, Istanbul, Turkey,
| | - Ziya Akingol
- Department of Ophthalmology, Faculty of Medicine, Maltepe University, Maltepe, Istanbul, Turkey,
| | - Ozlem Cam
- Department of Ophthalmology, Faculty of Medicine, Maltepe University, Maltepe, Istanbul, Turkey,
| | - Sadik Sencan
- Department of Ophthalmology, Faculty of Medicine, Maltepe University, Maltepe, Istanbul, Turkey,
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Lee JH, Sanchez LR, Porco T, Han Y, de Alba Campomanes AG. Correlation of Corneal and Scleral Pneumatonometry in Pediatric Patients. Ophthalmology 2018; 125:1209-1214. [DOI: 10.1016/j.ophtha.2018.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 01/30/2018] [Accepted: 02/05/2018] [Indexed: 10/17/2022] Open
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Effect of four local anesthetics (tetracaine, proparacaine, lidocaine, and bupivacaine) on intraocular pressure in dogs. Int Ophthalmol 2018; 39:1467-1474. [PMID: 29934932 DOI: 10.1007/s10792-018-0969-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 06/16/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To measure IOP in animals, it is often necessary to use topical anesthetics. The use of these drugs may cause changes in IOP and interfere with the final results. To address this issue, the effects of four local anesthetics (tetracaine, proparacaine, lidocaine, and bupivacaine) on IOP were investigated in ten adult dogs. METHODS One drop of tetracaine was instilled in the right eye of half of the dogs and in the left eye of the other dogs; normal saline was instilled in the fellow eyes. The IOP in each dog was measured before and at 0, 5, 10, 15, 20, 25, 30, and 35 min after drug instillation using an electronic rebound tonometer. The effects of the other anesthetics were studied in the same way at intervals of at least 1 week. RESULTS After instillation of tetracaine, the IOP decreased gradually, such that after 15 min, the IOP was significantly lower than the baseline (p = 0.022) and control values (p = 0.048). Proparacaine also reduced IOP after 10 min compared to baseline values (p = 0.046), but the two other drugs, bupivacaine and lidocaine, had no significant effect on IOP. The duration of eye anesthesia was 16, 20, 22, and 34 min for tetracaine, lidocaine, bupivacaine, and proparacaine, respectively. CONCLUSION We recommend using drugs that combine inducing longer anesthesia with producing the smallest change in IOP, such as bupivacaine and, subsequently, lidocaine. Tetracaine and proparacaine have a significant effect on IOP, and if these drugs are used, this effect should be considered.
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Chen YW, Chiu CC, Lin HT, Wang JJ, Hung CH. Adding Dopamine to Proxymetacaine or Oxybuprocaine Solutions Potentiates and Prolongs the Cutaneous Antinociception in Rats. Anesth Analg 2018; 126:1721-1728. [PMID: 29381510 DOI: 10.1213/ane.0000000000002635] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND We evaluated the interaction of dopamine-proxymetacaine and dopamine- oxybuprocaine antinociception using isobolograms. METHODS This experiment uses subcutaneous drug (proxymetacaine, oxybuprocaine, and dopamine) injections under the skin of the rat's back, thus simulating infiltration blocks. The dose-related antinociceptive curves of proxymetacaine and oxybuprocaine alone and in combination with dopamine were constructed, and then the antinociceptive interactions between the local anesthetic and dopamine were analyzed using isobolograms. RESULTS Subcutaneous proxymetacaine, oxybuprocaine, and dopamine produced a sensory block to local skin pinpricks in a dose-dependent fashion. The rank order of potency was proxymetacaine (0.57 [0.52-0.63] μmol/kg) > oxybuprocaine (1.05 [0.96-1.15] μmol/kg) > dopamine (165 [154-177] μmol/kg; P < .01 for each comparison) based on the 50% effective dose values. On the equianesthetic basis (25% effective dose, 50% effective dose, and 75% effective dose), the nociceptive block duration of proxymetacaine or oxybuprocaine was shorter than that of dopamine (P < .01). Oxybuprocaine or proxymetacaine coinjected with dopamine elicited a synergistic antinociceptive effect and extended the duration of action. CONCLUSIONS Oxybuprocaine and proxymetacaine had a higher potency and provoked a shorter duration of sensory block compared with dopamine. The use of dopamine increased the quality and duration of skin antinociception caused by oxybuprocaine and proxymetacaine.
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Affiliation(s)
- Yu-Wen Chen
- From the Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan
- Department of Physical Therapy, College of Health Care, China Medical University, Taichung, Taiwan
| | - Chong-Chi Chiu
- Department of General Surgery, Chi Mei Medical Center, Tainan and Liouying, Taiwan
- Department of Electrical Engineering, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Heng-Teng Lin
- Department of Physical Medicine and Rehabilitation, Madou Sin-Lau Hospital, Tainan, Taiwan
- Department of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Jhi-Joung Wang
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
| | - Ching-Hsia Hung
- Department of Physical Therapy
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Jóhannesson G, Eklund A, Lindén C. Intracranial and Intraocular Pressure at the Lamina Cribrosa: Gradient Effects. Curr Neurol Neurosci Rep 2018; 18:25. [PMID: 29651628 PMCID: PMC5897485 DOI: 10.1007/s11910-018-0831-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE OF REVIEW A pressure difference between the intraocular and intracranial compartments at the site of the lamina cribrosa has been hypothesized to have a pathophysiological role in several optic nerve head diseases. This paper reviews the current literature on the translamina cribrosa pressure difference (TLCPD), the associated pressure gradient, and its potential pathophysiological role, as well as the methodology to assess TLCPD. RECENT FINDINGS For normal-tension glaucoma (NTG), initial studies indicated low intracranial pressure (ICP) while recent findings indicate that a reduced ICP is not mandatory. Data from studies on the elevated TLCPD as a pathophysiological factor of NTG are equivocal. From the identification of potential postural effects on the cerebrospinal fluid (CSF) communication between the intracranial and retrolaminar space, we hypothesize that the missing link could be a dysfunction of an occlusion mechanism of the optic nerve sheath around the optic nerve. In upright posture, this could cause an elevated TLCPD even with normal ICP and we suggest that this should be investigated as a pathophysiological component in NTG patients.
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Affiliation(s)
- Gauti Jóhannesson
- Department of Clinical Sciences, Ophthalmology, Umeå University, Umeå, Sweden. .,Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden.
| | - Anders Eklund
- Department of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, Sweden
| | - Christina Lindén
- Department of Clinical Sciences, Ophthalmology, Umeå University, Umeå, Sweden
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Lindén C, Qvarlander S, Jóhannesson G, Johansson E, Östlund F, Malm J, Eklund A. Normal-Tension Glaucoma Has Normal Intracranial Pressure: A Prospective Study of Intracranial Pressure and Intraocular Pressure in Different Body Positions. Ophthalmology 2017; 125:361-368. [PMID: 29096996 DOI: 10.1016/j.ophtha.2017.09.022] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 09/14/2017] [Accepted: 09/19/2017] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To test the hypothesis that normal-tension glaucoma (NTG) is caused by an increased pressure difference across the lamina cribrosa (LC) related to a low intracranial pressure (ICP). DESIGN Prospective case-control study. PARTICIPANTS Thirteen NTG patients (9 women; median 71 [range: 56-83] years) were recruited for investigation with the same protocol as 11 healthy volunteers (8 women; 47 [30-59] years). A larger control group (n = 51; 30 women; 68 [30-81] years) was used only for ICP comparison in supine position. METHODS ICP and intraocular pressure (IOP) were simultaneously measured in supine, sitting, and 9° head-down tilt (HDT) positions. Trans-lamina cribrosa pressure difference (TLCPD) was calculated using ICP and IOP together with geometric distances estimated from magnetic resonance imaging to adjust for hydrostatic effects. MAIN OUTCOME MEASURES ICP, IOP, and TLCPD in different body positions. RESULTS Between NTG patients and healthy volunteers, there were no differences in ICP, IOP, or TLCPD in supine, sitting, or HDT (P ≥ 0.11), except for IOP in HDT (P = 0.04). There was no correlation between visual field defect and TLCPD, IOP, or ICP and in any body position (P ≥ 0.39). Mean ICP in supine was 10.3 mmHg (SD = 2.7) in the NTG group (n = 13) and 11.3 (2.2) mmHg in the larger control group (n = 51) (P = 0.24). CONCLUSIONS There was no evidence of reduced ICP in NTG patients as compared with healthy controls, either in supine or in upright position. Consequently, the hypothesis that NTG is caused by an elevated TLCPD from low ICP was not supported.
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Affiliation(s)
- Christina Lindén
- Department of Clinical Sciences, Ophthalmology, Umeå University, Umeå, Sweden.
| | - Sara Qvarlander
- Department of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, Sweden
| | - Gauti Jóhannesson
- Department of Clinical Sciences, Ophthalmology, Umeå University, Umeå, Sweden
| | - Elias Johansson
- Department of Pharmacology and Clinical Neuroscience, Neurology, Umeå University, Umeå, Sweden
| | - Fanny Östlund
- Department of Clinical Sciences, Ophthalmology, Umeå University, Umeå, Sweden
| | - Jan Malm
- Department of Pharmacology and Clinical Neuroscience, Neurology, Umeå University, Umeå, Sweden
| | - Anders Eklund
- Department of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, Sweden; Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden
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Prospective Comparative Analysis of 4 Different Intraocular Pressure Measurement Techniques and Their Effects on Pressure Readings. J Glaucoma 2017; 26:e194-e195. [DOI: 10.1097/ijg.0000000000000651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Zimmermann M, Pitz S, Schmidtmann I, Pfeiffer N, Wasielica-Poslednik J. Tonographic Effect of Ocular Response Analyzer in Comparison to Goldmann Applanation Tonometry. PLoS One 2017; 12:e0169438. [PMID: 28068365 PMCID: PMC5221819 DOI: 10.1371/journal.pone.0169438] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 12/06/2016] [Indexed: 11/29/2022] Open
Abstract
Aims The tonographic effect is a phenomenon of intraocular pressure (IOP) reduction following repeated tonometry. This study examines whether the tonographic effect occurs following IOP measurement performed with Ocular Response Analyzer (ORA). Methods Both eyes of 31 glaucoma patients and 35 healthy controls underwent nine IOP-measurements performed with GAT and ORA. The number of GAT and ORA measurements performed on each eye differed depending on the randomly allocated investigation scheme. Central corneal thickness (CCT), anterior chamber volume (ACV) and anterior chamber depth (ACD) were assessed with Pentacam before and after the repeated GAT/ORA measurements. Results There was no statistically significant tonographic effect for IOP readings obtained by the ORA: corneal compensated intraocular pressure (IOPcc) (-0.11 ± 3.06 mmHg, p = 0.843 in patients and -0.71 ± 3.28 mmHg, p = 0.208 for controls) and Goldmann-correlated intraocular pressure (IOPg) (-0.31 ± 2.38 mmHg, p = 0.469 in patients and -0.31 ± 2.37 mmHg, p = 0.441 in controls) measured with ORA. There was a significant IOP reduction from the first to the second GAT measurement, i.e. tonographic effect (-0.55 ± 2.00 mmHg, p = 0.138 in patients and -1.15 ± 1.52 mmHg, p < 0.001 in controls). CCT, corneal hysteresis (CH) and corneal resistance factor (CRF) were lower in glaucoma patients. The repeated IOP measurements resulted in an increase of CCT in all subjects (but no change of ACV and ACD). The tonographic effect of GAT correlated with CCT in glaucoma patients (r = 0.37). Conclusion In contrast to GAT, repeated ORA measurements do not result in the tonographic effect. Repeated IOP measurements resulted in an increase of central corneal thickness, but did not influence the volume and depth of anterior chamber.
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Affiliation(s)
- Martin Zimmermann
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- * E-mail:
| | - Susanne Pitz
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Irene Schmidtmann
- Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Joanna Wasielica-Poslednik
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Prospective Comparative Analysis of 4 Different Intraocular Pressure Measurement Techniques and Their Effects on Pressure Readings. J Glaucoma 2016; 25:e897-e904. [PMID: 26918913 DOI: 10.1097/ijg.0000000000000403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare intraocular pressure (IOP) measurement using the Goldmann applanation tonometry (GAT) without fluorescein, with fluorescein strips, with fluorescein droplets, and IOP measurement with Tono-Pen Avia (TPA). PATIENTS AND METHODS This was a prospective comparative clinical analysis. It was performed in clinical practice. The study population consisted of 40 volunteer patients, 1 eye per patient. All patients who were 18 years and older having routine ophthalmological examination were eligible to participate. Active corneal abrasions and/or ulcers, previous glaucoma surgery, or prostheses interfering with GAT measurement were excluded. GAT IOP was measured first without fluorescein, then with fluorescein strip, then with fluorescein droplet, and finally with the TPA device. The main outcome measure was central corneal IOP. RESULTS Mean±SD IOP measurements for GAT without fluorescein, with fluorescein strip, with fluorescein droplet, and for TPA groups were 12.65±3.01, 14.70±2.82, 15.78±2.64, and 16.33±3.08 mm Hg, respectively. Repeated-measures analysis of variance corrected with the Greenhouse-Geisser estimate ([Latin Small Letter Open E]=0.732) showed that measuring technique had a significant effect on IOP measurements (F2.20,85.59=34.66, P<0.001). The pairwise post hoc testing showed statistically significant mean differences (P≤0.001) between all techniques except when GAT with fluorescein droplet was compared with TPA (P=0.222). The Bland-Altman analyses showed 95% limits of agreement maximum potential discrepancies in measurement ranging from 5.89 mm Hg in the GAT with fluorescein strip versus droplet compared with 11.83 mm Hg in the GAT with fluorescein strip versus TPA comparison. CONCLUSIONS IOP measurement technique significantly impacted the values obtained. The ophthalmologist should ensure consistent measurement technique to minimize variability when following patients.
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Eklund A, Jóhannesson G, Johansson E, Holmlund P, Qvarlander S, Ambarki K, Wåhlin A, Koskinen LOD, Malm J. The pressure difference between eye and brain changes with posture. Ann Neurol 2016; 80:269-76. [DOI: 10.1002/ana.24713] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 06/27/2016] [Accepted: 06/27/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Anders Eklund
- Department of Radiation Sciences; Umeå University; Umeå Sweden
- Center for Biomedical Engineering and Physics; Umeå University; Umeå Sweden
| | - Gauti Jóhannesson
- Department of Clinical Science; Ophthalmology, Umeå University; Umeå Sweden
| | - Elias Johansson
- Department of Pharmacology and Clinical Neuroscience; Umeå University; Umeå Sweden
| | - Petter Holmlund
- Department of Radiation Sciences; Umeå University; Umeå Sweden
| | - Sara Qvarlander
- Department of Radiation Sciences; Umeå University; Umeå Sweden
| | - Khalid Ambarki
- Department of Radiation Sciences; Umeå University; Umeå Sweden
| | - Anders Wåhlin
- Department of Radiation Sciences; Umeå University; Umeå Sweden
- Umeå Center for Functional Brain Imaging; Umeå University; Umeå Sweden
| | - Lars-Owe D. Koskinen
- Department of Pharmacology and Clinical Neuroscience; Umeå University; Umeå Sweden
| | - Jan Malm
- Department of Pharmacology and Clinical Neuroscience; Umeå University; Umeå Sweden
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Jasien JV, Jonas JB, de Moraes CG, Ritch R. Intraocular Pressure Rise in Subjects with and without Glaucoma during Four Common Yoga Positions. PLoS One 2015; 10:e0144505. [PMID: 26698309 PMCID: PMC4689525 DOI: 10.1371/journal.pone.0144505] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 11/18/2015] [Indexed: 11/19/2022] Open
Abstract
Purpose To measure changes in intraocular pressure (IOP) in association with yoga exercises with a head-down position. Methods The single Center, prospective, observational study included 10 subjects with primary open-angle glaucoma and 10 normal individuals, who performed the yoga exercises of Adho Mukha Svanasana, Uttanasana, Halasana and Viparita Karani for two minutes each. IOP was measured by pneumatonometry at baseline and during and after the exercises. Results All yoga poses were associated with a significant (P<0.01) rise in IOP within one minute after assuming the yoga position. The highest IOP increase (P<0.01) was measured in the Adho Mukha Svanasana position (IOP increase from 17±3.2 mmHg to 28±3.8 mmHg in glaucoma patients; from 17±2.8 mmHg to 29±3.9 mmHg in normal individuals), followed by the Uttanasana position (17±3.9 mmHg to 27±3.4 mmHg (glaucoma patients) and from 18±2.5 mmHg to 26±3.6 mmHg normal individuals)), the Halasana position (18±2.8 mmHg to 24±3.5 mmHg (glaucoma patients); 18±2.7 mmHg to 22±3.4 mmHg (normal individuals)), and finally the Viparita Kirani position (17±4 mmHg to 21±3.6 mmHg (glaucoma patients); 17±2.8 to 21±2.4 mmHg (normal individuals)). IOP dropped back to baseline values within two minutes after returning to a sitting position. Overall, IOP rise was not significantly different between glaucoma and normal subjects (P = 0.813), all though glaucoma eyes tended to have measurements 2 mm Hg higher on average. Conclusions Yoga exercises with head-down positions were associated with a rapid rise in IOP in glaucoma and healthy eyes. IOP returned to baseline values within 2 minutes. Future studies are warranted addressing whether yoga exercise associated IOP changes are associated with similar changes in cerebrospinal fluid pressure and whether they increase the risk of glaucoma progression. Trial Registration ClinicalTrials.gov #NCT01915680
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Affiliation(s)
- Jessica V. Jasien
- Einhorn Clinical Research Center, New York Ear Eye and Ear Infirmary of Mount Sinai, New York, New York, United States of America
- * E-mail:
| | - Jost B. Jonas
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, Seegartenklinik Heidelberg, Germany
| | - C. Gustavo de Moraes
- Department of Ophthalmology, Columbia University Medical Center, New York, New York, United States of America
| | - Robert Ritch
- Einhorn Clinical Research Center, New York Ear Eye and Ear Infirmary of Mount Sinai, New York, New York, United States of America
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Jóhannesson G, Hallberg P, Ambarki K, Eklund A, Lindén C. Age-dependency of ocular parameters: a cross sectional study of young and elderly healthy subjects. Graefes Arch Clin Exp Ophthalmol 2015; 253:1979-83. [DOI: 10.1007/s00417-015-3129-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 06/28/2015] [Accepted: 07/28/2015] [Indexed: 10/23/2022] Open
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Karyotakis NG, Ginis HS, Dastiridou AI, Tsilimbaris MK, Pallikaris IG. Manometric measurement of the outflow facility in the living human eye and its dependence on intraocular pressure. Acta Ophthalmol 2015; 93:e343-e348. [PMID: 25645503 DOI: 10.1111/aos.12652] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 11/24/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE The intraocular pressure (IOP) is determined by a dynamic equilibrium between the production and outflow of the aqueous humour. The relationship between IOP and the outflow rate through the conventional and unconventional pathway is quantified by the outflow facility coefficient (C). The purpose of this study is to employ a direct (manometric) tonographic technique and determine C as well as its inverse, resistance (R), as a function of IOP in the living human eye. METHODS Nineteen cataract patients were enrolled in the study. An intraoperative manometric device was used to measure IOP. After cannulation of the anterior chamber, the IOP was increased by infusion of controlled amounts of saline solution. At 40 mmHg, the infusion stopped, and a pressure sensor recorded the IOP. The measured pressure-volume relationship was considered in order to convert pressure changes to corresponding ocular volume changes. An appropriate mathematical model was applied to calculate C and (its inverse), R. RESULTS The average C was 0.0672 ± 0.0296 μl/min/mmHg at 40 mmHg and 0.2652 ± 0.1164 μl/min/mmHg at 20 mmHg. There was a strong dependence of coefficient C on IOP in all subjects (p < 0.001). The corresponding values for R were 17.9 ± 11.17 min mmHg/μl at 40 mmHg and 4.51 ± 2.69 min mmHg/μl at 20 mmHg. CONCLUSION This study provides measurement of outflow facility and its dependence with pressure in healthy living human eyes. This relation is shown to be non-linear, using a direct manometric method.
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Affiliation(s)
| | - Harilaos S. Ginis
- Medical School; Institute of Vision and Optics; University of Crete; Heraklion Greece
| | - Anna I. Dastiridou
- Opththalmology Department; University Hospital of Larissa; Larissa Greece
| | - Miltiadis K. Tsilimbaris
- Medical School; Institute of Vision and Optics; University of Crete; Heraklion Greece
- Opththalmology Department; University Hospital of Heraklion; Heraklion Greece
| | - Ioannis G. Pallikaris
- Medical School; Institute of Vision and Optics; University of Crete; Heraklion Greece
- Opththalmology Department; University Hospital of Heraklion; Heraklion Greece
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Hamilton-Maxwell K, King N. Modern disposable hydrogel contact lens removal has a minimal effect on intraocular pressure. Ophthalmic Physiol Opt 2015; 35:231-5. [DOI: 10.1111/opo.12167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 10/14/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Kirsten Hamilton-Maxwell
- School of Optometry and Vision Sciences; College of Biomedical & Life Sciences; Cardiff University; Cardiff UK
| | - Nicole King
- School of Optometry and Vision Sciences; College of Biomedical & Life Sciences; Cardiff University; Cardiff UK
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Agnifili L, Mastropasqua R, Frezzotti P, Fasanella V, Motolese I, Pedrotti E, Iorio AD, Mattei PA, Motolese E, Mastropasqua L. Circadian intraocular pressure patterns in healthy subjects, primary open angle and normal tension glaucoma patients with a contact lens sensor. Acta Ophthalmol 2015; 93:e14-21. [PMID: 24720477 DOI: 10.1111/aos.12408] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 03/04/2014] [Indexed: 11/27/2022]
Abstract
PURPOSE To examine the circadian intraocular pressure (IOP) patterns in healthy subjects, in primary open angle and normal tension glaucoma (POAG; NTG) using a contact lens sensor (CLS; Sensimed Triggerfish, Lausanne, Switzerland). METHODS This was an observational, nonrandomized study. Ten healthy subjects (Group 1, 10 eyes) and 20 glaucomatous patients [20 eyes, 10 with POAG (Group 2) and 10 with NTG (Group 3)] were enrolled. All patients were controlled with prostaglandin analogues. The 24-hr IOP pattern was the main outcome. The morning (6AM-11AM), afternoon/evening (noon-11PM) and night (midnight-5AM) subperiod patterns, peaks and prolonged peaks (>1 hr) were secondary outcomes. RESULTS Mean 24-hr IOP pattern showed a nocturnal acrophase in all groups. Patterns were significantly different among groups (p = 0.02), with highest nocturnal IOP values in POAG. Prolonged peaks were more common in patients with glaucoma (70%) than in healthy subjects (33.3%) (p < 0.001). Significant differences were found for Groups 2 and 3 in the morning versus afternoon/evening (p = 0.019 and p = 0.035, Bonferroni correction), morning versus night (p = 0.005 and p < 0.0001) and afternoon/evening versus night periods comparisons (p < 0.0001 for both groups). In Group 1, patterns significantly differed in the morning versus night and afternoon/evening versus night period comparisons (p < 0.0001). CONCLUSIONS Continuous 24-hr IOP monitoring with the CLS revealed a nocturnal acrophase in healthy subjects and, more markedly, in glaucoma. Because the diurnal IOP profile seems not to predict the nocturnal rhythm, the circadian IOP pattern should be evaluated in clinical practice. These findings may be worthwhile for the management of glaucoma.
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Affiliation(s)
- Luca Agnifili
- Department of Medicine and Aging Science; Ophthalmology Clinic; University G. d'Annunzio of Chieti-Pescara; Chieti Italy
| | - Rodolfo Mastropasqua
- Ophthalmology Unit; Department of Neurological Neuropsychological, Morphological and Movement Sciences; University of Verona; Verona Italy
| | - Paolo Frezzotti
- Department of Medicine, Surgery and Neuroscience; Ophthalmology Clinic; University of Siena; Siena Italy
| | - Vincenzo Fasanella
- Department of Medicine and Aging Science; Ophthalmology Clinic; University G. d'Annunzio of Chieti-Pescara; Chieti Italy
| | - Ilaria Motolese
- Department of Medicine, Surgery and Neuroscience; Ophthalmology Clinic; University of Siena; Siena Italy
| | - Emilio Pedrotti
- Ophthalmology Unit; Department of Neurological Neuropsychological, Morphological and Movement Sciences; University of Verona; Verona Italy
| | - Angelo Di Iorio
- Department of Medicine and Aging Science; Laboratory of Clinical Epidemiology and Aging; University G. d'Annunzio of Chieti-Pescara; Chieti Italy
| | - Peter A. Mattei
- Department of Medicine and Aging Science; Ophthalmology Clinic; University G. d'Annunzio of Chieti-Pescara; Chieti Italy
| | - Eduardo Motolese
- Department of Medicine, Surgery and Neuroscience; Ophthalmology Clinic; University of Siena; Siena Italy
| | - Leonardo Mastropasqua
- Department of Medicine and Aging Science; Ophthalmology Clinic; University G. d'Annunzio of Chieti-Pescara; Chieti Italy
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[Pachymetry and intraocular pressure measurement by corneal visualization Scheimpflug technology (Corvis ST): A clinical comparison to the gold standard]. Ophthalmologe 2014; 112:770-7. [PMID: 25501931 DOI: 10.1007/s00347-014-3188-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Analyses regarding accuracy and reproducibility of intraocular pressure (IOP) measurements and pachymetry with corneal visualization Scheimpflug technology (Corvis ST®, CST). MATERIAL UND METHODS Retrospective analysis of 72 eyes with primary open angle glaucoma (POAG) and ocular hypertension (OHT) with no prior surgery or other pathology. The results of Goldmann applanation tonometry (GAT), non-contact tonometry (NCT) and ultrasound pachymetry (USP) were compared with repeat measurements with CST. For statistical analyses the t-test and Bland-Altman plots were applied. RESULTS The mean IOP was 15.5 ± 4.4 mmHg (CST), 14.8 ± 4.4 mmHg (GAT) and 15.6 ± 4.8 mmHg (NCT). The results of GAT and CST as well as GAT and NCT demonstrated statistically significant differences (p < 0.001) whereas NCT and CST displayed no significant differences in IOP (p = 0.72). The mean differences between the repeat measurements were 0.35 ± 1.7 mmHg (CST) and 0.04 ± 0.85 mmHg (GAT). The mean CST pachymetry results showed 551.3 ± 46.5 µm and the USP 526.5 ± 46.4 µm (p < 0.001). The mean difference between the repeated CST measurements was 24.8 ± 21 µm. No repeat measurement data were available for USP. CONCLUSION The CST is a new device for simultaneously measuring the IOP, pachymetry and biomechanical properties of the cornea. Whether the deviations in the IOP measured by CST and CST pachymetry from the manually performed gold standard has to be evaluated as deficient, tolerable or maybe as an improvement, has to be evaluated in further studies. Because of the automated and contact-free measurement method as well as the potential for simultaneously analyzing biomechanical properties of the cornea, the CST is a device that might help the quest for measuring the 'true' IOP.
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