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Liu X, Ye Y, Ge Y, Qu J, Liedberg B, Zhang Q, Wang Y. Smart Contact Lenses for Healthcare Monitoring and Therapy. ACS NANO 2024; 18:6817-6844. [PMID: 38407063 DOI: 10.1021/acsnano.3c12072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
The eye contains a wealth of physiological information and offers a suitable environment for noninvasive monitoring of diseases via smart contact lens sensors. Although extensive research efforts recently have been undertaken to develop smart contact lens sensors, they are still in an early stage of being utilized as an intelligent wearable sensing platform for monitoring various biophysical/chemical conditions. In this review, we provide a general introduction to smart contact lenses that have been developed for disease monitoring and therapy. First, different disease biomarkers available from the ocular environment are summarized, including both physical and chemical biomarkers, followed by the commonly used materials, manufacturing processes, and characteristics of contact lenses. Smart contact lenses for eye-drug delivery with advancing technologies to achieve more efficient treatments are then introduced as well as the latest developments for disease diagnosis. Finally, sensor communication technologies and smart contact lenses for antimicrobial and other emerging bioapplications are also discussed as well as the challenges and prospects of the future development of smart contact lenses.
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Affiliation(s)
- Xiaohu Liu
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
| | - Ying Ye
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
| | - Yuancai Ge
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
| | - Jia Qu
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
| | - Bo Liedberg
- School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798, Singapore
| | - Qingwen Zhang
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
- Engineering Research Center of Clinical Functional Materials and Diagnosis & Treatment Devices of Zhejiang Province, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325001, China
| | - Yi Wang
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
- Engineering Research Center of Clinical Functional Materials and Diagnosis & Treatment Devices of Zhejiang Province, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325001, China
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Alasbali T. Current State of Knowledge in Ocular Blood Flow in Glaucoma: A Narrative Review. Clin Ophthalmol 2023; 17:2599-2607. [PMID: 37671333 PMCID: PMC10476666 DOI: 10.2147/opth.s426709] [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: 07/12/2023] [Accepted: 08/24/2023] [Indexed: 09/07/2023] Open
Abstract
Glaucoma is a multifactorial disease that is dependent on Intra Ocular Pressure (IOP) and associated with risk factors related to reduced ocular blood flow (OBF). In clinical practice, it is instrumental to update and review the considerable evidence of the current imaging technologies utilized in the investigation of OBF involved in both the onset and progression of glaucoma. Bibliographic databases, including PubMed and Google Scholar, were searched for articles on OBF techniques published between 2018 and 2023 using keywords such as "ocular blood flow", "glaucoma", "invasive ocular blood flow measurement", and "non-invasive ocular blood flow measurement". All types of methodologies were considered, except for editorials, letters to the editor, and animal studies. This review provides comprehensive information on the recent state-of-the-art imaging innovations used to monitor and measure the ocular blood flow in glaucoma.
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Affiliation(s)
- Tariq Alasbali
- Department of Ophthalmology, Faculty of Medicine, College of Medicine, Imam Mohammed Ibn Saud Islamic University, Riyadh, Saudi Arabia
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Cheng Y, Ren T, Wang N. Biomechanical homeostasis in ocular diseases: A mini-review. Front Public Health 2023; 11:1106728. [PMID: 36733902 PMCID: PMC9886686 DOI: 10.3389/fpubh.2023.1106728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/02/2023] [Indexed: 01/18/2023] Open
Abstract
Diabetes mellitus-induced hyperglycemia is responsible for multiple pathological ocular alternations from vasculopathy to biomechanical dyshomeostasis. Biomechanical homeostasis is crucial to maintain the normal physiological condition of the eyes. Biomechanical features vary in eye tissues regarding different anatomical positions, tissue components, and cellular functions. The disturbance in biomechanical homeostasis may result in different ocular diseases. In this review, we provide a preliminary sketch of the latest evidence on the mechano-environment of the eyeball and its possible influencing factors, thereby underscoring the relationship between the dyshomeostasis of ocular biomechanics and common eye diseases (e.g., diabetic retinopathy, keratoconus, glaucoma, spaceflight-associated neuro-ocular syndrome, retinal vein occlusion and myopia, etc.). Together with the reported evidence, we further discuss and postulate the potential role of biomechanical homeostasis in ophthalmic pathology. Some latest strategies to investigate the biomechanical properties in ocular diseases help unveil the pathological changes at multiple scales, offering references for making new diagnostic and treatment strategies targeting mechanobiology.
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Affiliation(s)
- Ying Cheng
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Tianmin Ren
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ningli Wang
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China,Collaborative Innovation Center for Brain Disorders, Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China,Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China,*Correspondence: Ningli Wang ✉
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Arjmand P, Yu CW, Popovic MM, Jhaveri A, Mandelcorn ED. Prophylactic intraocular pressure lowering measures in anti-vascular endothelial growth factor therapy: A systematic review and meta-analysis. Surv Ophthalmol 2022; 68:425-445. [PMID: 36529267 DOI: 10.1016/j.survophthal.2022.12.002] [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: 04/09/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
Acute intraocular pressure (IOP) elevation following repeat intravitreal anti-vascular endothelial growth factor (VEGF) injections (IVI) may pose a risk to the integrity of the retinal nerve fiber (RNFL). This meta-analysis investigates the role of IOP-lowering interventions such as an anterior chamber paracentesis (ACP) and IOP-lowering medications on the IOP in patients undergoing IVIs. MEDLINE, EMBASE, and the Cochrane Library were searched up to February, 2021. Studies investigating IOP-lowering interventions in patients undergoing IVI versus controls were included. The primary outcome was the IOP in the short- and long-term post-IVI. Secondary outcomes were changes in the RNFL thickness and best corrected visual acuity (BCVA). ACP at time of anti-VEGF injection significantly lowered IOP immediately post anti-VEGF (WMD: -27.98 mm Hg, P < 0.001). Patients in the ACP group also had significantly thicker RNFL compared to control (WMD: 2.07 um, P < 0.00001) at median follow-up of 16.5 months. IOP-lowering medications (on the day of injection or in the long-term) significantly reduced IOP up to 30 minutes after injection (WMD: -3.31 mm Hg, P = 0.003). This effect was statistically significant between the 2 arms up to 1 month follow-up. There was no difference in BCVA in intervention versus controls. ACP reduces immediate IOP spikes post-IVI and preserves the RNFL in the short- and longterms IOP-lowering medications also reduce IOP spike, with limited data on RNFL thickness.
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Affiliation(s)
| | - Caberry W Yu
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Marko M Popovic
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Aaditeya Jhaveri
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - Efrem D Mandelcorn
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Ophthalmology, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
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Increased Risk of Ocular Hypertension in Patients With Cushing's Disease. J Glaucoma 2022; 31:941-946. [PMID: 35980841 DOI: 10.1097/ijg.0000000000002113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 07/14/2022] [Indexed: 12/29/2022]
Abstract
PRCIS An increased risk of ocular hypertension was seen in Cushing's disease. INTRODUCTION Systemic steroid use is a significant risk factor for increased intraocular pressure (IOP). The incidence of ocular hypertension may rise to 30%-40% of the general population due to topical or systemic glucocorticoid usage. However, the incidence of ocular hypertension in endogenous hypercortisolemia, as well as the ophthalmological outcomes after endocrine remission due to surgical resection, remain unknown. MATERIALS AND METHODS The IOP, visual field, and peripapillary retinal nerve fiber layer thickness were documented in all patients with Cushing's disease (CD) admitted to a tertiary pituitary center for surgery from January to July 2019. Patients with acromegaly and patients with nonfunctioning pituitary adenoma (NFPA) during the same study period served as controls. We calculated the odds ratio (OR), identified the risk factors of developing ocular hypertension, and presented postoperative trends of the IOP. RESULTS A total of 52 patients (38.4±12.4 y old) with CD were included. The IOP was higher in patients with CD (left 19.4±5.4 mm Hg and right 20.0±7.1 mm Hg) than in patients with acromegaly (left 17.5±2.3 mm Hg and right 18.6±7.0 mm Hg, P =0.033) and patients with NFPA (left 17.8±2.6 mm Hg and right 17.4±2.4 mm Hg, P =0.005). A total of 21 eyes (20.2%) in patients with CD were diagnosed with ocular hypertension compared with 4 eyes (4.7%) in the acromegaly group and 4 eyes (4.5%) in the NFPA group. The OR of developing ocular hypertension in patients with CD was 5.1 [95% confidence interval (CI), 1.3-25.1, P =0.029] and 6.6 (95% CI, 1.8-30.3, P =0.007) when compared with the 2 control groups. Among patients with CD, those with a higher urine-free cortisol were more likely to develop ocular hypertension (OR=19.4, 95% CI, 1.7-72.6). The IOP decreased at 1 month after surgery in patients with CD, and the change was sustained for 3 months after surgery. CONCLUSIONS An increased risk of ocular hypertension was seen in CD and suggests that endogenous hypercortisolemia should be considered as part of the glaucoma assessment. This result warrants the discretion of both ophthalmologists and neuroendocrinologists.
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Oldiges K, Steinmann M, Duevel JA, Gruhn S, Diener R, Leclaire MD, Al-Nawaiseh S, Eter N. SALUS-a non-inferiority trial to compare self-tonometry in glaucoma patients with regular inpatient intraocular pressure controls: study design and set-up. Graefes Arch Clin Exp Ophthalmol 2022; 260:3945-3955. [PMID: 35867146 PMCID: PMC9666328 DOI: 10.1007/s00417-022-05759-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 06/28/2022] [Accepted: 06/30/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The SALUS study aims to improve the healthcare situation for glaucoma patients in Germany. In order to detect diurnal intraocular pressure (IOP) fluctuations, inpatient monitoring of IOP in an eye hospital for a minimum of 24 h is the current standard. SALUS assesses the benefits of a new form of outpatient care, where IOP can be measured by the patients themselves at home using a self-tonometer. This approach should promote the patient’s health competence and empowerment within the healthcare system while reducing treatment costs. Methods The SALUS study is a randomized controlled, open non-inferiority trial, alongside an economic analysis, determining whether outpatient monitoring of IOP with self-tonometry is at least as effective as current standard care and would reduce treatment costs. Participants (n = 1980) will be recruited by local ophthalmologists in the area of Westphalia-Lippe, Germany, and randomized to receive 7-day outpatient or 24-h inpatient monitoring. Participants in both study arms will also receive 24-h blood pressure monitoring. Furthermore, patient data from both study groups will be collected in an electronic case file (ECF), accessible to practitioners, hospitals, and the study participants. The primary endpoint is the percentage of patients with IOP peaks, defined as levels 30% above the patient-specific target pressure. Data will also be collected during initial and final examinations, and at 3, 6, and 9 months after the initial examination. Results The study implementation and trial management are represented below. Conclusion SALUS is a pioneering prospective clinical trial focused on the care of glaucoma patients in Germany. If SALUS is successful, it could improve the healthcare situation and health literacy of the patients through the introduction of various telemedical components. Furthermore, the approach would almost certainly reduce the treatment costs of glaucoma care. Trial registration ClinicalTrials.gov ID: NCT04698876, registration date: 11/25/2020. DRKS-ID: DRKS00023676, registration date: 11/26/2020.
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Affiliation(s)
- Kristina Oldiges
- Department of Ophthalmology, University of Muenster Medical Center, Albert-Schweitzer-Campus 1, Building D15, 48149, Muenster, Germany
| | - Maren Steinmann
- Department for Health Economics and Health Care Management, School of Public Health, Bielefeld University, Universitaetsstrasse 25, 33615, Bielefeld, Germany
| | - Juliane Andrea Duevel
- Department for Health Economics and Health Care Management, School of Public Health, Bielefeld University, Universitaetsstrasse 25, 33615, Bielefeld, Germany
| | - Sebastian Gruhn
- Department for Health Economics and Health Care Management, School of Public Health, Bielefeld University, Universitaetsstrasse 25, 33615, Bielefeld, Germany
| | - Raphael Diener
- Department of Ophthalmology, University of Muenster Medical Center, Albert-Schweitzer-Campus 1, Building D15, 48149, Muenster, Germany
| | - Martin Dominik Leclaire
- Department of Ophthalmology, University of Muenster Medical Center, Albert-Schweitzer-Campus 1, Building D15, 48149, Muenster, Germany
| | - Sami Al-Nawaiseh
- Department of Ophthalmology, University of Muenster Medical Center, Albert-Schweitzer-Campus 1, Building D15, 48149, Muenster, Germany
| | - Nicole Eter
- Department of Ophthalmology, University of Muenster Medical Center, Albert-Schweitzer-Campus 1, Building D15, 48149, Muenster, Germany.
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Nanthini S, Ain-Nasyrah AS, Raja Omar RN, Yaakub A, Liza-Sharmini AT. Clinical Audit on the Effectiveness of Clinic-Based Intraocular Pressure Phasing for Patients With Glaucoma and Glaucoma Suspect. Cureus 2022; 14:e22726. [PMID: 35386148 PMCID: PMC8968089 DOI: 10.7759/cureus.22726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction: Glaucoma is a complex disease with intraocular pressure (IOP) playing an important role in its diagnosis and management. IOP has shown diurnal and nocturnal variations, which may affect the course of the disease. Objective: The objective of this study was to determine the effectiveness of clinic-based office hour phasing in the diagnosis and management of glaucoma and glaucoma suspect (GS). Methods: A retrospective clinical audit was conducted on patients who were subjected to office hour phasing in a glaucoma clinic, Hospital Universiti Sains Malaysia, Kelantan, Malaysia, between January 2015 and December 2019. The office hour phasing was conducted for various indications such as confirmation of diagnosis, screening, and effectiveness of treatment. IOP was recorded every two hours between 0800 and 1600 using an air puff tonometer by a trained nurse. Measurement of IOP was repeated with Goldmann applanation tonometer at sitting position by a trainee when the IOP ≥ 20 mmHg or discrepancy of IOP > 2 mmHg between two eyes. Other investigations including a Humphrey visual field and gonioscopy were conducted in between the IOP measurements. Diagnosis and clinical decisions on management were made at the end of the office hour clinic phasing. Results: A total of 83 patients (163 eyes) were included in this clinical audit. Their mean age was 59.3 (16.5) years with 59% of male patients. Both eyes showed an almost similar pattern of mean IOP over five daytime readings in the clinic. A total of 35 eyes (21.5%) showed fluctuation ≥ 6 mmHg, and 128 eyes (78.5%) showed stable IOP during the clinic hour phasing. There was a significant difference in the mean IOP pattern between groups with stable and fluctuating IOP based on repetitive measure analysis of variance (RM ANOVA) (p = 0.008). The final diagnosis was made for 39 eyes (21 OD [right eye] and 18 OS [left eye]) out of 131 eyes (29.8%) with GS. Confirmation of diagnosis was achieved in all eyes (100%) with suspected ocular hypertension (OHT) and normal-tension glaucoma (NTG). Progression of glaucoma was confirmed in four eyes (2 OD and 2 OS) out of 17 eyes (23.5%) with suspected progression. Conclusion: Clinic hour IOP phasing provides a practical approach in confirmation of diagnosis and adjustment in the management of patients with glaucoma and GS.
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Mouhammad ZA, Vohra R, Horwitz A, Thein AS, Rovelt J, Cvenkel B, Williams PA, Azuara-Blanco A, Kolko M. Glucagon-Like Peptide 1 Receptor Agonists – Potential Game Changers in the Treatment of Glaucoma? Front Neurosci 2022; 16:824054. [PMID: 35264926 PMCID: PMC8899005 DOI: 10.3389/fnins.2022.824054] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 01/10/2022] [Indexed: 12/22/2022] Open
Abstract
Glaucoma is a common ocular neurodegenerative disease characterized by the progressive loss of retinal ganglion cells and their axons. It is the most common cause of irreversible blindness. With an increasing number of glaucoma patients and disease progression despite treatment, it is paramount to develop new and effective therapeutics. Emerging new candidates are the receptor agonists of the incretin hormone glucagon-like-peptide-1 (GLP-1), originally used for the treatment of diabetes. GLP-1 receptor (GLP-1R) agonists have shown neuroprotective effects in preclinical and clinical studies on neurodegenerative diseases in both the brain (e.g., Alzheimer’s disease, Parkinson’s disease, stroke and diabetic neuropathy) and the eye (e.g., diabetic retinopathy and AMD). However, there are currently very few studies investigating the protective effects of GLP-1R agonists in the treatment of specifically glaucoma. Based on a literature search on PubMed, the Cochrane Library, and ClinicalTrials.gov, this review aims to summarize current clinical literature on GLP-1 receptor agonists in the treatment of neurodegenerative diseases to elucidate their potential in future anti-glaucomatous treatment strategies.
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Affiliation(s)
- Zaynab Ahmad Mouhammad
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Rupali Vohra
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
- Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anna Horwitz
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
| | - Anna-Sophie Thein
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Jens Rovelt
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Barbara Cvenkel
- Department of Ophthalmology, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Pete A. Williams
- Division of Eye and Vision, Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden
| | | | - Miriam Kolko
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
- *Correspondence: Miriam Kolko,
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Yang J, Zhang M, Song Q, Li S, Zhao X, Kan L, Zhu S. Integrating network pharmacological and experimental models to investigate the therapeutic effects of baicalein in glaucoma. Chin Med 2021; 16:124. [PMID: 34823561 PMCID: PMC8613988 DOI: 10.1186/s13020-021-00537-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 11/13/2021] [Indexed: 12/16/2022] Open
Abstract
Background Traditional Chinese medicine (TCM) has a long history of treating glaucoma with remarkable effects, but there is no clear conclusion on its mechanism. Methods Network pharmacology and molecular docking were used to analyze the mechanism and targets of TCM in the treatment of glaucoma, and baicalein was used to treat chronic ocular hypertension animal models rats for observation. Results The results of animal experiments showed that baicalein could significantly reduce intraocular pressure (IOP) in a rat model of chronic ocular hypertension and protect the structure of the retina and optic nerve, as shown by hematoxylin–eosin (H&E) staining and transmission electron microscopy (TEM). Reducing the apoptosis of retinal ganglion cells (RGCs) by upregulating the expression of the antiapoptotic protein BCL-2 is basically consistent with the results of molecular docking. In the network pharmacology analysis, many key proteins of biological pathways involved in the herbal therapeutic processes in glaucoma, such as threonine kinase 1 (AKT1, core protein of PI3K/AKT signaling), tumor protein p53 (TP53, a tumor suppressor gene coding tumor protein P53), signal transducer and activator of transcription 3 (STAT3, core protein of JAK/STAT signaling), interleukin 6 (IL-6) and interleukin 17 (IL-17, proinflammatory factors), were identified. Their interactions built complicated chain reactions in the process of glaucoma. Conclusion By combining the analysis of network pharmacology and animal experimental results, baicalein could effectively improve the symptoms of glaucoma and reduce RGC apoptosis, suggesting that the potential mechanism of TCM in treating glaucoma is related to regulating inflammation and cellular immunity and reducing apoptosis.
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Affiliation(s)
- Jiawei Yang
- Eye School, Chengdu University of Traditional Chinese Medicine, 37 Shi Er Qiao Road, Chengdu, 610075, China
| | - Mingxu Zhang
- Eye School, Chengdu University of Traditional Chinese Medicine, 37 Shi Er Qiao Road, Chengdu, 610075, China
| | - Qiuyi Song
- Eye School, Chengdu University of Traditional Chinese Medicine, 37 Shi Er Qiao Road, Chengdu, 610075, China
| | - Siqi Li
- Eye School, Chengdu University of Traditional Chinese Medicine, 37 Shi Er Qiao Road, Chengdu, 610075, China
| | - Xiulan Zhao
- Ineye Hospital of Chengdu University of TCM, Chengdu, China
| | - Liping Kan
- Eye School, Chengdu University of Traditional Chinese Medicine, 37 Shi Er Qiao Road, Chengdu, 610075, China
| | - Siquan Zhu
- Eye School, Chengdu University of Traditional Chinese Medicine, 37 Shi Er Qiao Road, Chengdu, 610075, China. .,Department of Ophthalmology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
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Brusini P, Salvetat ML, Zeppieri M. How to Measure Intraocular Pressure: An Updated Review of Various Tonometers. J Clin Med 2021; 10:3860. [PMID: 34501306 PMCID: PMC8456330 DOI: 10.3390/jcm10173860] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/17/2021] [Accepted: 08/23/2021] [Indexed: 02/05/2023] Open
Abstract
Intraocular pressure (IOP) is an important measurement that needs to be taken during ophthalmic examinations, especially in ocular hypertension subjects, glaucoma patients and in patients with risk factors for developing glaucoma. The gold standard technique in measuring IOP is still Goldmann applanation tonometry (GAT); however, this procedure requires local anesthetics, can be difficult in patients with scarce compliance, surgical patients and children, and is influenced by several corneal parameters. Numerous tonometers have been proposed in the past to address the problems related to GAT. The authors review the various devices currently in use for the measurement of intraocular pressure (IOP), highlighting the main advantages and limits of the various tools. The continuous monitoring of IOP, which is still under evaluation, will be an important step for a more complete and reliable management of patients affected by glaucoma.
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Affiliation(s)
- Paolo Brusini
- Department of Ophthalmology, Policlinico “Città di Udine”, 33100 Udine, Italy;
| | - Maria Letizia Salvetat
- Department of Ophthalmology, Azienda Sanitaria Friuli Occidentale, 33170 Pordenone, Italy;
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
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Chikasirimobi TG, Ndinyo M, Ondieki MN, Miti I, Ejiochi-Iyoke NJ, Osuagwu UL, Zeried FM, Agho K, Ogbuehi KC, Mashige KP. A comparison of postural and diurnal variations in intraocular pressure using the iCare rebound tonometer and Perkins applanation tonometer in admitted adults in Kenya. AFRICAN VISION AND EYE HEALTH 2021. [DOI: 10.4102/aveh.v80i1.617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: Elevated intraocular pressure (IOP) remained the most important known risk factor for glaucoma.Aim: To compare the postural and diurnal IOP variations using the iCare rebound tonometer (RT) and Perkins applanation tonometer (PAT).Setting: Kakamega County Hospital, Kenya.Methods: Elevated intraocular pressure measurements were taken by two (masked) examiners with two devices in the morning (06:00–09:00), midday (12:00–15:00) and evening (18:00–21:00), in the sitting followed by supine positions in one randomly selected eye of 24 oculo-visual healthy hospital-admitted patients. Effects of the time of the day and position of the body within and between devices were analysed with the Statistical Package for Social Sciences.Results: The mean IOP measured by the RT ranged from 6 mmHg to 24 millimetres of mercury (mmHg) in the sitting position and from 10 mmHg to 26 mmHg in the supine position. The mean IOP measured using PAT ranged from 6 mmHg to 21 mmHg in the sitting position and from 8 mmHg to 24 mmHg in the supine position. The IOP measured by both devices significantly varied with position (p 0.05). Perkins applanation tonometer on average gave a significantly higher IOP (1.7 mmHg [p = 0.003] and 1.3 mmHg [p = 0.034]) at 06:00 compared to that at 12:00 and 18:00, respectively. The IOP readings with the RT were on average 2.2 mmHg and 3.0 mmHg higher at 06:00 compared to that at 12:00 and 18:00, respectively (p 0.0005).Conclusion: Significant reductions were observed in postural and diurnal IOPs in the sitting positions and in the afternoon, respectively. Diurnal IOP variations were slightly higher when measured by RT compared to when measured by PAT.
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Kim K, Kim HJ, Zhang H, Park W, Meyer D, Kim MK, Kim B, Park H, Xu B, Kollbaum P, Boudouris BW, Lee CH. All-printed stretchable corneal sensor on soft contact lenses for noninvasive and painless ocular electrodiagnosis. Nat Commun 2021; 12:1544. [PMID: 33750806 PMCID: PMC7943761 DOI: 10.1038/s41467-021-21916-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 12/17/2020] [Indexed: 02/03/2023] Open
Abstract
Electroretinogram examinations serve as routine clinical procedures in ophthalmology for the diagnosis and management of many ocular diseases. However, the rigid form factor of current corneal sensors produces a mismatch with the soft, curvilinear, and exceptionally sensitive human cornea, which typically requires the use of topical anesthesia and a speculum for pain management and safety. Here we report a design of an all-printed stretchable corneal sensor built on commercially-available disposable soft contact lenses that can intimately and non-invasively interface with the corneal surface of human eyes. The corneal sensor is integrated with soft contact lenses via an electrochemical anchoring mechanism in a seamless manner that ensures its mechanical and chemical reliability. Thus, the resulting device enables the high-fidelity recording of full-field electroretinogram signals in human eyes without the need of topical anesthesia or a speculum. The device, superior to clinical standards in terms of signal quality and comfortability, is expected to address unmet clinical needs in the field of ocular electrodiagnosis.
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Affiliation(s)
- Kyunghun Kim
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Ho Joong Kim
- Charles D. Davidson School of Chemical Engineering, Purdue University, West Lafayette, IN, USA
| | - Haozhe Zhang
- Department of Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, VA, USA
| | - Woohyun Park
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, USA
| | - Dawn Meyer
- School of Optometry, Indiana University, Bloomington, IN, USA
| | - Min Ku Kim
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Bongjoong Kim
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, USA
| | - Heun Park
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Baoxing Xu
- Department of Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, VA, USA.
| | - Pete Kollbaum
- School of Optometry, Indiana University, Bloomington, IN, USA.
| | - Bryan W Boudouris
- Charles D. Davidson School of Chemical Engineering, Purdue University, West Lafayette, IN, USA.
- Department of Chemistry, Purdue University, West Lafayette, IN, USA.
| | - Chi Hwan Lee
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA.
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, USA.
- School of Materials Engineering, Purdue University, West Lafayette, IN, USA.
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