Diurnal Alterations of Refraction, Anterior Segment Biometrics, and Intraocular Pressure in Long-Time Dehydration due to Religious Fasting

Changes in Ocular Biometric Parameters Over a 24-Hour Period in Ocular Hypertensive Patients

Purpose: To identify 24-h changes in ocular biometric parameters in subjects with ocular hypertension (OHT), and to determine if an intraocular pressure (IOP)-lowering drug alters these parameters. Methods: Thirty volunteers with OHT (58.6 ± 9.2 years of age) were enrolled in this randomized, double-masked, placebo-controlled, crossover study. Participants self-administered 0.2% brimonidine or placebo 3 times daily for 6 weeks. Measurements of seated and supine IOP, central cornea thickness (CCT), anterior chamber depth (ACD), axial length (AXL), and lens thickness were made at 8 am, 3 pm, 8 pm, and 3 am. Statistical tests were Student's 2-tailed paired t-tests or 2-way analysis of variance (ANOVA) followed by one-way ANOVA and post hoc testing. Results: Time of day had a significant effect on IOP, CCT, ACD, and AXL. In placebo-treated eyes, CCT was greater at 3 am than at any other time (P < 0.01), ACD and AXL were greater at 3 am and 8 pm than at 3 pm (P < 0.01). Daytime IOPs were higher than nighttime (seated, P = 0.007; supine, P = 0.018), and supine IOP at night was higher than seated IOP during the day (P < 0.001). Brimonidine did not lower IOP at night nor did it alter the 24-h patterns of CCT, ACD, and AXL. Conclusions: Ocular biometric parameters exhibit characteristic 24-h fluctuations in patients with OHT. At night compared with day, the supine IOP increases, the cornea thickens, the anterior chamber deepens, and the AXL increases. Brimonidine does not alter these parameters at times when it lowers IOP (day) nor when it does not (night). Clinical Trial Registration number: NCT0132419.

Intermittent Fasting to the Eye: A New Dimension Involved in Physiological and Pathological Changes

Intermittent fasting (IF) is gaining popularity as a therapeutic dietary strategy that regulates metabolism and can alter the development of metabolic disorders. An increasing amount of research has connected ocular diseases to IF and discovered that it has a direct and indirect effect on the eye’s physiological structure and pathological alterations. This article summarizes the progress of research on IF in regulating the physiological structures of the ocular vasculature, the anterior segment of the eye, the retina, and the choroid. We explored the therapeutic potential of IF for various common ocular diseases. In the future, a comprehensive study into the fundamental processes of IF will provide a direct and rigorous approach to eye disease prevention and therapy.

Evaluation of the effect of fasting on intraocular pressure, anterior segment parameters and density of crystalline lens and cornea

PURPOSE

To evaluate the effect of fasting on anterior chamber depth, anterior chamber volume and corneal and lens density by Scheimpflug technology and to measure intraocular pressure changes.

METHODS

Totals of 50 healthy fasting individuals in Ramadan (study group) and 50 healthy non-fasting subjects (control group) were included. Central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber volume (ACV), corneal density (CD) and lens density (LD) were evaluated with Scheimpflug technology. Intraocular pressure (IOP) was measured with applanation tonometry. Both eyes of each participant were examined and also compared.

RESULTS

Comparison of groups: There was a statistically significant difference between CD, ACD, ACV and IOP (respectively, right/left eye: fasting: CD: 12.81 ± 0.76/12.73 ± 0.73; ACD: 2.92 ± 0.37 mm/2.93 ± 0.37 mm; ACV: 168.3 ± 41.82 mm³/183.34 ± 32.46 mm³; IOP: 13.80 ± 1.22 mmHg/14.88 ± 2.73 mmHg; non-fasting: CD: 13.28 ± 1.01/13.17 ± 0.77; ACD: 3.06 ± 0.31 mm/3.07 ± 0.31 mm; ACV: 167.46 ± 42.92 mm³/180.68 ± 31.45 mm³; IOP: 13.60 ± 1.65 mmHg/14.74 ± 2.93 mmHg) values on the right side (p < 0.01, p = 0.03, p = 0.04, p = 0.01, respectively). Although there was a statistically significant difference between the ACV, CD and IOP values on the left side (p < 0.01, p = 0.03, p = 0.01, respectively), no statistical significance was found for the ACV value on the left side (p = 0.08).

CONCLUSION

The results demonstrated that, while fasting did not lead to any change in LD and CCT, it caused a small decrease in ACD and ACV, and a significant decrease in CD and IOP values. Scheimpflug technology seems to be a valuable tool for the evaluation of anterior segment changes in patients who are fasting.

Investigation of the effects of Islamic fasting on ocular parameters

Purpose

To investigate the effects of religious fasting during the month of Ramadan on intraocular pressure (IOP), refractive error, corneal tomography and biomechanics, ocular biometry, and tear film layer properties.

Methods

This prospective study was carried out one week before and in the last week of Ramadan. Ninety-four eyes of 94 healthy adult volunteers (54 males and 40 females) with a mean ± SD age of 35.12 ± 9.07 were enrolled in this study. Patients with any systemic disorder, ocular disease, or a history of previous surgery were excluded. Corneal tomography and biomechanics, ocular biometry, IOP, refractive error, and tear break up time (TBUT) were evaluated in non-fasting and fasting periods by the Pentacam (Oculus), Corvis ST (Oculus), IOL Master (Carl Zeiss), computerized tonometer (Topcon CT-1/CT-1P), auto kerato-refractometer (Topcon KR-1), and Keratograph 5M (Oculus), respectively.

Results

There was no significant difference in the central corneal thickness (CCT) between the study groups (P = 0.123) using the Pentacam while the Corvis ST showed a significant difference in all participants (P < 0.0001). Moreover, the peak distance (distance of the two surrounding peaks of the cornea at the highest concavity) of male and female participants showed a significant difference between the fasting and non-fasting groups (P = 0.002). The anterior chamber depth (ACD) using the Pentacam decreased in the male group (P = 0.004) in the fasting period. During the fasting period, computerized tonometer showed a decrease in IOP only in males in comparison to the non-fasting group (P = 0.018) while the Corvis ST showed decreased IOP in all participants (P < 0.0001). The steep keratometry (K2) in the corneal posterior surface appeared to be different in males between the study groups (P = 0.034). We were unable to show any significant difference in other ocular parameters between fasting and non-fasting periods.

Conclusion

This study showed that ACD, IOP, CCT, and peak distance were different between fasting and non-fasting groups while no difference was observed in other ocular parameters. Interpretations of these significant differences should be considered in the clinical setting.