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Iglesias M, Kudsieh B, Laiseca A, Santos C, Nadal J, Barraquer R, Casaroli-Marano RP. Intraocular pressure after myopic laser refractive surgery measured with a new Goldmann convex prism: correlations with GAT and ORA. BMC Ophthalmol 2022; 22:79. [PMID: 35168601 PMCID: PMC8849021 DOI: 10.1186/s12886-022-02309-x] [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: 11/22/2021] [Accepted: 02/09/2022] [Indexed: 12/04/2022] Open
Abstract
Background The purpose of this study is to describe measurements using a newly developed modified Goldmann convex tonometer (CT) 1 year after myopic laser refractive surgery. Intraocular pressure (IOP) measurements were compared with IOP values obtained by Goldmann applanation tonometer (GAT), and Ocular Response Analyzer (ORA). Methods Prospective double-masked study performed on thirty eyes of thirty patients that underwent laser in situ keratomileusis (LASIK; n = 19) or photorefractive keratectomy (PRK; n = 11). IOP was measured before and 3 and 12 months after surgery. Intraclass correlation coefficient (ICC) and Bland-Altman plot were calculated to assess the agreement between GAT, CT, IOPg (Goldmann-correlated IOP) and IOPcc (corneal-compensated IOP) from ORA. Results Twelve months after LASIK, IOP measured with CT showed the best correlation with IOP measured with GAT before surgery (GATpre) (ICC = 0.886, 95% CI: 0.703–0.956) (15.60 ± 3.27 vs 15.80 ± 3.22; p < 0.000). However, a moderate correlation was found for IOP measured with IOPcc and CT 12 months after LASIK (ICC = 0.568, 95% CI: − 0.185 – 0.843) (15.80 ± 3.22 vs 12.87 ± 2.77; p < 0.004). Twelve months after PRK, CT showed a weak correlation (ICC = − 0.266, 95% CI: − 3.896 – 0.663), compared to GATpre (17.30 ± 3.47 vs 16.01 ± 1.45; p < 0.642), as well as poor correlation (ICC = 0.256, 95% CI: − 0.332 – 0.719) with IOPcc (17.30 ± 3.47 vs 13.38 ± 1.65; p < 0.182). Conclusions Twelve months after LASIK, IOP measured with CT strongly correlated with GAT before surgery and could therefore provide an alternative method for measuring IOP after this surgery. More studies regarding this new convex prism are needed to assess its accuracy.
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Affiliation(s)
- María Iglesias
- Instituto Universitario Barraquer, Barraquer Ophthalmology Centre, Laforja 88, 08012, Barcelona, Spain.
| | - Bachar Kudsieh
- Department of Ophthalmology, Hospital Universitario Puerta De Hierro, 28222, Madrid, Spain
| | - Andrea Laiseca
- Instituto Universitario Barraquer, Barraquer Ophthalmology Centre, Laforja 88, 08012, Barcelona, Spain
| | - Cristina Santos
- Unitat Antropologia Biològica, Department Biologia Animal, Biologia Vegetal i Ecologia, Universitat Autònoma de Barcelona (UAB), 08193, Barcelona, Spain
| | - Jeroni Nadal
- Instituto Universitario Barraquer, Barraquer Ophthalmology Centre, Laforja 88, 08012, Barcelona, Spain
| | - Rafael Barraquer
- Instituto Universitario Barraquer, Barraquer Ophthalmology Centre, Laforja 88, 08012, Barcelona, Spain.,International University of Catalunya (UIC), 08017, Barcelona, Spain
| | - Ricardo P Casaroli-Marano
- Department of Surgery, School of Medicine and Hospital Clinic de Barcelona, University of Barcelona (UB), 08036, Barcelona, Spain
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Sayah DN, Mazzaferri J, Ghesquière P, Duval R, Rezende F, Costantino S, Lesk MR. Non-invasive in vivo measurement of ocular rigidity: Clinical validation, repeatability and method improvement. Exp Eye Res 2020; 190:107831. [DOI: 10.1016/j.exer.2019.107831] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 09/05/2019] [Accepted: 10/04/2019] [Indexed: 11/28/2022]
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Ocular Surface Changes in Prostaglandin Analogue-Treated Patients. J Ophthalmol 2019; 2019:9798272. [PMID: 31885896 PMCID: PMC6925925 DOI: 10.1155/2019/9798272] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 11/25/2019] [Indexed: 11/18/2022] Open
Abstract
Glaucoma is the second leading cause of blindness globally. Reducing intraocular pressure (IOP) has been acknowledged to be the main therapy for glaucoma. Prostaglandin analogues (PGAs) have become the first-line therapy for patients with glaucoma due to their powerful efficacy for lowering (IOP). However, usage of PGAs can also cause several notable side effects, including the changes in ocular surface. The relationship between PGAs and ocular surface changes is complicated and still remains unclear. In the present review, we summarize the recent studies of the effects of PGAs on ocular changes as well as the possible mechanisms that might provide new considerations during clinical medication.
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Kovacic H, Wolfs RCW, Kılıç E, Ramdas WD. Changes in intraocular pressure after intraocular eye surgery-the influence of measuring technique. Int J Ophthalmol 2019; 12:967-973. [PMID: 31236354 DOI: 10.18240/ijo.2019.06.14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 09/06/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate the changes in intraocular pressure (IOP) before and after intraocular surgery measured with Goldmann applanation tonometry (GAT) and pascal dynamic contour tonometry (PDCT), and assessed their agreement. METHODS Patients who underwent trans pars plana vitrectomy (TPPV) with or without cataract extraction (CE) were included. The IOP was measured in both eyes with GAT and PDCT pre- and postoperatively, where the non-operated eyes functioned as control. RESULTS Preoperatively, mean IOP measurements were 16.3±6.0 mm Hg for GAT and 12.0±2.8 mm Hg for PDCT for the operated eyes. Postoperatively, the mean IOP dropped to 14.3±5.6 mm Hg for GAT (P=0.011) and rose up to 12.7±2.6 mm Hg for PDCT (P=0.257). Bland-Altman analysis showed a poor agreement between GAT and PDCT with a mean difference of 2.9 mm Hg preoperatively and 95% limits of agreement ranging from -3.2 to 9.0 mm Hg. Postoperatively, the mean difference was 1.2 mm Hg with 95% limits of agreement ranging from -8.3 to 10.7 mm Hg. There were no significant differences between the TPPV and TPPV+CE group, except when measured with PDCT postoperatively (P=0.012). CONCLUSION The IOP is reduced after surgery when measured with GAT and remained stable when measured with PDCT. However, the agreement between GAT and PDCT is poor. Although PDCT may be a more accurate predictor of the true IOP, it seems less suitable for daily use in the clinical practice.
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Affiliation(s)
- Hrvoje Kovacic
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam 3000 CA, the Netherlands
| | - Roger C W Wolfs
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam 3000 CA, the Netherlands
| | - Emine Kılıç
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam 3000 CA, the Netherlands
| | - Wishal D Ramdas
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam 3000 CA, the Netherlands
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Changes in Corneal Biomechanical Properties After Descemet Membrane Endothelial Keratoplasty. Cornea 2019; 38:964-969. [DOI: 10.1097/ico.0000000000001986] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Corneal hysteresis in post-radial keratotomy primary open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol 2018; 256:1971-1976. [DOI: 10.1007/s00417-018-4073-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 06/24/2018] [Accepted: 07/16/2018] [Indexed: 11/27/2022] Open
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Andreanos K, Koutsandrea C, Papaconstantinou D, Diagourtas A, Kotoulas A, Dimitrakas P, Moschos MM. Comparison of Goldmann applanation tonometry and Pascal dynamic contour tonometry in relation to central corneal thickness and corneal curvature. Clin Ophthalmol 2016; 10:2477-2484. [PMID: 28003737 PMCID: PMC5158174 DOI: 10.2147/opth.s115203] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose The aim of the study was to assess the influence of central corneal thickness (CCT) and corneal curvature in tonometry measurements taken by Goldmann applanation tonometry (GAT) and Pascal dynamic contour tonometry (DCT). Methods This was a prospective study of 185 eyes from 97 subjects, attending outpatient ophthalmology appointments, who underwent intraocular pressure measurements by GAT and Pascal DCT. CCT and corneal curvature were obtained using ultrasound pachymetry and Orbscan topography, respectively. All measurements were carried out among males and females during the period 2009–2012. Apart from the usual descriptive and exploratory data analysis, one-way analysis of variance and agreement analysis were performed, linear as well as intraclass correlation coefficients were estimated, and multiple scatter and Bland–Altman plots were produced. Results Mean IOP measurements obtained were 17.21±4.10 mmHg by DCT and 13.23±4.07 mmHg by GAT. Mean difference between the GAT and DCT measurements was 3.88±2.8 mmHg. Mean CCT and corneal curvature were 522.78±52 μm and 43.83±2.9823 D, respectively. Conclusion Intraocular pressure measured by GAT was consistently lower when compared with DCT, and this difference was greatest with thinner CCT. Flat corneas seem to influence GAT measurements compared to DCT.
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Affiliation(s)
- Konstantinos Andreanos
- First Department of Ophthalmology, University of Athens, "G. Gennimatas" General Hospital of Athens, Athens, Greece
| | - Chryssanthi Koutsandrea
- First Department of Ophthalmology, University of Athens, "G. Gennimatas" General Hospital of Athens, Athens, Greece
| | - Dimitris Papaconstantinou
- First Department of Ophthalmology, University of Athens, "G. Gennimatas" General Hospital of Athens, Athens, Greece
| | - Andreas Diagourtas
- First Department of Ophthalmology, University of Athens, "G. Gennimatas" General Hospital of Athens, Athens, Greece
| | - Andreas Kotoulas
- First Department of Ophthalmology, University of Athens, "G. Gennimatas" General Hospital of Athens, Athens, Greece
| | - Panagiotis Dimitrakas
- First Department of Ophthalmology, University of Athens, "G. Gennimatas" General Hospital of Athens, Athens, Greece
| | - Marilita M Moschos
- First Department of Ophthalmology, University of Athens, "G. Gennimatas" General Hospital of Athens, Athens, Greece
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Beyazyıldız E, Beyazyıldız O, Arifoğlu HB, Altıntaş AK, Köklü SG. Comparison of ocular response analyzer parameters in primary open angle glaucoma and exfoliative glaucoma patients. Indian J Ophthalmol 2016; 62:782-7. [PMID: 25116770 PMCID: PMC4152647 DOI: 10.4103/0301-4738.138180] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM We sought to identify differences in the following measures of the ocular response analyser (ORA) between primary open angle glaucoma (POAG) and exfoliative glaucoma (EXG) patients: Corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated intraocular pressure (IOPcc) and Goldmann-correlated intraocular pressure (IOPg). We also sought to relate these ORA measures with central corneal thickness (CCT). MATERIALS AND METHODS This cross-sectional study was conducted on a total of 162 individuals (46 EXG patients, 66 POAG patients and 50 healthy subjects without any ocular and systemic disease). ORA measurements were performed, and a minimum of three readings were obtained from each test subject. Groups were compared according to their ORA parameters. RESULTS The mean CH levels of the EXG, POAG and healthy subjects were 7.6 ± 2.1, 9.1 ± 1.9 and 9.6 ± 1.7 mmHg, respectively. CH was significantly lower in the EXG patients compared to the other groups (P < 0.001).The mean CRF levels of the EXG, POAG and healthy subjects were 9.0 ± 2.0, 10.1 ± 1.7 and 9.8 ± 1.8mmHg, respectively. CRF levels in the eyes of the EXG patients were significantly lower compared to those of either the POAG patients (P = 0.005) or the healthy subjects (P = 0.03), but there was no significant difference in CRF levels between the POAG patients and the healthy subjects (P = 0.59). There was a significant positive correlation between CH and CCT in the EXG patients and healthy subjects (P < 0.001), but this correlation was not present in the POAG patients (P = 0.70). CONCLUSIONS In this study, CH and CRF were found to be significantly reduced in the eyes of EXG patients compared to both the POAG patients and healthy subjects. Reduced CH in EXG patients might result in decreased support of peripapillary scleral structure and increased damage to the optic nerve during IOP increase.
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Corneal thickness of eyes with unilateral age-related macular degeneration. Eur J Ophthalmol 2014; 25:214-7. [PMID: 25449636 DOI: 10.5301/ejo.5000544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the central corneal thicknesses (CCT), peripheral corneal thicknesses, and corneal volumes (CV) of the 2 eyes of patients with unilateral age-related macular degeneration (AMD). METHODS Twenty patients who were diagnosed with unilateral AMD were included in this prospective study for the purpose of making comparison between the diseased and healthy eyes. Optical coherence tomography and fundus fluorescein angiography imaging were applied to all patients in order to confirm and reveal the presence of unilateral AMD. Then, the measurements of CCT, peripheral corneal thickness measured 4 mm distant from the center of the cornea (4 mm CT), and CV of each eye of these patients were obtained through the rotating Scheimpflug corneal topographer. RESULTS Wilcoxon signed-rank test did not demonstrate a statistically significant difference between the 2 eyes of patients with unilateral AMD when we compared the CCT and CV of diseased and healthy eyes (p>0.05). However, 4 mm CT of the diseased eyes of these patients were statistically significantly thicker than the healthy eyes (p<0.05). CONCLUSIONS The significant difference in terms of 4 mm CT between the diseased and healthy eyes of patients with unilateral AMD may demonstrate the possible effect of peripheral corneal thickness on the development of AMD.
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Ortiz S, Mena L, Rio-San Cristobal A, Martin R. Relationships between central and peripheral corneal thickness in different degrees of myopia. JOURNAL OF OPTOMETRY 2014; 7:44-50. [PMID: 24646900 PMCID: PMC3938742 DOI: 10.1016/j.optom.2013.03.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 02/07/2013] [Accepted: 02/07/2013] [Indexed: 05/03/2023]
Abstract
PURPOSE To analyze the relationship between the central corneal thickness (CCT) and mid-peripheral corneal thickness (PCT) with the degree of myopia [axial length (AL) and spherical equivalent refractive error (SE)]. METHODS 175 right myopic eyes from 175 patients were divided according to the degree of SE: group #1 (n=76, <6.00 D), group #2 (n=72, between 6.00 and 12.00 D) and group #3 (n=27, >12.00 D). The CCT and PCT (3mm from the apex to the superior, inferior, nasal and temporal locations) were measured with the Orbscan-II. Relative peripheral index (RPI) was calculated by dividing the PCT by the CCT. The AL was measured with the IOL Master, and the SE was obtained with subjective refraction. RESULTS AL was 25.18±1.16 mm, 26.59±1.26 mm and 29.45±2.58 mm and SE was -3.31±1.40 D, -8.32±1.64 D and -16.44±4.48 D for groups #1, #2 and #3, respectively. Non-statistically significant differences in central and peripheral corneal thickness were found between groups (P>0.05 ANOVA). Non-significant relationship was found between central and peripheral corneal thickness with the AL and SE in the three study groups and in the total sample (r<0.24; P>0.05). The RPI values were similar between groups without significant difference between groups (P>0.05 ANOVA). Linear relationship was found between RPI superior location in group #2 (r=-0.23; P=0.04) and RPI nasal location in group #3 with the EE (r=0.41; P=0.03). CONCLUSION There are no significant differences among low, moderate and extremely myopic eyes related to the CCT and PCT. Corneal thickness is very similar in myopic eyes with small differences that are not clinically relevant to myopic patient management.
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Affiliation(s)
- Sara Ortiz
- Optometry Research Group, IOBA-Eye Institute, University of Valladolid, Valladolid, Spain
| | - Laura Mena
- Optometry Research Group, IOBA-Eye Institute, University of Valladolid, Valladolid, Spain
| | - Ana Rio-San Cristobal
- Optometry Research Group, IOBA-Eye Institute, University of Valladolid, Valladolid, Spain
| | - Raul Martin
- Optometry Research Group, IOBA-Eye Institute, University of Valladolid, Valladolid, Spain; Department of Physics TAO, School of Optometry, University of Valladolid, Valladolid, Spain.
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Corneal biomechanical properties: precision and influence on tonometry. Cont Lens Anterior Eye 2013; 37:124-31. [PMID: 24121009 DOI: 10.1016/j.clae.2013.09.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 08/19/2013] [Accepted: 09/16/2013] [Indexed: 11/23/2022]
Abstract
PURPOSE To assess the precision and reproducibility of the corneal biomechanical parameters, and their relationships with the intraocular pressure (IOP) measured with the Goldmann tonometer and a noncontact tonometer. METHODS Readings for biomechanical properties and for IOP measured with the Goldmann and noncontact tonometers, were taken on one randomly selected eye of 106 normal subjects, on each one of two measurement sessions. Measurements with the ocular response analyzer (ORA) and the noncontact tonometer were randomized, followed by the measurement of central corneal thickness and with the Goldmann tonometer. RESULTS Repeatability coefficients for CCT, corneal hysteresis (CH) and corneal resistance factor (CRF) in Session 1 were ± 0.01 μm, ± 3.05 mmHg and ± 2.62 mmHg, respectively. The mean CCT, CH, CRF, Goldmann and noncontact tonometry did not vary significantly between sessions. Reproducibility coefficients for CCT, CH and CRF were ± 0.02 μm, ± 2.19 mmHg and ± 1.97 mmHg, respectively. Univariate regression analysis showed that CCT, CH and CRF significantly (P<0.0001) correlated with the IOP measured with the Goldmann and noncontact tonometers (and with the differences between tonometers) in Session 1. There were no significant correlations with the differences between tonometers in Session 2. Multivariate analysis revealed a minimal effect of CCT on Goldmann measurements but a significant effect on those of the noncontact tonometer. CONCLUSIONS Measurement of the biomechanical properties of the cornea, using the ORA, are repeatable and reproducible, affect Goldmann tonometry less than noncontact tonometry, and have a minimal influence on the difference in measured intraocular pressure between tonometers.
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Tsikripis P, Papaconstantinou D, Koutsandrea C, Apostolopoulos M, Georgalas I. The effect of prostaglandin analogs on the biomechanical properties and central thickness of the cornea of patients with open-angle glaucoma: a 3-year study on 108 eyes. Drug Des Devel Ther 2013; 7:1149-56. [PMID: 24115838 PMCID: PMC3793594 DOI: 10.2147/dddt.s50622] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the effect of prostaglandin analogs (PGAs) on the biomechanical properties (corneal hysteresis [CH], corneal resistance factor [CRF]) and central corneal thickness (CCT) of patients with open-angle glaucoma. Methods A total of 108 eyes were prospectively included for repeated measurements of intraocular pressure (IOP) with Goldmann applanation tonometry (GAT) and ocular response analyzer (ORA), CCT, followed by CH and CRF measurements by the ORA, during the same visit. Of these, 66 were treated with latanoprost, and 42 were treated with latanoprost and timolol. IOP, CH, CRF, and CCT were measured before treatment and at 6-month intervals. Results It appears that under local PGA treatment, IOP values decreased and CH and CCT significantly increased, whereas CRF did not. CCT slightly but significantly increased at all time points of the study (0.50–3.00 μm and 1.50–5.50 μm), and we observed a constant significant increase in CH (0.4–0.7 mmHg and 0.65–0.95 mmHg). Concerning the correlation of GAT IOP with CCT and CH, it was found that at the time points 0, 1, and 2 there were statistically significant correlations. Conclusion The changes of CCT and CH under PGA treatment in clinical practice may influence IOP measurements and patient follow-up significantly. This should be investigated further to confirm the relationship between corneal properties and treatment of open-angle glaucoma.
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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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Medeiros FA, Meira-Freitas D, Lisboa R, Kuang TM, Zangwill LM, Weinreb RN. Corneal hysteresis as a risk factor for glaucoma progression: a prospective longitudinal study. Ophthalmology 2013; 120:1533-40. [PMID: 23642371 DOI: 10.1016/j.ophtha.2013.01.032] [Citation(s) in RCA: 199] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Revised: 12/20/2012] [Accepted: 01/15/2013] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To evaluate the role of corneal hysteresis (CH) as a risk factor for the rate of visual field progression in a cohort of patients with glaucoma followed prospectively over time. DESIGN Prospective observational cohort study. PARTICIPANTS The study group included 114 eyes of 68 patients with glaucoma followed for an average of 4.0 ± 1.1 years. Visual fields were obtained with standard automated perimetry. Included eyes had a median number of 7 (range, 5-12) tests during follow-up. METHODS The CH measurements were acquired at baseline using the Ocular Response Analyzer (Reichert Instruments, Depew, NY). Evaluation of rates of visual field change during follow-up was performed using the visual field index (VFI). Linear mixed models were used to investigate the relationship between rates of visual field loss and baseline CH, baseline intraocular pressure (IOP), and central corneal thickness (CCT), while adjusting for potentially confounding factors. An interaction term between IOP and CH was included in the model to investigate whether the effect of IOP on rates of progression depended on the level of CH. MAIN OUTCOME MEASURES Effects of CH, IOP, and CCT on rates of VFI loss over time. RESULTS The CH had a significant effect on rates of visual field progression over time. In the univariable model including only CH as a predictive factor along with time and their interaction, each 1 mmHg lower CH was associated with a 0.25%/year faster rate of VFI decline over time (P<0.001). The multivariable model showed that the effect of IOP on rates of progression depended on CH. Eyes with high IOP and low CH were at increased risk for having fast rates of disease progression. The CH explained a larger proportion of the variation in slopes of VFI change than CCT (17.4% vs. 5.2%, respectively). CONCLUSIONS The CH measurements were significantly associated with risk of glaucoma progression. Eyes with lower CH had faster rates of visual field loss than those with higher CH. The prospective longitudinal design of this study supports the role of CH as an important factor to be considered in the assessment of the risk of progression in patients with glaucoma. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Felipe A Medeiros
- Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, California, USA.
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Meyer LM, Schönfeld CL. Secondary glaucoma after intravitreal dexamethasone 0.7 mg implant in patients with retinal vein occlusion: a one-year follow-up. J Ocul Pharmacol Ther 2013; 29:560-5. [PMID: 23480270 DOI: 10.1089/jop.2012.0253] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To investigate the rate of secondary glaucoma after intravitreal dexamethasone 0.7 mg (Ozurdex(®)) implantation over a clinical treatment period of 1 year. METHODS A prospective study of a series of 16 patients (9 males, 7 females; mean age 76 years) suffering from central- or branch retinal vein occlusion treated with dexamethasone 0.7 mg were followed up for 12 months. Main outcome measures were intraocular pressure (IOP) determined with Goldmann applanation tonometry (GAT) and Pascal dynamic contour tonometry (DCT), as well as best-corrected visual acuity (BCVA) and central retinal thickness measured with optical coherence tomography (OCT). RESULTS BCVA (logMAR) improved in treated patients from mean 0.81 at baseline to a peak of 0.47 after 2 months but declined irrespective of reinjections to 0.87 at 12 months. Central retinal thickness measured with OCT initially decreased but increased again with recurring macular edema. 69% of patients treated with dexamethasone 0.7 mg had an IOP increase of at least 5 mmHg. In total, 50% of patients had an increase of ≥10 mmHg during the studied period. The IOP increase in treated eyes was significant 1, 2, 3, and 8 months after dexamethasone 0.7 mg implantation. CONCLUSION Secondary glaucoma after intravitreal injection of dexamethasone 0.7 mg might be underestimated in the GENEVA studies. The clinical safety profile reported here calls for thorough identification of suitable patients and frequent IOP control if dexamethasone 0.7 mg (Ozurdex) is applied as a long-term treatment.
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Ogbuehi KC, Mucke S, Osuagwu UL. Influence of central corneal thickness on measured intraocular pressure differentials: Nidek RKT-7700, Topcon CT-80 NCTs and Goldmann Tonometer. Ophthalmic Physiol Opt 2012; 32:547-55. [PMID: 23009324 DOI: 10.1111/j.1475-1313.2012.00945.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 08/31/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE We sought to compare the intraocular pressure (IOP) measured by RKT-7700 and CT-80 noncontact tonometers (NCTs) with that measured by Goldmann applanation tonometry (GAT). We also examined the influence of central corneal thickness (CCT) on the agreement between both NCTs and GAT in a sub-population of healthy, young normals. METHODS Triplicate IOP and CCT measurements were obtained twice from one randomized eye of 49 subjects (28 males and 21 females) aged 22.2 ± 1.3 (mean ± S.D.) years. Goldmann tonometry was performed subsequent to assessment with the RKT-7700 and CT-80, to negate the 'ocular massage effect', followed by ultrasound pachymetry. The results from each method were compared and assessed for repeatability and between-observer reproducibility. Analysis was performed to determine the correlation between the differences in IOP measurements and corneal thicknesses. RESULTS The mean differences (±S.D.) in sessions 1 and 2 respectively between RKT-7700 and GAT (2.6 ± 2.0 and 2.7 ± 1.4 mmHg), between CT-80 and GAT (2.8 ± 2.0 and 3.2 ± 1.3 mmHg) were statistically significant (p < 0.0001). The repeatability coefficients in sessions 1 and 2 respectively were; ±1.2 and ±1.0 mmHg (GAT), ±1.3 and ±1.6 mmHg (CT-80), ±2.3 and ±1.7 mmHg (RKT-7700) and inter-observer reproducibility was; ±1.9 (RKT-7700), ±2.3 (GAT) and ±2.6 mmHg (CT-80). Between the corneal thickness and the differences in GAT-measured and NCT-measured IOPs, there was a significant negative correlation and a trend for a larger difference in thicker corneas. CONCLUSION Neither the RKT-7700 nor the CT-80 can be used interchangeably with the Goldmann tonometer, although all three tonometers give repeatable measurements of IOP, in this sub-population. IOP differences between GAT and the NCTs significantly correlated with CCT, with the possibility of even greater differences in thicker corneas.
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Affiliation(s)
- Kelechi C Ogbuehi
- Corneal Research Chair, Department of Optometry and Vision Sciences, King Saud University, Riyadh, Saudi Arabia
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Detorakis ET, Pallikaris IG. Ocular rigidity: biomechanical role,
in vivo
measurements and clinical significance. Clin Exp Ophthalmol 2012; 41:73-81. [PMID: 22594543 DOI: 10.1111/j.1442-9071.2012.02809.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Efstathios T Detorakis
- Department of Ophthalmology, University Hospital of Heraklion, and Institute of Vision and Optics (IVO), Heraklion, Crete, Greece
| | - Ioannis G Pallikaris
- Department of Ophthalmology, University Hospital of Heraklion, and Institute of Vision and Optics (IVO), Heraklion, Crete, Greece
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Comparison of dynamic contour tonometry and Goldmann applanation tonometry in relation to central corneal thickness in primary congenital glaucoma. Graefes Arch Clin Exp Ophthalmol 2012; 251:117-21. [PMID: 22555897 DOI: 10.1007/s00417-012-2027-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 02/13/2012] [Accepted: 04/03/2012] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND To compare intraocular pressure (IOP) measurements obtained with dynamic contour tonometer (DCT) and Goldmann applanation tonometer (GAT), and to investigate their relationship to central corneal thickness (CCT) in primary congenital glaucoma (PCG) eyes. METHODS Thirty-one eyes of 31 PCG patients (25.7 ± 7.2 years old) were examined. PCG was defined as elevated IOP, enlarged corneal diameter (buphthalmos), Haab's striae and abnormal findings at gonioscopy. The mean of three measurements of GAT, DCT (quality scores 1 and 2), and CCT were obtained and assessed for agreement by means of Bland-Altman plot and for Spearman correlation test. RESULTS Mean CCT was 534 ± 72.3 μm (range: 430 to 610 μm). Mean IOP measurements were 15.1 ± 4.2 mmHg (range: 5.5 to 22.7 mmHg) for DCT and 14.5 ± 5.6 mmHg (range: 7.0 to 34.0 mmHg) for GAT (P = 0.244). Spearman correlation tests showed that IOP difference (DCT - GAT) was not correlated with CCT (r (2) = 0.023, P = 0.417). IOP measurements by DCT were weakly but statistically correlated with those obtained with GAT (r(2) = 0.213, P = 0.0089). Bland-Altman analysis revealed poor agreement between DCT and GAT readings, considering the 95 % confidence intervals of ± 10.45 mmHg. CONCLUSIONS The differences between DCT and GAT readings were not influenced by CCT in this series of patients. Considering the weak correlation and the poor agreement observed between GAT and DCT measurements and that they both may be affected by corneal biomechanical changes, these methods should not be used interchangeably, and may possibly give no meaningful IOP values in PCG patients.
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