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Rabiolo A, Montesano G, Crabb DP, Garway-Heath DF. Relationship between Intraocular Pressure Fluctuation and Visual Field Progression Rates in the United Kingdom Glaucoma Treatment Study. Ophthalmology 2024; 131:902-913. [PMID: 38354911 DOI: 10.1016/j.ophtha.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 02/03/2024] [Accepted: 02/06/2024] [Indexed: 02/16/2024] Open
Abstract
PURPOSE To investigate whether intraocular pressure (IOP) fluctuation is associated independently with the rate of visual field (VF) progression in the United Kingdom Glaucoma Treatment Study. DESIGN Randomized, double-masked, placebo-controlled multicenter trial. PARTICIPANTS Participants with ≥5 VFs (213 placebo, 217 treatment). METHODS Associations between IOP metrics and VF progression rates (mean deviation [MD] and five fastest locations) were assessed with linear mixed models. Fluctuation variables were mean Pascal ocular pulse amplitude (OPA), standard deviation (SD) of diurnal Goldmann IOP (diurnal fluctuation), and SD of Goldmann IOP at all visits (long-term fluctuation). Fluctuation values were normalized for mean IOP to make them independent from the mean IOP. Correlated nonfluctuation IOP metrics (baseline, peak, mean, supine, and peak phasing IOP) were combined with principal component analysis, and principal component 1 (PC1) was included as a covariate. Interactions between covariates and time from baseline modeled the effect of the variables on VF rates. Analyses were conducted separately in the two treatment arms. MAIN OUTCOME MEASURES Associations between IOP fluctuation metrics and rates of MD and the five fastest test locations. RESULTS In the placebo arm, only PC1 was associated significantly with the MD rate (estimate, -0.19 dB/year [standard error (SE), 0.04 dB/year]; P < 0.001), whereas normalized IOP fluctuation metrics were not. No variable was associated significantly with MD rates in the treatment arm. For the fastest five locations in the placebo group, PC1 (estimate, -0.58 dB/year [SE, 0.16 dB/year]; P < 0.001), central corneal thickness (estimate, 0.26 dB/year [SE, 0.10 dB/year] for 10 μm thicker; P = 0.01) and normalized OPA (estimate, -3.50 dB/year [SE, 1.04 dB/year]; P = 0.001) were associated with rates of progression; normalized diurnal and long-term IOP fluctuations were not. In the treatment group, only PC1 (estimate, -0.27 dB/year [SE, 0.12 dB/year]; P = 0.028) was associated with the rates of progression. CONCLUSIONS No evidence supports that either diurnal or long-term IOP fluctuation, as measured in clinical practice, are independent factors for glaucoma progression; other aspects of IOP, including mean IOP and peak IOP, may be more informative. Ocular pulse amplitude may be an independent factor for faster glaucoma progression. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Alessandro Rabiolo
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom; Ophthalmology Unit, University Hospital Maggiore della Carità, Novara, Italy; Department of Health Sciences, University of Eastern Piedmont "A. Avogadro," Novara, Italy
| | - Giovanni Montesano
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom; Optometry and Visual Sciences, City University of London, London, United Kingdom
| | - David P Crabb
- Optometry and Visual Sciences, City University of London, London, United Kingdom
| | - David F Garway-Heath
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom.
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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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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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Abdul-Rahman A, Morgan W, Jo Khoo Y, Lind C, Kermode A, Carroll W, Yu DY. Linear interactions between intraocular, intracranial pressure, and retinal vascular pulse amplitude in the fourier domain. PLoS One 2022; 17:e0270557. [PMID: 35763528 PMCID: PMC9239478 DOI: 10.1371/journal.pone.0270557] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 06/13/2022] [Indexed: 11/19/2022] Open
Abstract
Purpose To compare the retinal vascular pulsatile characteristics in subjects with normal (ICPn) and high (ICPh) intracranial pressure and quantify the interactions between intraocular pressure, intracranial pressure, and retinal vascular pulse amplitude in the Fourier domain. Materials and methods Twenty-one subjects were examined using modified photoplethysmography with simultaneous ophthalmodynamometry. A harmonic regression model was fitted to each pixel in the time-series, and used to quantify the retinal vascular pulse wave parameters including the harmonic regression wave amplitude (HRWa). The pulse wave attenuation was measured under different ranges of induced intraocular pressure (IOPi), as a function of distance along the vessel (VDist). Intracranial pressure (ICP) was measured using lumbar puncture. A linear mixed-effects model was used to estimate the correlations between the Yeo-Johnson transformed harmonic regression wave amplitude (HRWa-YJt) with the predictors (IOPi, VDist and ICP). A comparison of the model coefficients was done by calculating the weighted Beta (βx) coefficients. Results The median HRWa in the ICPn group was higher in the retinal veins (4.563, interquartile range (IQR) = 3.656) compared to the retinal arteries (3.475, IQR = 2.458), p<0.0001. In contrast, the ICPh group demonstrated a reduction in the median venous HRWa (3.655, IQR = 3.223) and an elevation in the median arterial HRWa (3.616, IQR = 2.715), p<0.0001. Interactions of the pulsation amplitude with ICP showed a significant disordinal interaction and the loss of a main effect of the Fourier sine coefficient (bn1) in the ICPh group, suggesting that this coefficient reflects the retinal vascular response to ICP wave. The linear mixed-effects model (LME) showed the decay in the venous (HRWa-YJt) was almost twice that in the retinal arteries (−0.067±0.002 compared to −0.028±0.0021 respectively, p<0.00001). The overall interaction models had a total explanatory power of (conditional R2) 38.7%, and 42% of which the fixed effects explained 8.8%, and 5.8% of the variance (marginal R2) for the venous and arterial models respectively. A comparison of the damping effect of VDist and ICP showed that ICP had less influence on pulse decay than distance in the retinal arteries (βICP = -0.21, se = ±0.017 compared to βVDist=-0.26, se = ±0.019), whereas the mean value was equal for the retinal veins (venous βVDist=-0.42, se = ±0.015, βICP = -0.42, se = ±0.019). Conclusion The retinal vascular pulsation characteristics in the ICPh group showed high retinal arterial and low venous pulsation amplitudes. Interactions between retinal vascular pulsation amplitude and ICP suggest that the Fourier sine coefficient bn1 reflects the retinal vascular response to the ICP wave. Although a matrix of regression lines showed high linear characteristics, the low model explanatory power precludes its use as a predictor of ICP. These results may guide future predictive modelling in non-invasive estimation of ICP using modified photoplethysmography.
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Affiliation(s)
- Anmar Abdul-Rahman
- Department of Ophthalmology, Counties Manukau District Health Board, Auckland, New Zealand
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
- * E-mail:
| | - William Morgan
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
- Lions Eye Institute, University of Western Australia, Perth, Australia
| | - Ying Jo Khoo
- Lions Eye Institute, University of Western Australia, Perth, Australia
- Royal Perth Hospital, Perth, Australia
| | - Christopher Lind
- Neurosurgical Service of Western Australia, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Department of Surgery, University of Western Australia, Crawley, Western Australia, Australia
| | - Allan Kermode
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, Sir Charles Gairdner Hospital Department of Neurology and Clinical Neurophysiology, Nedlands, Western Australia, Australia
- Institute for Immunology and Infectious Disease, Murdoch University Faculty of Health Sciences, Murdoch, Western Australia, Australia
| | - William Carroll
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, Sir Charles Gairdner Hospital Department of Neurology and Clinical Neurophysiology, Nedlands, Western Australia, Australia
| | - Dao-Yi Yu
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
- Lions Eye Institute, University of Western Australia, Perth, Australia
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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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Relationship between blood pressure and retrobulbar blood flow in dipper and nondipper primary open-angle glaucoma patients. Eur J Ophthalmol 2016; 26:588-593. [PMID: 27338118 DOI: 10.5301/ejo.5000789] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the relationship between retrobulbar hemodynamic parameters in the ophthalmic artery (OA), central retinal artery, and short posterior ciliary artery and 24-hour blood pressure (BP) measurements in dipper and nondipper patients with primary open-angle glaucoma (POAG). METHODS A prospective, cross-sectional, and observational study was conducted on consecutive patients, referred or recruited, attending the outpatient service of our ophthalmology department. Ambulatory BP monitoring, Doppler imaging, and ocular pulse amplitude measurements were performed on the same day. Patients with nocturnal BP decrease up to 10% of the diurnal BP were defined as dippers and those with BP decrease less than 10% were defined as nondippers. RESULTS A total of 114 patients (36 nondippers and 78 dippers) were included in the study. The end-diastolic velocity was significantly lower and the resistivity index (RI) was significantly higher in the dippers than in the nondippers (p<0.0001 and p<0.0001, respectively). The RI in the OA was significantly correlated with daytime and nighttime systolic BP and with the daytime mean arterial pressure in the dippers. CONCLUSIONS The RI in the OA significantly correlates with BP in patients with POAG with nocturnal BP dips. Additionally, retrobulbar blood flow parameters are reduced in dippers as compared with nondippers with POAG.
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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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Kim YH, Lee MV, Ahn JH. Comparison of Ocular Pulse Amplitude Measured Using Dynamic Contour Tonometry and Ocular Blood Flow Analyzer. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.12.1906] [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)
- Yong Hyun Kim
- Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea
| | - Mar Vin Lee
- Department of Ophthalmology, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Jae Hong Ahn
- Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea
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Bertelmann T, Langanke S, Potstawa M, Strempel I. Can dynamic contour tonometry and ocular pulse amplitude help to detect severe cardiovascular pathologies? Clin Ophthalmol 2014; 8:1317-21. [PMID: 25075172 PMCID: PMC4106920 DOI: 10.2147/opth.s63182] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We demonstrate the close relationship between a conspicuous ocular pulse amplitude and severe underlying cardiovascular disease. Two otherwise symptom-free glaucoma patients without any previously diagnosed underlying cardiovascular pathology but with a conspicuous ocular pulse amplitude and who underwent routine examinations in our glaucoma department were referred to the appropriate specialty for further diagnostic procedures. In both patients, the diagnosis of a tachyarrhythmia was made as suspected on dynamic contour tonometry measurements. In addition to medical treatment, one patient underwent electric cardioversion and the second patient was scheduled for pacemaker implantation. A third patient with an unexpected high ocular pulse amplitude despite severe cardiovascular pathology underwent major surgery due to an aortic aneurysm. Carotid stenosis was diagnosed due to side differences in ocular pulse amplitude as well. Ocular pulse amplitude might be a noninvasive and affordable screening tool and could be used to detect severe cardiovascular disease. A prospective study including a larger number of patients is needed to prove this hypothesis.
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Affiliation(s)
- T Bertelmann
- Department of Ophthalmology, Philipps-University of Marburg, Marburg, Germany
| | - S Langanke
- Department of Ophthalmology, Philipps-University of Marburg, Marburg, Germany
| | - M Potstawa
- Section Cardiology, Internal Medicine Clinic, Schwalmstadt, Germany
| | - I Strempel
- Department of Ophthalmology, Philipps-University of Marburg, Marburg, Germany
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Asejczyk-Widlicka M, Krzyżanowska-Berkowska P, Kowalska M, Iskander DR. Clinical utility of spectral analysis of intraocular pressure pulse wave. BMC Ophthalmol 2014; 14:30. [PMID: 24620786 PMCID: PMC3975190 DOI: 10.1186/1471-2415-14-30] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Accepted: 03/03/2014] [Indexed: 12/01/2022] Open
Abstract
Background To evaluate the clinical utility of spectral analysis of intraocular pressure pulse wave in healthy eyes of a control group (CG), patients having glaucomatous optic disc appearance or ocular hypertension, and patients with primary open angle glaucoma or primary angle closure glaucoma. Methods This is a prospective study that enrolled 296 patients from a single glaucoma clinic. Age matched CG consisted of 62 individuals. Subjects underwent comprehensive clinical diagnostic procedures including intraocular pressure (IOP) measurement with dynamic contour tonometry (DCT) and Goldmann applanation tonometry (GAT). DCT time series were analyzed with custom written software that included signal preprocessing, filtering and spectral analysis. An amplitude and energy content analysis, which takes into account non-stationarity of signals but also provides methodology that is independent of IOP and ocular pulse amplitude (OPA) levels, was applied. Spectral content up to the 6th harmonic of the pressure pulse wave was considered. Statistical analyses included descriptive statistics, normality test, and a multicomparison of medians for independent groups using Kruskal-Wallis test. Results GAT IOP showed statistical significance (Kruskal-Willis test p < 0.05) for three out of 10 considered multiple comparisons, DCT IOP and OPA showed statistically significant results in five and seven cases, respectively. Changes in heart rate and central corneal thickness between the groups were statistically significant in two cases. None of the above parameters showed statistically significant differences between CG and the suspects with glaucomatous optic disc appearance (GODA). On the other hand, spectral analysis showed statistically significant differences for that case. Conclusions Spectral analysis of the DCT signals was the only method showing statistically significant differences between healthy eyes and those of GODA suspects.
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Affiliation(s)
- Magdalena Asejczyk-Widlicka
- Faculty of Materials, Strength and Welding, Wroclaw University of Technology, Smoluchowskiego 25, 50-372 Wroclaw, Poland.
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Figueiredo BP, Cronemberger S, Kanadani FN. Correlation between ocular perfusion pressure and ocular pulse amplitude in glaucoma, ocular hypertension, and normal eyes. Clin Ophthalmol 2013; 7:1615-21. [PMID: 23966769 PMCID: PMC3745293 DOI: 10.2147/opth.s44523] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background The purpose of this study was to investigate the correlation between ocular perfusion pressure and ocular pulse amplitude in glaucoma, ocular hypertension, and normal eyes. Methods Ninety eyes from 90 patients were included. Thirty patients had been recently diagnosed with glaucoma and had no previous history of treatment for ocular hypotension, 30 had elevated intraocular pressure (IOP) without evidence of glaucoma, and 30 had normal IOP (<21 mmHg) with no detectable glaucomatous damage. Goldmann applanation tonometry (GAT), dynamic contour tonometry (DCT), blood pressure measurement, pachymetry, Humphrey visual field, and routine ophthalmic examination was performed in each patient. Ocular perfusion pressure was calculated as the difference between mean arterial pressure and IOP. The ocular pulse amplitude was given by DCT. The Pearson correlation coefficient was used to compare the glaucomatous and ocular hypertensive groups, and comparisons with the normal IOP group were done using the Spearman’s rank correlation coefficient. Results Mean IOP by DCT was 22.7 ± 4.3 mmHg in the glaucoma group, 22.3 ± 2.8 mmHg in the ocular hypertension group, and 14.3 ± 1.6 mmHg in the control group. Mean IOP by GAT was 19.0 ± 5.1 mmHg for glaucoma, 22.4 ± 2.1 mmHg for ocular hypertension, and 12.9 ± 2.2 mmHg for controls. Mean ocular pulse amplitude was 3.4 ± 1.2 mmHg in the glaucoma group, 3.5 ± 1.2 mmHg in the ocular hypertension group, and 2.6 ± 0.9 mmHg in the control group. Mean ocular perfusion pressure was 46.3 ± 7.9 mmHg in the glaucoma group, 46.3 ± 7.9 mmHg in the ocular hypertension group, and 50.2 ± 7.0 mmHg in controls. No significant correlation between ocular perfusion pressure and ocular pulse amplitude was found in any of the groups (P = 0.865 and r = −0.032, P = 0.403 and r = −0.156, P = 0.082 and ρ = −0.307 for glaucoma, ocular hypertension, and normal eyes, respectively). Conclusion There is no significant correlation between ocular perfusion pressure and ocular pulse amplitude values in glaucoma, ocular hypertension, or normal eyes. IOP values measured by GAT correlate with those measured by DCT.
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Affiliation(s)
- Bruno P Figueiredo
- Departments of Ophthalmology, Federal University of Minas Gerais, Belo Horizonte, Brazil ; Departments of Ophthalmology, Glaucoma and Cataract Service, Santa Casa of Belo Horizonte, Brazil
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