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Nayak A, Ramesh SV, Kuzhuppilly NIR, Pai VH, Chaitanya A. Performance of home-based self-tonometry (iCare HOME (TA022)) for measuring intraocular pressure among healthy and glaucoma patients. F1000Res 2023; 12:128. [PMID: 38894819 PMCID: PMC11184277 DOI: 10.12688/f1000research.123104.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 06/21/2024] Open
Abstract
Introduction: The purpose of this study was to compare iCare HOME (TA022) with Goldmann applanation tonometer and to evaluate the self-tonometry measurements among the Indian population. Methods: Eligible patients underwent iCare HOME training through guided demonstration (verbal, pictorial, video) and practised self-tonometry measures using iCare HOME. Certification for independent iCare HOME measure was provided if first iCare HOME intraocular pressure (IOP) measurement fell within ± 5 mmHg of Goldmann applanation tonometer (GAT) measurement which was measured by the trained clinician (principal investigator). Certified participants underwent simulated home self-tonometry measurements using iCare HOME, and agreement with GAT IOP measurements was assessed. Results: Seven of 83 participants (8.43%) failed to complete the study due to difficulty in performing the task, leading to non-certification. Patients who could use the iCare HOME had a mean age of 53 ± 15.55years (53% males; 46% females). Only one in 12 subjects did not qualify to use iCare HOME. The overall mean difference between iCare HOME and GAT was 0.83 mmHg (95%, 3.92 and -2.25). At various pressure ranges, 7-16 mmHg, 17-23 mmHg and >23 mmHg, the mean difference between iCare HOME and GAT was 1.22 mmHg (95%, 4.32 and -1.86), 0.77 mmHg (95%,3.69 and -2.19), -0.11 mmHg (95%, 2.52 and -2.74) respectively. The intra-class correlation coefficient of the iCare HOME device was 0.997(95% CI,0.995-0.998). Conclusions: Patients were able to perform self- tonometry using iCare HOME with good reliability and safety. iCare HOME can be used to address the issue of difficulty in acquiring frequent and diurnal IOP measurements by patients doing self-tonometry from home.
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Affiliation(s)
- Anush Nayak
- Department of Allied Health Sciences,Faculty of Life & Allied Health Sciences(FLAHS), Ramaiah University of Applied Sciences, Bangalore, Karnataka, 560054, India
- Department of Optometry, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, Udupi (Dist), Karnataka, 576104, India
| | - S Ve Ramesh
- Department of Optometry, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, Udupi (Dist), Karnataka, 576104, India
| | - Neetha I R Kuzhuppilly
- Department of Ophthalmology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education (MAHE), Manipal, Udupi (Dist), Karnataka, 576104, India
| | - Vijaya H Pai
- Department of Ophthalmology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education (MAHE), Manipal, Udupi (Dist), Karnataka, 576104, India
| | - Aditya Chaitanya
- Department of Optometry, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, Udupi (Dist), Karnataka, 576104, India
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Porwal AC, Shrishrimal M, Punamia RP, Mathew BC. Assessment of intraocular pressure measurement between Goldman applanation tonometer, rebound tonometer, non-contact tonometer, and its correlation with central corneal thickness. Indian J Ophthalmol 2023; 71:1927-1931. [PMID: 37203058 PMCID: PMC10391371 DOI: 10.4103/ijo.ijo_1982_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
Purpose To compare readings of intraocular pressure (IOP) taken with the Goldmann applanation tonometer (GAT), the non-contact tonometer (NCT), and the rebound tonometer (RBT), and to compare their correlation with central corneal thickness (CCT). Methods This was a prospective, cross-sectional, observational study to which patients above 18 years of age were enrolled. A total of 400 eyes of 200 non-glaucomatous patients underwent IOP recordings using the GAT, NCT, and RBT, and CCT was also noted. Informed consent of the patients was taken. The IOP readings taken via the three methods were compared and correlated with CCT. Paired t test was used to compare the two devices. Simple and multivariate linear regression analyses were used to study the relationship between factors. A P value less than 0.05 was considered significant. Correlation was determined using the Pearson correlation coefficient, and a Bland-Altman graph was plotted. Results Mean IOP measured by the NCT was 15.65 ± 2.80 mmHg, by the RBT was 14.23 ± 3.05 mmHg, and by the GAT was 14.69 ± 2.97 mmHg. The mean CCT was 510.61 ± 33.83 microns. The difference between mean IOP recorded by the NCT and that by the RBT was 1.41 ± 2.39 mmHg, between the NCT and GAT was 0.95 ± 2.03 mmHg, and between the GAT and RBT was 0.45 ± 2.22 mmHg. The difference between the IOP values was statistically significant (P < 0.005). All tonometers showed a statistically significant correlation with CCT, but it was observed that the NCT had a stronger correlation (0.4037). Conclusion The IOP readings taken by all the three methods were comparable; however, RBT values were closer to GAT values. CCT did influence the IOP values, and this should be kept in mind while evaluating.
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Affiliation(s)
- Amit C Porwal
- Senior Consultant Cataract and Head Glaucoma Services, Department of Cataract and Glaucoma, Choithram Netralaya, Indore, Madhya Pradesh, India
| | - Meghna Shrishrimal
- Department of Community Ophthalmology, Choithram Netralaya, Indore, Madhya Pradesh, India
| | - Ravin P Punamia
- Department of Ophthalmology, Choithram Netralaya, Indore, Madhya Pradesh, India
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Pesonen T, Saarela KM, Falck A, Edgren J, Kyngäs H, Siira H. Visual impairment and the need for vision care services amongst older Finnish people receiving home care. Nurs Open 2023; 10:2519-2529. [PMID: 36564916 PMCID: PMC10006660 DOI: 10.1002/nop2.1510] [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: 07/28/2022] [Revised: 10/25/2022] [Accepted: 11/20/2022] [Indexed: 12/25/2022] Open
Abstract
AIM This study aimed to describe visual performance and the need for vision care services among Finnish older people receiving home care. We evaluated the applicability of the Resident Assessment Instrument of Home Care (RAI HC) in identifying visual impairment (VI) and the need for vision care services among older people. DESIGN A descriptive quantitative, cross-sectional design. METHODS Visual impairment and the need for vision care services for older people receiving home care (N = 70) were determined by an optometrist's screening examination and vision assessment by home care workers using the RAI HC instrument. In this study, the definition of visual impairment was visual acuity (VA) <0.63 (logMAR >0.2). RESULTS According to the distance VA measurements, 41% of the participants showed VI (<0.63) of the better eye, while the RAI HC assessment revealed VI among 36% of the participants. The Kappa value for interrater reliability in classifying VI was 0.137. The optometrist's vision screening examination recognized a previously unknown and unmet need for vision care services more than twice as often as the RAI HC assessment.
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Affiliation(s)
- Tiina Pesonen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Kaisa-Mari Saarela
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Aura Falck
- Department of Ophthalmology, Oulu University Hospital, Oulu, Finland
| | - Johanna Edgren
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Helvi Kyngäs
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Heidi Siira
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
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Zorić Geber M, Lončarić K, Škunca Herman J, Krolo I, Tadić R, Belak M, Koluder A, Kaurić Ž, Knežević L, Novak-Lauš K, Runjić T, Vatavuk Z. The analysis of the glaucoma screening event results obtained during the World Glaucoma Week in Zagreb, Croatia. Int Ophthalmol 2022; 42:3129-3136. [PMID: 35567692 DOI: 10.1007/s10792-022-02312-7] [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: 10/07/2021] [Accepted: 04/18/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To report the prevalence of undiagnosed glaucoma, as well as demographic characteristics and risk factors among glaucoma suspects who were detected in a publicly promoted intraocular pressure (IOP) based glaucoma screening event. METHODS A total of 2468 subjects older than 18 years participated in the glaucoma screening event in Zagreb, in 2014, which included a medical interview and IOP measurement using Icare tonometer. 256 subjects (10.37%) were identified as glaucoma suspects, out of which 125 (5.06%) subjects underwent further detailed ophthalmic examination and were classified into five diagnostic groups. RESULTS The prevalence of all types of newly diagnosed glaucoma was 1.175%, while the prevalence of ocular hypertension (OH), primary open-angle glaucoma (POAG), primary angle closure (PAC) and secondary glaucoma (SG) was 0.16%, 0.89%, 0.16% and 0.12%, respectively. The prevalence of newly diagnosed glaucoma in glaucoma suspects was 23.2%. 17.60% of glaucoma suspects were diagnosed as POAG. Older age was statistically significantly associated with POAG (p = 0.001) and PAC (p = 0.029). At the univariate level, refractive errors were a statistically significant predictor of POAG, and those with hyperopia had more than three times larger odds for POAG. At the multivariate level, none of the predictors reached statistical significance. CONCLUSION Successful cooperation between healthcare institutions and media can be a useful way of increasing awareness and detection of individuals at an increased risk for developing glaucoma.
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Affiliation(s)
- Mia Zorić Geber
- University Department of Ophthalmology and Optometry, Sestre Milosrdnice University Hospital Center, Vinogradska 29, Zagreb, Croatia.
| | - Kristina Lončarić
- University Department of Ophthalmology and Optometry, Sestre Milosrdnice University Hospital Center, Vinogradska 29, Zagreb, Croatia
| | - Jelena Škunca Herman
- University Department of Ophthalmology and Optometry, Sestre Milosrdnice University Hospital Center, Vinogradska 29, Zagreb, Croatia
| | - Iva Krolo
- University Department of Ophthalmology and Optometry, Sestre Milosrdnice University Hospital Center, Vinogradska 29, Zagreb, Croatia.,Optical Express Group, Strojarska cesta 18, Zagreb, Croatia
| | - Rašeljka Tadić
- University Department of Ophthalmology and Optometry, Sestre Milosrdnice University Hospital Center, Vinogradska 29, Zagreb, Croatia
| | - Marin Belak
- University Department of Ophthalmology and Optometry, Sestre Milosrdnice University Hospital Center, Vinogradska 29, Zagreb, Croatia
| | - Ana Koluder
- University Department of Ophthalmology and Optometry, Sestre Milosrdnice University Hospital Center, Vinogradska 29, Zagreb, Croatia.,Department of Ophthalmology, General Hospital Koprivnica, Ul. doktora Željka Selingera bb, Koprivnica, Croatia
| | - Željko Kaurić
- University Department of Ophthalmology and Optometry, Sestre Milosrdnice University Hospital Center, Vinogradska 29, Zagreb, Croatia
| | - Lana Knežević
- University Department of Ophthalmology and Optometry, Sestre Milosrdnice University Hospital Center, Vinogradska 29, Zagreb, Croatia
| | - Katia Novak-Lauš
- University Department of Ophthalmology and Optometry, Sestre Milosrdnice University Hospital Center, Vinogradska 29, Zagreb, Croatia
| | - Tina Runjić
- Faculty of Education and Rehabilitation Sciences, University of Zagreb, Borongajska cesta 83f, Zagreb, Croatia
| | - Zoran Vatavuk
- University Department of Ophthalmology and Optometry, Sestre Milosrdnice University Hospital Center, Vinogradska 29, Zagreb, Croatia
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Powell S, Doolan E, Curtin K, Doyle A, O'Brien C. Audit of outcomes following attendance at the City West drive-through IOP glaucoma clinic during the COVID-19 pandemic. Ir J Med Sci 2022; 191:2813-2822. [PMID: 35034276 PMCID: PMC8761105 DOI: 10.1007/s11845-021-02893-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/07/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Glaucoma is the leading cause of irreversible blindness globally. During the COVID-19 pandemic, an enforced reduction in capacity resulted in the deferral of routine outpatient appointments for glaucoma patients. AIM This study analyses patient outcomes following the establishment of a drive-through intra-ocular pressure (IOP) clinic during the COVID-19 pandemic to alleviate increased pressure on the tertiary glaucoma services at Royal Victoria Eye and Ear Hospital (RVEEH) and Mater Misericordiae University Hospital (MMUH) between August 2020 and June 2021. METHODS A 1-lane driveway system was established in a marquee on the grounds of City West hotel. IOPs were measured in patients' cars using a hand held iCare100 tonometer. Results were reviewed by a consultant ophthalmologist. At hospital follow-up clinic visits, IOP was measured using the Goldmann applanation tonometer (GAT). RESULTS Three hundred one patients of a total of 672 who attended the drive-through clinic have subsequently attended a designated hospital follow-up appointment. In this cohort, the mean drive-through iCare IOP of 19.4 mmHg ± 6.0 was significantly higher (< 0.005) than the mean GAT IOP at the pre-drive through clinic visit (16.3 mmHg ± 3.7) and the post drive-through hospital follow-up visit (17.2 mmHg ± 4.1). Two hundred twenty-six (75%) patients did not need any treatment change, 53 (18%) required eye drop medication changes, 10 (3%) underwent a laser procedure, 4(1%) required surgical intervention, and 8 (3%) were discharged. When patient outcomes were analysed according to IOP grade assigned at the drive-through clinic, those with an iCare IOP < 21 were significantly less likely to require a treatment change. The cohort with iCare IOP ≥ 30 were significantly more likely to have a laser or surgical intervention. CONCLUSION The implementation of a drive-through IOP clinic was a safe and effective way to monitor glaucoma patients during COVID-19, and identify those at high risk of poor IOP control or requiring a change in treatment.
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Affiliation(s)
- Sarah Powell
- Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Emer Doolan
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Karen Curtin
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Aoife Doyle
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Colm O'Brien
- Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland.
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Fortepiani L, Foutch BK, Wilson MR. The Effects of Sex, Oral Contraception, and Menstrual Cycle Phase on Intraocular Pressure, Central Corneal Thickness, and Foveal Thickness: A Descriptive Analysis. Vision (Basel) 2021; 5:vision5040048. [PMID: 34698316 PMCID: PMC8544721 DOI: 10.3390/vision5040048] [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: 09/09/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 01/03/2023] Open
Abstract
The primary goal of this study was to investigate the effects of sex, oral contraceptive (OC) use, and menstrual cycle phase on common ocular parameters assessed during ophthalmic evaluations, namely intraocular pressure (IOP), central corneal thickness (CCT), and foveal thickness (FT), in young healthy adults. We measured IOP, CCT, and FT in 60 participants (16 men, 16 contraceptive users, and 28 cycling women) over two sessions that characterized the menstrual cycle phase in women. For men in our study, two sessions were separated by two weeks. For women, the two sessions were scheduled during the follicular and luteal phases of the menstrual cycle. There was a trend towards higher IOP in men, and the difference was significant for white, non-Hispanic subjects and for white subjects considered separately. There was also a trend for thicker corneas in women, but men had significantly thicker foveae. CCT and FT were not different between men and OC-users, hinting at a moderating hormonal effect of oral contraceptive use. We found that IOP, CCT, and FT were equivalent between the follicular and luteal phases, which may be owing to the timing of our sessions. However, our findings strongly suggest that clinicians should consider contraceptive use during routine ophthalmic evaluations, as it could inform glaucomatous risk in women.
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Affiliation(s)
- Lourdes Fortepiani
- Rosenberg School of Optometry, University of the Incarnate Word, San Antonio, TX 78229, USA; (L.F.); (M.R.W.)
- Department of Cellular and Integrative Physiology, UT Health San Antonio, San Antonio, TX 78229, USA
| | - Brian K. Foutch
- Rosenberg School of Optometry, University of the Incarnate Word, San Antonio, TX 78229, USA; (L.F.); (M.R.W.)
- Correspondence: or ; Tel.: +1-210-930-8162
| | - Molly R. Wilson
- Rosenberg School of Optometry, University of the Incarnate Word, San Antonio, TX 78229, USA; (L.F.); (M.R.W.)
- Omni Vision, San Antonio, TX 78245, USA
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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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8
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Ocular manifestations in phakomatosis pigmentovascularis: Current concepts on pathogenesis, diagnosis, and management. Surv Ophthalmol 2020; 66:482-492. [PMID: 33058925 DOI: 10.1016/j.survophthal.2020.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 09/30/2020] [Accepted: 10/05/2020] [Indexed: 02/03/2023]
Abstract
Phakomatosis pigmentovascularis is a rare congenital multisystemic disease with variable manifestations where a vascular malformation of the skin is associated with a pigmentary nevus. Ocular involvement includes glaucoma, choroidal hemangioma, and pigmentary alterations that predispose to uveal melanoma. Diagnosis is made on clinical grounds, although recent advances in molecular genetics have better clarified the etiopathogenesis of the condition. The advent of improved imaging techniques such as enhanced depth imaging spectral domain optical coherence tomography has provided new insight into the ocular alterations, enabling better follow-up of patients. We review the ophthalmic manifestations of the disease with an update on etiopathogenesis and current management strategies.
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Short-Term Effects of Dark Chocolate on Retinal and Choriocapillaris Perfusion in Young, Healthy Subjects Using Optical Coherence Tomography Angiography. Nutrients 2020; 12:nu12030664. [PMID: 32121339 PMCID: PMC7146134 DOI: 10.3390/nu12030664] [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: 01/23/2020] [Revised: 02/25/2020] [Accepted: 02/25/2020] [Indexed: 11/17/2022] Open
Abstract
(1) Aim: Contrasting results have been published on the effect of dark chocolate on visual function. The aim of this study was to evaluate retinal and choriocapillaris perfusion, using optical coherence tomography angiography (OCT-A), and visual function in healthy subjects following dark chocolate ingestion. (2) Methods: This prospective randomized study was carried out on 18 healthy young subjects at the St. Andrea Hospital, Sapienza, University of Rome. Visual acuity assessment and a complete ophthalmologic examination were carried out at baseline. In session one, each subject was randomized to eat either a 100 g dark chocolate bar or a 100 g white chocolate bar. In session two, the opposite chocolate was given to each participant. OCT-A and best corrected visual acuity (BCVA) were performed before the chocolate was eaten and repeated 1, 2, and 3 h after that. Retinal vessel density and choriocapillaris flow area were assessed. (3) Results: 18 patients with a mean (SD) age of 26.3 (1.5) years were included. No significant differences between dark or white chocolate were found when evaluating foveal density (%), whole density (%), choriocapillaris flow area, and BCVA. (4) Conclusions: Dark chocolate did not result in significant changes in retinal perfusion and choriocapillaris flow area. However, given the results of other studies showing the positive effects of flavonoids on visual function, further studies are warranted using pure chocolate without other components such as caffeine that can potentially affect results. Furthermore, we cannot rule out the possible benefits of higher doses of flavonoids in dietary supplementation over a more extended period and in a larger patient population.
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Effect of Near Work on Intraocular Pressure in Emmetropes. J Ophthalmol 2020; 2020:1352434. [PMID: 32082620 PMCID: PMC7007961 DOI: 10.1155/2020/1352434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 12/16/2019] [Accepted: 01/11/2020] [Indexed: 11/06/2022] Open
Abstract
Objective To determine whether accommodation induced by reading alters intraocular pressure (IOP) in healthy, young, emmetropic adults and to document the duration and magnitude of this effect. Design Cross-sectional study. Participants. Fifteen healthy, emmetropic young adults. Methods Subjects performed 20 minutes of near work (reading at 33 cm) followed by 20 minutes of far work (reading at 520 cm) while IOP was measured using an iCare tonometer at baseline and every 5 minutes thereafter. Statistical analysis was performed using repeated measures ANOVA. Main Outcome Measures. Intraocular pressure. Results IOP decreased significantly compared to baseline IOP after 10 minutes of near work (average change of −1.60 ± 2.2 (SD) mm Hg, p < 0.05). IOP remained lower than baseline IOP throughout all subsequent near and far work. The difference in IOP at the end of experimentation compared to baseline IOP was −1.87 ± 1.81 mm Hg (p < 0.05). IOP remained lower than baseline IOP throughout all subsequent near and far work. The difference in IOP at the end of experimentation compared to baseline IOP was −1.87 ± 1.81 mm Hg ( Conclusions Near work decreases IOP in healthy emmetropes, and this effect is sustained for at least 20 minutes after discontinuing prolonged near work. Providers may need to consider this effect when measuring IOP in clinical practice.
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Chen M, Zhang L, Xu J, Chen X, Gu Y, Ren Y, Wang K. Comparability of three intraocular pressure measurement: iCare pro rebound, non-contact and Goldmann applanation tonometry in different IOP group. BMC Ophthalmol 2019; 19:225. [PMID: 31726999 PMCID: PMC6857285 DOI: 10.1186/s12886-019-1236-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 11/01/2019] [Indexed: 01/23/2023] Open
Abstract
Background Measurement of intraocular pressure (IOP) is essential for glaucoma patients. Many factors such as central corneal thickness (CCT) can affect the accuracy of IOP measurement. The purpose of this study was to evaluate the agreement of IOP measured by non-contact tonometer (NCT), iCare pro rebound tonometer (iCare), and Goldmann applanation tonometer (GAT) in different IOP group. Methods This was a Hospital-based cross-sectional study. Two hundred subjects were enrolled in this study. All subjects underwent IOP measurement using an NCT–iCare–GAT sequence. Bland-Altman, Pearson correlation and intraclass correlation analysis were performed using SPSS 17.0 software. The influence of CCT on each IOP measurement methods was evaluated by linear regression analysis. Results The mean difference (Δ) of NCT–GAT did not differ from (Δ) iCare–GAT in IOP < 10 and 10–21 mmHg group. However, (Δ) NCT–GAT was significantly higher than (Δ) iCare–GAT in IOP 22–30 and > 30 mmHg group (P < 0.05). Bland–Altman analysis showed significant agreement between the three devices (P < 0.01). IOP measurements of the three methods were significantly correlated with CCT (P < 0.01). Conclusions ICare pro shows a higher agreement with GAT over a wide range of IOP compared with NCT. The consistency between the three tonometers was similar in a low and normal IOP range. However, NCT shows a greater overestimate of IOP in moderate and higher IOP group. The variability of IOP measurement affected by CCT is NCT > iCare pro > GAT.
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Affiliation(s)
- Min Chen
- Eye Center, the 2nd Affiliated Hospital, Medical College of Zhejiang University, No.88 Jiefang Road, Hangzhou, 310009, China.,Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, China
| | - Lina Zhang
- Eye Center, the 2nd Affiliated Hospital, Medical College of Zhejiang University, No.88 Jiefang Road, Hangzhou, 310009, China.,Lishui People's Hospital, Lishui, Zhejiang, China
| | - Jia Xu
- Eye Center, the 2nd Affiliated Hospital, Medical College of Zhejiang University, No.88 Jiefang Road, Hangzhou, 310009, China.,Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, China
| | - Xinyi Chen
- Eye Center, the 2nd Affiliated Hospital, Medical College of Zhejiang University, No.88 Jiefang Road, Hangzhou, 310009, China.,Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, China
| | - Yuxiang Gu
- Eye Center, the 2nd Affiliated Hospital, Medical College of Zhejiang University, No.88 Jiefang Road, Hangzhou, 310009, China.,Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, China
| | - Yuping Ren
- Shaoxing Traditional Chinese Medicine Hospital, Shaoxing, Zhejiang, China
| | - Kaijun Wang
- Eye Center, the 2nd Affiliated Hospital, Medical College of Zhejiang University, No.88 Jiefang Road, Hangzhou, 310009, China. .,Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, China.
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12
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Scuderi G, Scuderi L, Calafiore S, Fenicia V, Abdolrahimzadeh S. Deep topical anesthesia with ropivacaine-soaked sponge for phacoemulsification. Int Ophthalmol 2019; 39:2851-2856. [PMID: 31152290 DOI: 10.1007/s10792-019-01132-6] [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: 01/07/2019] [Accepted: 05/22/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE To assess safety and efficacy of deep topical anesthesia with ropivacaine-soaked sponge compared with topical anesthesia with oxybuprocaine in patients undergoing phacoemulsification. METHODS This was a retrospective study where records of patients operated for cataract were evaluated. Patients using a visual analogue scale scored pain during surgery, and the surgeon on a questionnaire recorded ease of operation. Medical records were evaluated for patients who received topical anesthesia with multiple administrations of oxybuprocaine 0.4% or those who received deep topical anesthesia with a polyvinyl acetal sponge impregnated with ropivacaine 0.75% and positioned under the eyelid 30 min before surgery. RESULTS A total of one hundred patient records, equally divided in patients receiving deep topical anesthesia or topical anesthesia, were included. The visual analogue scale scores among the groups were statistically significant for a lower pain score in patients who received deep topical anesthesia with ropivacaine-soaked sponges (p = 0.0069). The average surgeon score was significantly higher for the deep topical anesthesia group indicating favorable ease of surgery (p = 0.0341). Six patients had major complications during surgery. No additional anesthesia was necessary to manage the complications in four patients in the deep anesthesia group, whereas propofol was used for the induction and maintenance of anesthesia in two patients in the topical anesthesia group. CONCLUSIONS Deep topical anesthesia with ropivacaine-soaked sponges performed as well as topical oxybuprocaine regarding safety and efficacy. It provided a lower patient pain score, favorable surgeon satisfaction, and long-lasting anesthesia.
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Affiliation(s)
- Gianluca Scuderi
- Ophthalmology Unit, NESMOS Department, St. Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035/1039, Rome, Italy
| | - Luca Scuderi
- Ophthalmology Unit, Department of Sense Organs, Azienda Policlinico Umberto I, "Sapienza "University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
| | - Silvia Calafiore
- Ophthalmology Unit, NESMOS Department, St. Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035/1039, Rome, Italy
| | - Vito Fenicia
- Ophthalmology Unit, NESMOS Department, St. Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035/1039, Rome, Italy
| | - Solmaz Abdolrahimzadeh
- Ophthalmology Unit, NESMOS Department, St. Andrea Hospital, "Sapienza" University of Rome, Via di Grottarossa 1035/1039, Rome, Italy
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Scuderi G, Contestabile MT, Scuderi L, Librando A, Fenicia V, Rahimi S. Pigment dispersion syndrome and pigmentary glaucoma: a review and update. Int Ophthalmol 2018; 39:1651-1662. [PMID: 29721842 DOI: 10.1007/s10792-018-0938-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 04/23/2018] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Pigment dispersion syndrome (PDS) is a condition where anomalous iridozonular contact leads to pigment dispersion throughout the anterior segment and the released pigment is abnormally deposited on various ocular structures. CLINICAL PRESENTATION The clinical presentation of PDS is defined by the presence of pigmented cells on the corneal endothelium, an increase of pigmentation of the trabecular meshwork, and mid-periphery transillumination defects of the iris. This syndrome, more common in myopes, is usually bilateral and can be associated with ocular hypertension or glaucoma. Secondary open-angle pigmentary glaucoma (PG) can develop due to reduction of the outflow of aqueous humour and consequent increase in intraocular pressure leading to glaucomatous optic neuropathy. Diagnosis of PG is commonly between 40 and 50 years of age, occurring more frequently in men. The advent of ultrasound biomicroscopy and anterior segment optical coherence tomography has contributed to enhancing our knowledge on the condition. Typical alterations of the anterior segment are the posterior insertion of the iris and iris concavity. Treatment of PG should be initiated early to hinder disease progression, glaucomatous damage, and vision loss. Management is based on medical therapy, laser iridotomy, selective laser trabeculoplasty, and filtration procedures. CONCLUSIONS The differential diagnosis of PDS with other disorders can be challenging and awareness of the condition together with meticulous ophthalmologic examination allows early diagnosis followed by appropriate management strategies. The present review is a comprehensive report on the clinical characteristics, pathogenesis, current management, and status quo of PDS and PG.
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Affiliation(s)
- Gianluca Scuderi
- Ophthalmology Unit, St. Andrea Hospital, Faculty of Medicine and Psychology, NESMOS Department, University of Rome "Sapienza", Rome, Italy
| | - Maria Teresa Contestabile
- Ophthalmology Unit, St. Andrea Hospital, Faculty of Medicine and Psychology, NESMOS Department, University of Rome "Sapienza", Rome, Italy
| | - Luca Scuderi
- Ophthalmology Unit, Azienda Ospedaliera Universitaria Policlinico Umberto I, University of Rome "Sapienza", Viale del Policlinico 155, Rome, 00161, Italy.
| | - Aloisa Librando
- Ophthalmology Unit, Azienda Ospedaliera Universitaria Policlinico Umberto I, University of Rome "Sapienza", Viale del Policlinico 155, Rome, 00161, Italy
| | - Vito Fenicia
- Ophthalmology Unit, St. Andrea Hospital, Faculty of Medicine and Psychology, NESMOS Department, University of Rome "Sapienza", Rome, Italy
| | - Siavash Rahimi
- Pathology Centre-Histopathology, Queen Alexandra Hospital, School of Pharmacy and Biomedical Science, University of Portsmouth, Portsmouth, UK
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Kim JW, Jung JW. Clinical Evaluation of a Rebound Tonometer in Patients Who Underwent Penetrating Keratoplasty. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.12.1122] [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)
- Jong Woo Kim
- Department of Ophthalmology, Inha University School of Medicine, Incheon, Korea
| | - Ji Won Jung
- Department of Ophthalmology, Inha University School of Medicine, Incheon, Korea
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Hark LA, Katz LJ, Myers JS, Waisbourd M, Johnson D, Pizzi LT, Leiby BE, Fudemberg SJ, Mantravadi AV, Henderer JD, Zhan T, Molineaux J, Doyle V, Divers M, Burns C, Murchison AP, Reber S, Resende A, Bui TDV, Lee J, Crews JE, Saaddine JB, Lee PP, Pasquale LR, Haller JA. Philadelphia Telemedicine Glaucoma Detection and Follow-up Study: Methods and Screening Results. Am J Ophthalmol 2017; 181:114-124. [PMID: 28673747 DOI: 10.1016/j.ajo.2017.06.024] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/22/2017] [Accepted: 06/23/2017] [Indexed: 12/13/2022]
Abstract
PURPOSE To describe methodology and screening results from the Philadelphia Telemedicine Glaucoma Detection and Follow-up Study. DESIGN Screening program results for a prospective randomized clinical trial. METHODS Individuals were recruited who were African-American, Hispanic/Latino, or Asian over age 40 years; white individuals over age 65 years; and any ethnicity over age 40 years with a family history of glaucoma or diabetes. Primary care offices and Federally Qualified Health Centers were used for telemedicine (Visit 1). Two posterior fundus photographs and 1 anterior segment photograph were captured per eye in each participant, using a nonmydriatic, autofocus, hand-held fundus camera (Volk Optical, Mentor, Ohio, USA). Medical and ocular history, family history of glaucoma, visual acuity, and intraocular pressure measurements using the ICare rebound tonometer (ICare, Helsinki, Finland) were obtained. Images were read remotely by a trained retina reader and a glaucoma specialist. RESULTS From April 1, 2015, to February 6, 2017, 906 individuals consented and attended Visit 1. Of these, 553 participants were female (61.0%) and 550 were African-American (60.7%), with a mean age of 58.7 years. A total of 532 (58.7%) participants had diabetes, and 616 (68%) had a history of hypertension. During Visit 1, 356 (39.3%) participants were graded with a normal image. Using image data from the worse eye, 333 (36.8%) were abnormal and 155 (17.1%) were unreadable. A total of 258 (28.5%) had a suspicious nerve, 62 (6.8%) had ocular hypertension, 102 (11.3%) had diabetic retinopathy, and 68 (7.5%) had other retinal abnormalities. CONCLUSION An integrated telemedicine screening intervention in primary care offices and Federally Qualified Health Centers detected high rate of suspicious optic nerves, ocular hypertension, and retinal pathology.
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Prophylactic Effect of Oral Acetazolamide against Intraocular Pressure Elevation after Cataract Surgery in Eyes with Glaucoma. Ophthalmology 2017; 124:701-708. [DOI: 10.1016/j.ophtha.2016.12.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 12/15/2016] [Accepted: 12/17/2016] [Indexed: 11/22/2022] Open
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Plateroti AM, Plateroti R, Mollo R, Librando A, Contestabile MT, Fenicia V. Sturge-Weber Syndrome Associated with Monolateral Ocular Melanocytosis, Iris Mammillations, and Diffuse Choroidal Haemangioma. Case Rep Ophthalmol 2017; 8:375-384. [PMID: 28868033 PMCID: PMC5567108 DOI: 10.1159/000477612] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 05/15/2017] [Indexed: 11/19/2022] Open
Abstract
We present the case of a 12-year-old boy with Sturge-Weber syndrome and ocular melanocytosis who presented with bilateral naevus flammeus of the face and hyperpigmentation of the right iris associated with ipsilateral iris mammillations. The patient had glaucoma and a diffuse choroidal haemangioma of the right eye. Optical coherence tomography of the anterior segment confirmed iris hyper-pigmentation and did not show abnormalities of the chamber angle structures. B-scan ultrasonography and enhanced depth imaging optical coherence tomography were performed and showed a marked difference in thickness and reflectance between the right and left choroid. Visual field examinations with perimetry showed early defects in the right eye. Peripapillary optical coherence imaging showed borderline values of retinal nerve fibre layer thickness reduction in the right eye. Sturge-Weber syndrome associated with ocular melanocytosis and iris mammillations is an extremely rare condition. This paper highlights the role of multi-imaging methods in the enhanced evaluation of rare diseases towards choosing the most appropriate management strategies and improving the follow-up of patients over time.
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Affiliation(s)
- Andrea Maria Plateroti
- Ophthalmology Unit, DAI Head and Neck, Azienda Ospedaliera Universitaria Policlinico Umberto I, University of Rome “Sapienza”, Rome, Italy
| | - Rocco Plateroti
- Ophthalmology Unit, DAI Head and Neck, Azienda Ospedaliera Universitaria Policlinico Umberto I, University of Rome “Sapienza”, Rome, Italy
| | - Roberto Mollo
- Ophthalmology Unit, DAI Head and Neck, Azienda Ospedaliera Universitaria Policlinico Umberto I, University of Rome “Sapienza”, Rome, Italy
| | - Aloisa Librando
- Ophthalmology Unit, DAI Head and Neck, Azienda Ospedaliera Universitaria Policlinico Umberto I, University of Rome “Sapienza”, Rome, Italy
| | - Maria Teresa Contestabile
- Ophthalmology Unit, St. Andrea Hospital, NESMOS Department, University of Rome “Sapienza”, Rome, Italy
| | - Vito Fenicia
- Ophthalmology Unit, St. Andrea Hospital, NESMOS Department, University of Rome “Sapienza”, Rome, Italy
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Kato Y, Nakakura S, Matsuo N, Yoshitomi K, Handa M, Tabuchi H, Kiuchi Y. Agreement among Goldmann applanation tonometer, iCare, and Icare PRO rebound tonometers; non-contact tonometer; and Tonopen XL in healthy elderly subjects. Int Ophthalmol 2017; 38:687-696. [PMID: 28393323 DOI: 10.1007/s10792-017-0518-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 04/04/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the inter-device agreement among the Goldmann applanation tonometer (GAT), iCare and Icare PRO rebound tonometers, non-contact tonometer (NCT), and Tonopen XL tonometer. METHODS Sixty healthy elderly subjects were enrolled. The intraocular pressure (IOP) in each subject's right eye was measured thrice using each of the five tonometers. Intra-device agreement was evaluated by calculating intraclass correlation coefficients (ICCs). Inter-device agreement was evaluated by ICC and Bland-Altman analyses. RESULTS ICCs for intra-device agreement for each tonometer were >0.8. IOP as measured by iCare (mean ± SD, 11.6 ± 2.5 mmHg) was significantly lower (p < 0.05) than that measured by GAT (14.0 ± 2.8 mmHg), NCT (13.6 ± 2.5 mmHg), Tonopen XL (13.7 ± 4.1 mmHg), and Icare PRO (12.6 ± 2.2 mmHg; Bonferroni test). There was no significant difference in mean IOP among GAT, NCT, and Tonopen XL. Regarding inter-device agreement, ICC was lower between Tonopen XL and other tonometers (all ICCs < 0.4). However, ICCs of GAT, iCare, Icare PRO, and NCT showed good agreement (0.576-0.700). The Bland-Altman analysis revealed that the width of the 95% limits of agreement was larger between the Tonopen XL and the other tonometers ranged from 14.94 to 16.47 mmHg. Among the other tonometers, however, the widths of 95% limits of agreement ranged from 7.91 to 9.24 mmHg. CONCLUSION There was good inter-device agreement among GAT, rebound tonometers, and NCT. Tonopen XL shows the worst agreement with the other tonometers; therefore, we should pay attention to its' respective IOP. CLINICAL TRIAL REGISTRATION Japan Clinical Trials Register; number: UMIN000011544.
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Affiliation(s)
- Yoshitake Kato
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan
| | - Shunsuke Nakakura
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan.
| | - Naoko Matsuo
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan
| | - Kayo Yoshitomi
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan
| | - Marina Handa
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan
| | - Hitoshi Tabuchi
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
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Pahlitzsch M, Brünner J, Gonnermann J, Maier AKB, Torun N, Bertelmann E, Klamann MK. Comparison of ICare and IOPen vs Goldmann applanation tonometry according to international standards 8612 in glaucoma patients. Int J Ophthalmol 2016; 9:1624-1628. [PMID: 27990366 DOI: 10.18240/ijo.2016.11.14] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Accepted: 05/16/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To compare IOPen and ICare rebound tonometry to Goldmann applanation tonometry (GAT) according to International Standards Organization (ISO) 8612 criteria. METHODS Totally 191 eyes (n=107 individuals) were included. Criteria of ISO 8612 were fulfilled: 3 clusters of IOP, measured by GAT, were formed. The GAT results were given as mean±standard deviation. RESULTS GAT (19.7±0.5 mm Hg) showed a significant correlation to ICare (19.8±0.5 mm Hg) (r=0.547, P<0.001) and IOPen (19.5±0.5 mm Hg) (r=0.526, P<0.001). According to ISO 8612 criteria in all 3 IOP groups the number of outliers (of the 95% limits of agreement) exceeded 5% for ICare and IOPen vs GAT: No.1 (n=68) 29.4% and 22.1%, No.2 (n=62) 35.5% and 37.1%, No.3 (n=61) 26.2% and 42.6%, respectively. CONCLUSION The strict requirements of the ISO 8612 are not fulfilled in a glaucoma collective by ICare and IOPen at present. As long as the Goldmann tonometry is applicable it should be used first of all for reproducible IOP readings. ICare and IOPen tonometry should be considered as an alternative tool, if application of Goldmann tonometry is not possible.
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Affiliation(s)
- Milena Pahlitzsch
- Glaucoma and Retinal Degeneration Research Group, UCL, Institute of Ophthalmology, Bath Street, London, EC1V 9EL, United Kingdom
| | - Jeanette Brünner
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
| | - Johannes Gonnermann
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
| | - Anna-Karina B Maier
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
| | - Necip Torun
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
| | - Eckart Bertelmann
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
| | - Matthias Kj Klamann
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
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Hayashi K, Ogawa S, Yoshida M, Yoshimura K. Wound stability and surgically induced corneal astigmatism after transconjunctival single-plane sclerocorneal incision cataract surgery. Jpn J Ophthalmol 2016; 61:113-123. [PMID: 27714572 DOI: 10.1007/s10384-016-0480-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 08/30/2016] [Indexed: 12/01/2022]
Abstract
PURPOSE To compare intraocular pressure (IOP) immediately after cataract surgery, and surgically induced corneal astigmatism (SIA) and corneal shape changes between eyes with transconjunctival single-plane sclerocorneal incisions (TSSIs) and eyes with clear corneal incisions (CCIs). METHODS Bilateral eyes of 64 patients undergoing phacoemulsification were randomized to undergo 2.4-mm temporal TSSI or CCI. IOP was measured preoperatively, and in the immediate postoperative periods. SIA was determined using vector analysis, and corneal shape changes and irregular astigmatism were evaluated using a videokeratography preoperatively, and in the early postoperative periods. RESULTS Wound hydration was performed in 23 eyes (35.9 %) of the TSSI group and in 60 (93.8 %) of the CCI group (P < 0.0001). Mean IOP was significantly higher in the TSSI group than in the CCI group at 30, 60, and 120 min postoperatively (P ≤ 0.0179). SIA tended to be smaller in the TSSI group than the CCI group, but the difference was not significant. The higher order irregular astigmatism was smaller in the TSSI group than in the CCI group at 2 days (P = 0.0312). The videokeratography revealed a wound-related flattening postoperatively in both groups; this change disappeared within 4 weeks in the TSSI group, whereas it persisted until 12 weeks in the CCI group. CONCLUSION IOP was significantly higher immediately after TSSI than after CCI and required less wound hydration, suggesting better stability with TSSI. Higher order irregular astigmatism and wound-related corneal flattening were smaller after TSSI than after CCI in the early periods, suggesting that fewer corneal shape changes with TSSI.
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Affiliation(s)
- Ken Hayashi
- Hayashi Eye Hospital, 4-23-35 Hakataekimae, Hakata-Ku, Fukuoka, 812-0011, Japan.
| | - Soichiro Ogawa
- Hayashi Eye Hospital, 4-23-35 Hakataekimae, Hakata-Ku, Fukuoka, 812-0011, Japan
| | - Motoaki Yoshida
- Hayashi Eye Hospital, 4-23-35 Hakataekimae, Hakata-Ku, Fukuoka, 812-0011, Japan
| | - Koichi Yoshimura
- Hayashi Eye Hospital, 4-23-35 Hakataekimae, Hakata-Ku, Fukuoka, 812-0011, Japan
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Calafiore S, Perdicchi A, Scuderi G, Contestabile MT, Abdolrahimzadeh S, Recupero SM. Glaucoma Management in Carotid Cavernous Fistula. Case Rep Ophthalmol 2016; 7:296-302. [PMID: 27462258 PMCID: PMC4943307 DOI: 10.1159/000446151] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 04/12/2016] [Indexed: 11/19/2022] Open
Abstract
Carotid cavernous fistulas (CCF) are vascular communications between the carotid artery and the cavernous sinus. Ophthalmologists are called to diagnose and manage the condition in cases that present with ocular features. A 73-year-old female was referred to our glaucoma center clinic. Eight years before, she had started receiving medication for glaucoma and had undergone laser iridotomy, but a satisfactory management of intraocular pressure (IOP) had not been achieved. The patient was complaining of intermittent diplopia, bilateral proptosis, and conjunctival chemosis over the past 6 months. Best-corrected visual acuity in the right (OD) and left eye (OS) was 9/10 and 10/10, respectively. Visual field testing showed slight paracentral field defects mostly in OS. IOP was 20 mm Hg in OD and 34 mm Hg in OS. We referred the patient to neuroradiology, and MRI angiography revealed a CCF with angiographic classification of Cognard grade 2. Closure of the CCF by transarterial embolization was performed in the neuroradiology department. One week following the procedure, the clinical signs of diplopia, proptosis, and conjunctival chemosis had greatly improved, and IOP was reduced to 12 mm Hg OD and 19 mm Hg in OS. Glaucoma treatment was maintained with topical brimatoprost, brinzolamide, and timolol. Owing to the risk of vision loss associated with vascular stasis, retinal ischemia, and high IOP, ophthalmologists must be aware of the clinical features of CCF and should request appropriate imaging studies such as MRI angiography in order to confirm the diagnosis and plan multidisciplinary treatment.
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Affiliation(s)
- Silvia Calafiore
- Ophthalmology Unit, NESMOS Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Andrea Perdicchi
- Ophthalmology Unit, NESMOS Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Gianluca Scuderi
- Ophthalmology Unit, NESMOS Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Maria Teresa Contestabile
- Ophthalmology Unit, NESMOS Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Solmaz Abdolrahimzadeh
- Ophthalmology Unit, Azienda Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Santi Maria Recupero
- Ophthalmology Unit, NESMOS Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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An Update on the Ophthalmologic Features in the Phakomatoses. J Ophthalmol 2016; 2016:3043026. [PMID: 27493794 PMCID: PMC4967465 DOI: 10.1155/2016/3043026] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 05/11/2016] [Accepted: 06/06/2016] [Indexed: 11/18/2022] Open
Abstract
Neurofibromatosis type 1, tuberous sclerosis complex, and Von Hippel-Lindau disease, historically classified as the phakomatoses, are hereditary multisystem disorders characterized by the presence of hamartoma, which carry the risk of malignant transformation. The alteration of tumor suppressor genes seems to be at the basis of their pathophysiogenetic mechanism. Lisch and choroidal nodules in neurofibromatosis type 1, retinal astrocytomas in tuberous sclerosis complex, and retinal capillary hemangioma in Von Hippel-Lindau disease are the principal ophthalmic hamartomatous manifestations. The advent of novel imaging techniques such as near infrared reflectance and optical coherence tomography has provided unprecedented insight on the choroidal and retinal features of these diseases. These methods have improved early diagnosis and the ongoing surveillance in these conditions. Among an array of treatment modalities, antivascular endothelial growth factor therapy has been used in the management of retinal hamartomas but results have been varied. This review is an update on the pathophysiogenetic mechanisms, ophthalmic manifestations, and novel treatment strategies in the phakomatoses with emphasis on the role of imaging techniques.
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Bruscolini A, Amorelli GM, Rama P, Lambiase A, La Cava M, Abbouda A. Involvement of the Anterior Segment of the Eye in Patients with Mucopolysaccharidoses: A Review of Reported Cases and Updates on the Latest Diagnostic Instrumentation. Semin Ophthalmol 2016; 32:707-714. [DOI: 10.3109/08820538.2016.1170160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- A. Bruscolini
- Department of Sense Organs, Section of Ophthalmology, University of Rome “Sapienza,” Rome, Italy
| | - G. M. Amorelli
- Department of Sense Organs, Section of Ophthalmology, University of Rome “Sapienza,” Rome, Italy
| | - P. Rama
- Cornea and Ocular Surface Unit, Scientific Institute San Raffaele, Milan, Italy
| | - A. Lambiase
- Department of Sense Organs, Section of Ophthalmology, University of Rome “Sapienza,” Rome, Italy
| | - M. La Cava
- Department of Sense Organs, Section of Ophthalmology, University of Rome “Sapienza,” Rome, Italy
| | - A. Abbouda
- Department of Sense Organs, Section of Ophthalmology, University of Rome “Sapienza,” Rome, Italy
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Mudie LI, LaBarre S, Varadaraj V, Karakus S, Onnela J, Munoz B, Friedman DS. The Icare HOME (TA022) Study: Performance of an Intraocular Pressure Measuring Device for Self-Tonometry by Glaucoma Patients. Ophthalmology 2016; 123:1675-1684. [PMID: 27289178 DOI: 10.1016/j.ophtha.2016.04.044] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 04/22/2016] [Accepted: 04/22/2016] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To evaluate the Icare HOME (TA022) device (Icare Oy, Vanda, Finland) for use by glaucoma patients for self-tonometry. DESIGN Prospective performance evaluation of a medical device. PARTICIPANTS One hundred eighty-nine participants with glaucoma or suspected glaucoma were recruited from the Wilmer Eye Institute, Baltimore, Maryland, between July 2014 and April 2015. METHODS Participants had standardized training and had to be able use the Icare HOME device independently. Subjects also had to be able to obtain the first intraocular pressure (IOP) measurement within 5 mmHg of Goldmann applanation tonometry (GAT). Those certified obtained 3 IOP measures using the HOME device, and these were compared with Icare TA01i and GAT IOP measurements. MAIN OUTCOME MEASURES The agreement between Icare HOME and reference tonometers was used to assess precision. The intraclass correlation coefficient was used to assess within-patient reliability for the HOME device. RESULTS Eighteen of 189 recruited patients were ineligible to take part in the study. Forty-four of 171 patients (25.7%) started but failed to complete the study: 7 stopped because of time concerns, 10 of 171 patients (6%) stopped because of difficulty using the device during certification, and 27 of 171 patients (16%) failed to be certified based on IOP. The HOME and GAT measurements agreed within 5 mmHg in 116 of 127 participants (91.3%); 2 participants (1.6%) had a difference of more than 7 mmHg. The mean difference between the Icare HOME and GAT measurements was -0.33 mmHg (standard deviation, 3.11 mmHg). The overall intraclass correlation coefficient for the HOME device was 0.92 (95% confidence interval, 0.89-0.95). CONCLUSIONS Not all participants could learn how to use the Icare HOME device, but for those who could, most were able to obtain measurements similar to those obtained by GAT. The Icare HOME device is safe and reliable for self-tonometry, but nearly 1 in 6 individuals may fail to certify in use of the device based on large differences in IOP when comparing GAT with the Icare HOME measurements. The device has the potential to address an unmet need by providing more frequent IOP measurements in a patient's day to day life.
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Affiliation(s)
- Lucy I Mudie
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
| | - Sophie LaBarre
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
| | | | - Sezen Karakus
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
| | | | - Beatriz Munoz
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
| | - David S Friedman
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
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LoVecchio F, Salveson P, Mulrow M, Malashock H. Icare vs Tono-Pen in the ED. Am J Emerg Med 2016; 34:670-3. [DOI: 10.1016/j.ajem.2016.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 01/06/2016] [Accepted: 01/06/2016] [Indexed: 10/22/2022] Open
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Evaluation of Agreement between HRT III and iVue OCT in Glaucoma and Ocular Hypertension Patients. J Ophthalmol 2016; 2015:691031. [PMID: 26788363 PMCID: PMC4693011 DOI: 10.1155/2015/691031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Accepted: 11/24/2015] [Indexed: 11/24/2022] Open
Abstract
Purpose. To determine the agreement between Moorfields Regression Analysis (MRA), Glaucoma Probability Score (GPS) of Heidelberg retinal tomograph (HRT III), and peripapillary nerve fibers thickness by iVue Optical Coherence Tomography (OCT). Methods. 72 eyes with ocular hypertension or primary open angle glaucoma (POAG) were included in the study: 54 eyes had normal visual fields (VF) and 18 had VF damage. All subjects performed achromatic 30° VF by Octopus Program G1X dynamic strategy and were imaged with HRT III and iVue OCT. Sectorial and global MRA, GPS, and OCT parameters were used for the analysis. Kappa statistic was used to assess the agreement between methods. Results. A significant agreement between iVue OCT and GPS for the inferotemporal quadrant (κ: 0.555) was found in patients with abnormal VF. A good overall agreement between GPS and MRA was found in all the eyes tested (κ: 0.511). A good agreement between iVue OCT and MRA was shown in the superonasal (κ: 0.656) and nasal (κ: 0.627) quadrants followed by the superotemporal (κ: 0.602) and inferotemporal (κ: 0.586) sectors in all the studied eyes. Conclusion. The highest percentages of agreement were found per quadrant of the MRA and the iVue OCT confirming that in glaucoma damage starts from the temporal hemiretina.
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Intradevice and Interdevice Agreement Between a Rebound Tonometer, Icare PRO, and the Tonopen XL and Kowa Hand-held Applanation Tonometer When Used in the Sitting and Supine Position. J Glaucoma 2016; 24:515-21. [PMID: 24145289 DOI: 10.1097/ijg.0000000000000016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE The aim of the study was to investigate the agreement between a new portable tonometer, Icare PRO, and the Tonopen XL and Kowa hand-held applanation tonometers (HAT). METHODS The right eyes of 127 healthy subjects were enrolled. Intraocular pressure (IOP) was measured in both sitting and supine positions using the Icare PRO, Tonopen XL, and Kowa HAT tonometers. The repeatability of the IOP measurements was evaluated by calculating intraclass correlation coefficients. Between-method agreements of tonometer measurements were evaluated using Bland-Altman analysis. RESULTS Intradevice agreement: The intraclass correlation coefficients (sitting, supine) of Icare PRO, Tonopen XL, and Kowa HAT were (0.863, 0.656), (0.845, 0.819), and (0.957, 0.956), respectively.Interdevice agreement: The Bland-Altman analysis revealed that, in the sitting position, the mean differences between Icare PRO and Tonopen XL, and between Icare PRO and Kowa HAT were -0.43 and 0.43 mm Hg, respectively (95% limits of agreement: -6.24 to 5.34 mm Hg, -4.04 to 4.90 mm Hg). In the supine position, the corresponding mean differences were -0.88 and 0.14 mm Hg (95% limits of agreement: -5.66 to 3.91 mm Hg, -4.06 to 4.33 mm Hg). IOP differences between Icare PRO and the other tonometers were unaffected by central corneal thickness. CONCLUSIONS The repeatability of Icare PRO was slightly lower in the supine position than in the sitting position. Although Icare PRO underestimated IOP values in eyes with higher IOP when compared with Tonopen XL and Kowa HAT in both positions, we observed good interdevice agreement between Icare PRO and both Tonopen XL and Kowa HAT.
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Sacchetti M, Macchi I, Tiezzi A, La Cava M, Massaro-Giordano G, Lambiase A. Pathophysiology of Corneal Dystrophies: From Cellular Genetic Alteration to Clinical Findings. J Cell Physiol 2015; 231:261-9. [DOI: 10.1002/jcp.25082] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 06/19/2015] [Indexed: 02/04/2023]
Affiliation(s)
- Marta Sacchetti
- Cornea and Ocular Surface Unit; Ospedale San Raffaele, IRCCS-Milan; Milano Italy
| | - Ilaria Macchi
- Department of Ophthalmology; University of Rome “Campus Bio-Medico”; Rome Italy
| | - Alessandro Tiezzi
- Section of Ophthalmology, Department of Sense Organs; University of Rome “Sapienza”; Rome Italy
| | - Maurizio La Cava
- Section of Ophthalmology, Department of Sense Organs; University of Rome “Sapienza”; Rome Italy
| | | | - Alessandro Lambiase
- Section of Ophthalmology, Department of Sense Organs; University of Rome “Sapienza”; Rome Italy
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Twelve-Month Results of a Single or Multiple Dexamethasone Intravitreal Implant for Macular Edema following Uncomplicated Phacoemulsification. BIOMED RESEARCH INTERNATIONAL 2015; 2015:362564. [PMID: 26509151 PMCID: PMC4609771 DOI: 10.1155/2015/362564] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 02/17/2015] [Indexed: 11/18/2022]
Abstract
The clinical efficacy of one or two intravitreal injections of a continued deliverance dexamethasone 700 μg implant in ten patients with persistent macular edema following uncomplicated phacoemulsification was evaluated. Complete ophthalmological examination and spectral domain optical coherence tomography were carried out. Follow-up was at day 7 and months 1, 2, 4, 6, 8, and 12. At baseline mean best corrected visual acuity was 62 Early Treatment Diabetic Retinopathy Study Chart letters, which showed statistically significant improvement at each follow-up, except at month 6, to reach 79 letters at month 12 (P = 0.018). Prior to treatment mean central foveal thickness was 622 μm, which showed statistically significant improvement at each follow-up to reach a mean value of 282 μm (P = 0.012) at month 12. Five patients received a second dexamethasone implant at month 7. Two patients were excluded from the study at months 4 and 8. Intraocular pressure remained stable during the study period with the exception of mild increase in two patients requiring topical therapy. In conclusion there was statistically significant improvement of best corrected visual acuity and mean central foveal thickness with one or two intravitreal dexamethasone implants over 12 months.
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Pediatric Glaucoma: A Literature's Review and Analysis of Surgical Results. BIOMED RESEARCH INTERNATIONAL 2015; 2015:393670. [PMID: 26451368 PMCID: PMC4588360 DOI: 10.1155/2015/393670] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 05/27/2015] [Indexed: 11/17/2022]
Abstract
The purpose of this paper is to review the surgical options available for the management of pediatric glaucoma, to evaluate their advantages and disadvantages together with their long-term efficacy, all with the intent to give guidelines to physicians on which elements are to be considered when taking a surgical decision. Currently there is a range of surgical procedures that are being used for the management of pediatric glaucoma. Within these, some are completely new approaches, while others are improvements of the more traditional procedures. Throughout this vast range of surgical options, angle surgery remains the first choice in mild cases and both goniotomy and trabeculotomy have good success rates. Trabeculectomy with or without mitomycin C (MMC) is preferred in refractory cases, in aphakic eyes, and in older children. GDIs have a good success rate in aphakic eyes. Nonpenetrating deep sclerectomy is still rarely used; nevertheless the results of ongoing studies are encouraging. The different clinical situations should always be weighed against the risks associated with the procedures for the individual patients. Glaucomatous progression can occur many years after its stabilization and at any time during the follow-up period; for this reason life-long assessment is necessary.
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Abdolrahimzadeh S, Fameli V, Mollo R, Contestabile MT, Perdicchi A, Recupero SM. Rare Diseases Leading to Childhood Glaucoma: Epidemiology, Pathophysiogenesis, and Management. BIOMED RESEARCH INTERNATIONAL 2015; 2015:781294. [PMID: 26451378 PMCID: PMC4588342 DOI: 10.1155/2015/781294] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 04/22/2015] [Indexed: 11/17/2022]
Abstract
Noteworthy heterogeneity exists in the rare diseases associated with childhood glaucoma. Primary congenital glaucoma is mostly sporadic; however, 10% to 40% of cases are familial. CYP1B1 gene mutations seem to account for 87% of familial cases and 27% of sporadic cases. Childhood glaucoma is classified in primary and secondary congenital glaucoma, further divided as glaucoma arising in dysgenesis associated with neural crest anomalies, phakomatoses, metabolic disorders, mitotic diseases, congenital disorders, and acquired conditions. Neural crest alterations lead to the wide spectrum of iridocorneal trabeculodysgenesis. Systemic diseases associated with childhood glaucoma include the heterogenous group of phakomatoses where glaucoma is frequently encountered in the Sturge-Weber syndrome and its variants, in phakomatosis pigmentovascularis associated with oculodermal melanocytosis, and more rarely in neurofibromatosis type 1. Childhood glaucoma is also described in systemic disorders of mitotic and metabolic activity. Acquired secondary glaucoma has been associated with uveitis, trauma, drugs, and neoplastic diseases. A database research revealed reports of childhood glaucoma in rare diseases, which do not include glaucoma in their manifestation. These are otopalatodigital syndrome, complete androgen insensitivity, pseudotrisomy 13, Brachmann-de Lange syndrome, acrofrontofacionasal dysostosis, caudal regression syndrome, and Wolf-Hirschhorn syndrome.
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Affiliation(s)
- Solmaz Abdolrahimzadeh
- Ophthalmology Unit, DAI Head/Neck, Umberto I Policlinic, University of Rome “Sapienza”, Viale del Policlinico 155, 00161 Rome, Italy
| | - Valeria Fameli
- Ophthalmology Unit, Department of Sense Organs, University of Rome “Sapienza”, Viale del Policlinico 155, 00161 Rome, Italy
| | - Roberto Mollo
- Ophthalmology Unit, DAI Head/Neck, Umberto I Policlinic, University of Rome “Sapienza”, Viale del Policlinico 155, 00161 Rome, Italy
| | - Maria Teresa Contestabile
- Ophthalmology Unit, St. Andrea Hospital, NESMOS Department, University of Rome “Sapienza”, via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Andrea Perdicchi
- Ophthalmology Unit, St. Andrea Hospital, NESMOS Department, University of Rome “Sapienza”, via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Santi Maria Recupero
- Ophthalmology Unit, St. Andrea Hospital, NESMOS Department, University of Rome “Sapienza”, via di Grottarossa 1035-1039, 00189 Rome, Italy
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Ganglion Cell Complex Evaluation in Exudative Age-Related Macular Degeneration after Repeated Intravitreal Injections of Ranibizumab. BIOMED RESEARCH INTERNATIONAL 2015; 2015:268796. [PMID: 26167478 PMCID: PMC4475747 DOI: 10.1155/2015/268796] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 10/17/2014] [Accepted: 10/26/2014] [Indexed: 12/01/2022]
Abstract
Purpose. To detect the effects of intravitreal ranibizumab injections on GCC in patients with wet AMD. Methods. 32 wet AMD eyes were selected and submitted at three ranibizumab injections. RTVue-OCT GCC and MM5 protocol were performed before treatment and twenty days after each injection. Results. At baseline mean GCC thickness was 93.9 ± 18.5 μm. Twenty days after each intravitreal injection it was, respectively, 85.8 ± 10.1, 86.5 ± 9.3, and 91.1 ± 11.5 μm, without statistical significance. A significant improvement in visual acuity (P = 0.031) and a reduction of mean foveal (P = 0.001) and macular thickness (P = 0.001) were observed. Conclusion. The clinical results confirm therapeutic efficacy of intravitreal injections of ranibizumab in wet AMD. A contemporary not statistically significant reduction of GCC thickness suggests that the loading phase of ranibizumab does not have any toxic effects on ganglion cell complex.
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Mantelli F, Lambiase A, Sacchetti M, Orlandi V, Rosa A, Casella P, Bonini S. Cocaine snorting may induce ocular surface damage through corneal sensitivity impairment. Graefes Arch Clin Exp Ophthalmol 2015; 253:765-72. [DOI: 10.1007/s00417-015-2938-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 12/01/2014] [Accepted: 01/13/2015] [Indexed: 11/24/2022] Open
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Son GS, Kim JW, Lim TH, Choi KY, Cho BJ. Comparison of Clinical Outcomes in Implantable Collamer Lens Implantation between AQUA ICL® and Conventional ICL. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.9.1316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Mantelli F, Abdolrahimzadeh S, Mannino G, Lambiase A. Unusual case of angle closure glaucoma in a patient with neurofibromatosis type 1. Case Rep Ophthalmol 2014; 5:386-91. [PMID: 25762928 PMCID: PMC4342860 DOI: 10.1159/000369334] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report the case of a 29-year-old female patient who presented with an acute onset of anisocoria, blurred vision, nausea and severe left-sided headache. There was no history of trauma, drug abuse, or instillation of topical mydriatic compounds. The ocular history was negative for similar events. On presentation, her visual acuity was 0.2 in the left and 1.0 in the right eye with a +2.5 dpt sph. correction. Slit-lamp examination demonstrated a shallow anterior chamber as well as the presence of iris nodules in both eyes. These nodules were identified as Lisch nodules as the patient referred to the previous diagnosis as being neurofibromatosis type 1. A third nerve palsy was considered, but a brain MRI showed normal results. Her ocular motility was normal, but the left pupil was mydriatic and poorly reacting to light, with an associated raised intraocular pressure (IOP) of 38 mm Hg. An examination of the fellow eye was normal, with the IOP measuring 18 mm Hg. Gonioscopy of the right eye showed a narrow angle. On further anamnestic investigation, the patient revealed that the pain and the blurred vision begun in the morning while she was helping her mother in the garden. Finally, after showing the patient a picture of Datura flowers, which she recognized immediately, we made the unusual diagnosis of angle closure glaucoma by Datura, a well-known toxic plant with mydriatic properties. The patient was successfully treated with systemic acetazolamide and topical pilocarpine.
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Affiliation(s)
- Flavio Mantelli
- IRCCS Fondazione Bietti, Azienda Policlinico Umberto I, Rome, Italy
| | | | - Giuseppe Mannino
- Ophthalmology Unit, NESMOS Department, St. Andrea Hospital, Rome, Italy
| | - Alessandro Lambiase
- Ophthalmology Section, Department Organi di Senso, University of Rome Sapienza, Rome, Italy
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Fenicia V, Balestrieri M, Perdicchi A, MauriziEnrici M, DelleFave M, Recupero SM. Intravitreal injection of dexamethasone implant and ranibizumab in cystoid macular edema in the course of irvine-gass syndrome. Case Rep Ophthalmol 2014; 5:243-8. [PMID: 25232337 PMCID: PMC4163690 DOI: 10.1159/000365945] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To evaluate the efficacy of 2 dexamethasone intravitreal implants and 1 ranibizumab intravitreal injection after a bilateral postoperative complication of cataract surgery as pseudophakic cystoid macular edema. PATIENTS AND METHODS A 70-year-old male patient with systemic hypertension developed a progressive cystoid macular edema (CME) in both eyes starting between 10 and 20 days after cataract surgery. Two intravitreal dexamethasone implants and 1 ranibizumab injection were administered; first in the right eye (RE) and then in the left eye (LE). The patient was checked for 1 whole week and then once a month for 5 months after the injections. RESULTS One month after the first dexamethasone implant in his RE, the spectral domain optical coherence tomography (SD-OCT) showed a progressive reduction of the foveal thickness until a complete resolution of the CME occurred, which was associated with an improvement of visual acuity. After 3 months, the SD-OCT showed a relapse of the CME, which was then treated with 1 injection of ranibizumab. One month after this injection, there was a complete resolution of the CME. A new CME in his RE was diagnosed 2 months after the last ranibizumab injection; it was treated with a new dexamethasone implant. A complete resolution of the CME was obtained; a normal foveal profile was still present 5 months after the last injection, and the best-corrected visual acuity was 20/20. His LE developed a CME 40 days after surgery. One intravitreal injection of ranibizumab was first administered in his LE, with a complete resolution of the CME at SD-OCT 2 weeks later. As observed in his RE, 40 days after the ranibizumab injection, there was a relapse of the CME that was treated with 1 intravitreal injection of dexamethasone implant. Five months later, the patient showed a worsening of the CME, but it was completely resolved with a second dexamethasone injection. After 3 months, the foveal thickness was back to normal with a BCVA of 20/20. CONCLUSION Treatment with dexamethasone implants (Ozurdex(®)) and ranibizumab injections (Lucentis(®)) induced a progressive reduction of our patient's CME after cataract surgery (Irvine-Gass syndrome) until a complete normal foveal thickness was restored and his visual function was improved despite the order of injections.
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Affiliation(s)
- Vito Fenicia
- Ophthalmology Unit, NESMOS Department, S. Andrea Hospital, Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Rome, Italy
| | - Marco Balestrieri
- Ophthalmology Unit, NESMOS Department, S. Andrea Hospital, Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Rome, Italy
| | - Andrea Perdicchi
- Ophthalmology Unit, NESMOS Department, S. Andrea Hospital, Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Rome, Italy
| | - Maurizio MauriziEnrici
- Ophthalmology Unit, NESMOS Department, S. Andrea Hospital, Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Rome, Italy
| | - Martina DelleFave
- Ophthalmology Unit, NESMOS Department, S. Andrea Hospital, Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Rome, Italy
| | - Santi Maria Recupero
- Ophthalmology Unit, NESMOS Department, S. Andrea Hospital, Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Rome, Italy
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Hayashi K, Tsuru T, Yoshida M, Hirata A. Intraocular pressure and wound status in eyes immediately after scleral tunnel incision and clear corneal incision cataract surgery. Am J Ophthalmol 2014; 158:232-41. [PMID: 24792102 DOI: 10.1016/j.ajo.2014.04.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 04/18/2014] [Accepted: 04/22/2014] [Indexed: 11/17/2022]
Abstract
PURPOSE To compare intraocular pressure (IOP) and wound architecture immediately after cataract surgery using a scleral tunnel incision or clear corneal incision. DESIGN Prospective randomized clinical trial. METHODS Bilateral eyes of 64 patients undergoing phacoemulsification were randomized to 2 groups: 2.4 mm scleral tunnel incision or 2.4 mm clear corneal incision. IOP was adjusted upon completion of surgery to between 15 and 30 mm Hg. The wound was hydrated in 87.5% of eyes in the clear corneal incision group. IOP was measured using a rebound tonometer preoperatively; at the conclusion of surgery; and at 5, 10, 15, 30, and 60 minutes postoperatively. The Seidel test and anterior segment optical coherence tomography (AS OCT) were performed at 30 minutes postoperatively. RESULTS In the scleral tunnel incision group, mean IOP decreased to the preoperative level within 15 minutes postoperatively and did not change significantly for up to 60 minutes. In the clear corneal incision group, IOP decreased to lower than the preoperative IOP at 30 minutes postoperatively. Mean IOP was significantly higher in the scleral tunnel incision group than in the clear corneal incision group throughout the postoperative period (P≤.0339). Hypotony (<10 mm Hg) was observed in 7 eyes (10.9%) that underwent clear corneal incision and in no eyes that underwent scleral tunnel incision (P=.0131). Wound leakage and loss of wound coaptation were not observed in any eyes. CONCLUSIONS IOP was significantly higher immediately after scleral tunnel incision without hydration than after clear corneal incision with hydration, and both incisions closed within 30 minutes postoperatively without leakage based on AS OCT.
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Lemos-Reis R, Moreira-Gonçalves N, Melo AB, Carneiro AM, Falcão-Reis FM. Immediate effect of intravitreal injection of bevacizumab on intraocular pressure. Clin Ophthalmol 2014; 8:1383-8. [PMID: 25092962 PMCID: PMC4114901 DOI: 10.2147/opth.s64721] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Purpose To investigate the immediate effect of intravitreal injection of bevacizumab on intraocular pressure (IOP). Methods This was a prospective and nonrandomized study. A total of 291 eyes with macular edema or active choroidal neovascularization were submitted to a single 1.25 mg (0.05 mL) bevacizumab intravitreal injection. Intraocular pressure was measured with an Icare® tonometer immediately before and after injection in a seated position. The presence of subconjunctival reflux was recorded. The fellow eye served as the control. Results Mean preoperative IOP was 18.0±5.9 mmHg in the treated eye versus 16.9±6.0 mmHg in the fellow eye. Mean postoperative IOP was 42.1±14.5 mmHg in the treated eye versus 17.5±6.0 mmHg in the fellow eye. The IOP variation was statistically significant in both cases and controls (P<0.001 and P=0.003, respectively), and this increase was higher in cases than in controls (P<0.001). Postoperative IOPs higher than 50 mmHg were achieved in 32.0% of the eyes. Subconjunctival reflux was present in 21.3% and determined a lower IOP rise (P<0.001). Tested variables (glaucoma, phakic status, and sex) did not have a statistically significant effect on IOP rise or subconjunctival reflux. Conclusion IOP increases with intravitreal bevacizumab injection, reaching 50 mmHg or more in about one third of patients. A higher IOP is expected if no subconjunctival reflux occurs. The baseline IOP does not influence the incidence of subconjunctival reflux. The clinical relevance of these facts has yet to be clarified.
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Affiliation(s)
| | | | - António B Melo
- Department of Ophthalmology of Hospital de São João, Porto, Portugal
| | - Angela M Carneiro
- Department of Ophthalmology of Hospital de São João, Porto, Portugal ; Department of Sense Organs, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Fernando M Falcão-Reis
- Department of Ophthalmology of Hospital de São João, Porto, Portugal ; Department of Sense Organs, Faculty of Medicine, University of Porto, Porto, Portugal
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Abstract
PURPOSE To determine intrasession and intersession repeatability of retinal vessel oxygen saturation from the Oxymap Retinal Oximeter using a whole image-based analysis technique and so determine optimal analysis parameters to reduce variability. METHODS Ten fundus oximetry images were acquired through dilated pupils from 18 healthy participants (aged 22 to 38) using the Oxymap Retinal Oximeter T1. A further 10 images were obtained 1 to 2 weeks later from each individual. Analysis was undertaken for subsets of images to determine the number of images needed to return a stable coefficient of variation (CoV). Intrasession and intersession variability were quantified by evaluating the CoV and establishing the 95% limits of agreement using Bland and Altman analysis. Retinal oxygenation was derived from the distribution of oxygenation values from all vessels of a given width in an image or set of images, as described by Paul et al. in 2013. RESULTS Grouped in 10-μm-wide bins, oxygen saturation varied significantly for both arteries and veins (p < 0.01). Between 110 and 150 μm, arteries had the least variability between individuals, with average CoVs less than 5% whose confidence intervals did not overlap with the greater than 10% average CoVs for veins across the same range. Bland and Altman analysis showed that there was no bias within or between recording sessions and that the 95% limits of agreement were generally lower in arteries. CONCLUSIONS Retinal vessel oxygen saturation measurements show variability within and between clinical sessions when the whole image is used, which we believe more accurately reflects the true variability in Oxymap images than previous studies on select image segments. Averaging data from vessels 100 to 150 μm in width may help to minimize such variability.
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Hayashi K, Yoshida M, Yoshimura K. Immediate changes in intraocular pressure after clear corneal micro-incision versus small-incision cataract surgery. Jpn J Ophthalmol 2014; 58:402-8. [PMID: 24969339 DOI: 10.1007/s10384-014-0331-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 04/30/2014] [Indexed: 11/24/2022]
Abstract
PURPOSE We sought to examine changes in intraocular pressure (IOP) in the immediate period after clear corneal micro-incision cataract surgery (MICS) and after small-incision cataract surgery (SICS). METHODS Sixty-eight eyes of 34 patients scheduled for coaxial phacoemulsification were randomized into one of two groups: (a) eyes that were to undergo a 2.0-mm MICS, and (b) a 2.65-mm SICS. At the conclusion of surgery, the IOP was adjusted to the range between 15-40 mmHg with stromal hydration. The IOP was measured using a rebound tonometer preoperatively, at the conclusion of surgery, and at 3, 6, 9, 12, and 15 min postoperatively. The Seidel test and anterior segment-optical coherence tomography were performed at 20 min postoperatively. RESULTS Mean IOP at the conclusion of surgery was 27.7 ± 4.7 mmHg in the MICS group and 29.7 ± 5.1 mmHg in the SICS group (p = 0.1239). In both groups, mean IOP decreased to the preoperative level within 9 min postoperatively and did not change significantly for up to 15 min. Mean IOP was similar between the MICS and SICS groups throughout the observation period (p ≥ 0.1239). Hypotony (≤10 mmHg), positive Seidel test, and loss of wound coaptation were not detected in all eyes. CONCLUSIONS After adjusting the IOP to a relatively high level at the conclusion of surgery, the IOP decreased within 9 min and was stable within 15 min without hypotony. The IOP was comparable between eyes after MICS and SICS, and both incisions virtually closed within 20 min postoperatively.
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Affiliation(s)
- Ken Hayashi
- Hayashi Eye Hospital, 4-23-35 Hakataekimae, Hakata-Ku, Fukuoka, 812-0011, Japan,
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Olafsdottir OB, Vandewalle E, Abegão Pinto L, Geirsdottir A, De Clerck E, Stalmans P, Gottfredsdottir MS, Kristjansdottir JV, Van Calster J, Zeyen T, Stefánsson E, Stalmans I. Retinal oxygen metabolism in healthy subjects and glaucoma patients. Br J Ophthalmol 2014; 98:329-33. [DOI: 10.1136/bjophthalmol-2013-303162] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Ganglion Cell Complex Evaluation in Exudative Age-Related Macular Degeneration after Repeated Intravitreal Injections of Ranibizumab. BIOMED RESEARCH INTERNATIONAL 2014. [DOI: 10.1155/2014/268796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. To detect the effects of intravitreal ranibizumab injections on GCC in patients with wet AMD.Methods. 32 wet AMD eyes were selected and submitted at three ranibizumab injections. RTVue-OCT GCC and MM5 protocol were performed before treatment and twenty days after each injection.Results. At baseline mean GCC thickness was 93.9 ± 18.5 μm. Twenty days after each intravitreal injection it was, respectively, 85.8 ± 10.1, 86.5 ± 9.3, and 91.1 ± 11.5 μm, without statistical significance. A significant improvement in visual acuity (P= 0.031) and a reduction of mean foveal (P= 0.001) and macular thickness (P= 0.001) were observed.Conclusion. The clinical results confirm therapeutic efficacy of intravitreal injections of ranibizumab in wet AMD. A contemporary not statistically significant reduction of GCC thickness suggests that the loading phase of ranibizumab does not have any toxic effects on ganglion cell complex.
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Hayashi K, Yoshida M, Manabe SI, Yoshimura K. Effect of high pressurization versus normal pressurization on changes in intraocular pressure immediately after clear corneal cataract surgery. J Cataract Refract Surg 2014; 40:87-94. [DOI: 10.1016/j.jcrs.2013.07.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 07/08/2013] [Accepted: 07/11/2013] [Indexed: 10/26/2022]
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Grosso A, Scozzari G, Bert F, Mabilia MA, Siliquini R, Morino M. Intraocular pressure variation during colorectal laparoscopic surgery: standard pneumoperitoneum leads to reversible elevation in intraocular pressure. Surg Endosc 2013; 27:3370-6. [DOI: 10.1007/s00464-013-2919-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Accepted: 02/22/2013] [Indexed: 10/27/2022]
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Kerr NM, Abell RG, Vote BJ, Toh T'Y. Intraocular pressure during femtosecond laser pretreatment of cataract. J Cataract Refract Surg 2013; 39:339-42. [PMID: 23312148 DOI: 10.1016/j.jcrs.2012.12.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 11/08/2012] [Accepted: 12/03/2012] [Indexed: 02/02/2023]
Abstract
PURPOSE To analyze the course of intraocular pressure (IOP) during femtosecond laser pretreatment to cataract surgery. SETTING Launceston Eye Institute, Tasmania, Australia. DESIGN Interventional prospective study. METHODS Femtosecond laser pretreatment was performed using the Catalys Precision Laser System with Liquid Optics Interface. The IOP was measured using a rebound tonometer (iCare PRO) during different stages of surgery and analyzed by number of docking attempts, vacuum time, treatment time, and central corneal thickness (CCT). RESULTS The mean baseline IOP in the 25 eyes was 17.5 mm Hg ± 2.4 (SD). During vacuum application, the mean IOP rise was 11.4 ± 3.3 mm Hg. Peak IOPs were recorded immediately after laser capsulotomy and lens fragmentation (mean 36.0 ± 4.4 mm Hg; mean increase from baseline 18.5 ± 4.7 mm Hg) and remained above baseline 2 minutes after the procedure (26.6 ± 4.0 mm Hg) (P<.001). Multiple regression analysis found no association between IOP rise and number of docking attempts, vacuum time, treatment time, or CCT. CONCLUSION Femtosecond laser pretreatment was associated with a mean peak increase in IOP of 18.5 mm Hg from baseline and appeared to be safe and well tolerated.
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Affiliation(s)
- Nathan M Kerr
- Launceston Eye Institute, Launceston, Tasmania, Australia.
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Lee K, Lee JY, Moon JI, Park MH. Comparison of Icare Rebound Tonometer with Goldmann Applanation Tonometry. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.2.296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Kook Lee
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Ji Young Lee
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jung Il Moon
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Myoung Hee Park
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
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Halkiadakis I, Stratos A, Stergiopoulos G, Patsea E, Skouriotis S, Mitropoulos P, Papaconstantinou D, Georgopoulos G. Evaluation of the Icare-ONE rebound tonometer as a self-measuring intraocular pressure device in normal subjects. Graefes Arch Clin Exp Ophthalmol 2012; 250:1207-11. [PMID: 22297535 DOI: 10.1007/s00417-011-1875-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Revised: 11/07/2011] [Accepted: 11/15/2011] [Indexed: 10/14/2022] Open
Abstract
PURPOSE To compare Icare ONE rebound self-tonometer (ICRBT) measurements with Goldman applanation tonometry (GAT). METHODS A trained examiner instructed each of 60 normal subjects on use of the ICRBT. Each subject then took two measurements of his/her own pressure using the ICRBT. Finally, a different examiner, who was masked to the earlier readings, measured IOP by GAT. Bland–Altman limits of agreement (LOA), intraclass correlation coefficients (ICCs), Kappa values, and paired t-test were used to assess the agreement between the two methods. Pearson’s correlation coefficient was used for correlation analysis. RESULTS All of the subjects were able to obtain correct measurements with ICRBT after three attempts. The mean intraocular pressure with ICRBT and GAT measurements were 16.0 ± 3.3 mmHg and 13.7 ± 2.5 mmHg respectively. The mean difference between patient’s ICRBT and technician’s GAT measurements was 2.3 mmHg (p < 0.001). In 63% (38/60) of the cases the IOP difference (ICRBT − GAT) was within ± 3 mmHg. The weighted Kappa for the IOP measurements of the two methods was 0.49 (95% CI: 0.30–0.68, p < 0.001), indicating acceptable agreement. A significantly positive correlation was found between ICRBT IOP measurements and central corneal thickness (CCT) (r = 0.48, p < 0.001). In addition, the difference in IOP measurements (ICRBT − GAT) between the two methods was positively correlated with CCT (r = 0.31, p = 0.015), indicating that greater thickness is associated with greater differences between the two methods. CONCLUSION The ICRBT was reliable in the hands of normal subjects, and may be used for self-monitoring of IOP. ICRBT measurements generally overestimated GAT measurements.
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Affiliation(s)
- Ioannis Halkiadakis
- Ophthalmiatrion Athinon, Athens Eye Hospital, Konstadinoupoleos 17 Marousi, 15124 Athens, Greece.
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Hohmann J, Schulze-Schwering M, Chirambo Nyaka T, Moyo V, Kayange PC, Doycheva D, Batumba NH, Spitzer MS. [Comparison of the iCare tonometer with the Goldmann tonometer in Malawi]. Ophthalmologe 2012; 109:1098-102. [PMID: 22932851 DOI: 10.1007/s00347-012-2599-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The risk for glaucoma is 4-5 times higher in patients from sub-Saharan Africa. Thus, especially in developing countries an easy and effective method for assessing the intraocular pressure (IOP) is needed. METHODOLOGY In this hospital-based survey 150 eyes were divided into 3 groups concerning the IOP (group I < 16 mmHg, group II 16-23 mmHg and group III > 23 mmHg) and underwent examination with ultrasound pachymetry followed by iCare tonometry (ICT) and Goldmann applanation tonometry (GAT). Agreement of the measurements by two tonometers was assessed with the Bland-Altman method and the influence of the central corneal thickness (CCT) on the ICT measurements was determined. RESULTS The mean difference between the IOD measured with GAT and ICT was 0.84 ± 2.63 mmHg. The differences were similar in all three groups (0.77-0.97 mmHg), however, the standard deviation in group III (4.04 mmHg) was greater than in groups I (1.98 mmHg) and II (1.79 mmHg). The mean CCT was 513.51 ± 36.22 µm. CONCLUSIONS The agreement of measurements by GAT and ICT was good for lower IOP values but less accurate in patients with higher IOP values (group III). A dependency of the CCT on the ICT measurements was observed. In comparison to other countries the lowest CCTs were found in Malawian patients.
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Affiliation(s)
- J Hohmann
- Universitäts-Augenklinik Tübingen, Tübingen, Deutschland.
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