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Stodtmeister R, Menzel A, Klimova A, Herber R, Pillunat KR, Pillunat LE. Measurement of the retinal venous pressure with a new instrument in patients with primary open angle glaucoma. Graefes Arch Clin Exp Ophthalmol 2024; 262:1633-1639. [PMID: 38214734 PMCID: PMC11031493 DOI: 10.1007/s00417-023-06326-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 08/28/2023] [Accepted: 11/20/2023] [Indexed: 01/13/2024] Open
Abstract
PURPOSE To compare the results of retinal venous pressure (RVP) measurement performed with contact lens dynamometry (CLD) and with the new IOPstim. METHODS In this cross-sectional study, we included 36 patients with primary open angle glaucoma with a median age (Q25; Q75) of 74 (64; 77) years (m/f = 18/18), baseline intraocular pressure (IOP): 13.9 (12.2; 15.1) mmHg. Median mean defect: - 5.8 (- 11.9; - 2.6) db. Principle of the IOPstim: an empty balloon with a diameter of 8 mm is positioned on the eye, laterally of the limbus. Under observation of the central retinal vein (CRV), the examiner inflates the balloon. As soon as the CRV starts pulsation, the inflation is stopped and the IOP is measured, equaling the RVP at this moment. In the CLD, the pulsation of the CRV is observed with a contact lens. The RVP is calculated from the attachment force applied when pulsation appears. COURSE OF EXAMINATIONS Three single measurements of RVP in quick succession with both methods. The sequence of the two methods was randomized. The means of the three RVP measurements were compared. RESULTS Pressures in mmHg. RVP: IOPstim: 19.4 ± 5.4 (mean ± SD), CLD: 20.3 ± 5.9. Range of three single measurements: IOPstim: 2.9 ± 1.5, CLD: 2.2 ± 1.1. The differences were RVPIOPstim - RVPCLD = - 0.94 ± 1.15, and approximately normally distributed. Bland-Altman analysis: only one data point was 0.5 mmHg higher than the upper line of agreement. The confidence interval of this line was 0.65 mmHg. Concordance correlation coefficient according to Lin (CCC): 0.96. Intraclass correlation coefficient: both methods, 0.94. CONCLUSION In both methods, the range of the single measurements may be taken as a sign of good reliability, the CCC of 0.96 as a sign of a very good agreement. At the mean, the IOPstim RVP values were 1 mmHg lower than those obtained with the CLD. This difference may be due to the different directions of the prevailing force vectors induced by the instruments. The IOPstim seems applicable in glaucoma diagnostics.
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Affiliation(s)
- Richard Stodtmeister
- Department of Ophthalmology, Univ. Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Aline Menzel
- Department of Ophthalmology, Univ. Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Anna Klimova
- National Center for Tumor Diseases (NCT/UCC), German Cancer Research Center (DKFZ), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), 01307, Dresden, Germany
| | - Robert Herber
- Department of Ophthalmology, Univ. Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Karin R Pillunat
- Department of Ophthalmology, Univ. Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
| | - Lutz E Pillunat
- Department of Ophthalmology, Univ. Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
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Harvey DH, Roberts CJ, Mahmoud AM, Nuñez FM, Ma Y, Fleming GP. Biomechanical and Vascular Metrics Between Eyes of Patients With Asymmetric Glaucoma and Symmetric Glaucoma. J Glaucoma 2024; 33:334-339. [PMID: 38194297 DOI: 10.1097/ijg.0000000000002363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/25/2023] [Indexed: 01/10/2024]
Abstract
PRCIS Corneal hysteresis (CH) and pulsatile ocular blood volume (POBV) were significantly lower in the eye with greater damage in asymmetric glaucoma, without a difference in intraocular pressure (IOP) or central corneal thickness (CCT), and no difference in elastic parameters. OBJECTIVE To compare biomechanical and vascular metrics between the eyes of patients with asymmetric glaucoma (ASYMM) and those with symmetric glaucoma (SYMM). PATIENTS AND METHODS Forty-five patients were prospectively recruited and divided into ASYMM, defined as cup-to-disc (C/D) ratio difference >0.1 between eyes and SYMM, with C/D difference ≤0.1. For ASYMM, the smaller C/D was defined as the best eye ("best") and the fellow eye was defined as the worst eye ("worse"). All metrics were subtracted as "worse" minus "best," including the viscoelastic parameter CH, and elastic parameters from the Corvis ST, including stiffness parameter at first applanation, stiffness parameter at highest concavity, integrated inverse radius, deformation amplitude ratio, IOP, CCT, mean deviation (MD), ganglion cell complex (GCC), and POBV were included. Paired t tests were performed between eyes in both groups. Statistical analyses were performed with SAS using a significance threshold of P <0.05. RESULTS For ASYMM (16 patients), "worse" showed significantly lower CH (-0.76 ± 1.22), POBV (-0.38 ± 0.305), MD (-3.66 ± 6.55), and GCC (-7.9 ± 12.2) compared with "best." No other parameters were significantly different. For SYMM (29 patients), there were no significantly different metrics between eyes. CONCLUSIONS Lower CH, POBV, GCC, and worse MD were associated with greater glaucomatous damage in asymmetric glaucoma without a difference in IOP or CCT. Lower CH and GCC are consistent with previous studies. POBV, a new clinical parameter that may indicate reduced blood flow, is also associated with greater damage.
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Affiliation(s)
| | - Cynthia J Roberts
- Ophthalmology and Visual Sciences, The Ohio State University
- Biomedical Engineering, The Ohio State University, Columbus, Ohio
| | - Ashraf M Mahmoud
- Ophthalmology and Visual Sciences, The Ohio State University
- Biomedical Engineering, The Ohio State University, Columbus, Ohio
| | | | - Yanhui Ma
- Ophthalmology and Visual Sciences, The Ohio State University
| | - Gloria P Fleming
- Ophthalmology and Visual Sciences, The Ohio State University
- Biomedical Engineering, The Ohio State University, Columbus, Ohio
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Carr F, Rezai P, Melmane S, Poole T, Gangwani V. Out glides the lens, up goes the pressure: multicenter analysis of intraocular pressure after preloaded hydrophobic acrylic monofocal intraocular lens insertion. J Cataract Refract Surg 2024; 50:536-537. [PMID: 38651699 DOI: 10.1097/j.jcrs.0000000000001377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 11/29/2023] [Indexed: 04/25/2024]
Affiliation(s)
- Francis Carr
- From the Ashford & St Peter's NHS Foundation Trust, Surrey, United Kingdom (Carr, Rezai, Gangwani); Frimley Health NHS Foundation Trust, Surrey, United Kingdom (Melmane, Poole)
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Hoang TT, Anh BV, Subramanian P. Is Glaucoma a Two-Pressure-Related Optic Neuropathy? A Systematic Review and Meta-Analysis. Turk J Ophthalmol 2024; 54:83-89. [PMID: 38645613 PMCID: PMC11034542 DOI: 10.4274/tjo.galenos.2024.66267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 01/28/2024] [Indexed: 04/23/2024] Open
Abstract
Objectives To review the current literature related to the correlation between translaminar pressure difference (TLPD) and glaucoma. Materials and Methods In this article, we conducted a literature review using MEDLINE via PubMed, Cochrane Eyes and Vision, and Google Scholar from 01/01/2010 to 31/12/2022. Search terms included "glaucoma", "intraocular pressure", "translaminar cribrosa pressure gradient/difference", "intracranial pressure", and "cerebrospinal fluid pressure". Of 471 results, 8 articles were selected for the meta-analysis. Results Our meta-analysis demonstrated significantly higher intraocular pressure, lower cerebrospinal fluid pressure (CSFp), and greater TLPD in high-tension and normal-tension glaucoma groups compared to healthy groups. Conclusion The differences in CSFp and TLPD between glaucoma and healthy people detected in current studies suggests a potential relationship between TLPD and glaucoma.
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Affiliation(s)
- Tung Thanh Hoang
- Hanoi Medical University, Department of Ophthalmology, Hanoi, Vietnam
- Hanoi Medical University Hospital, Division of Ophthalmology, Hanoi, Vietnam
- The University of Sydney School of Medicine, Save Sight Institute, Sydney, Australia
| | - Bui Van Anh
- Vietnam National Eye Hospital, Department of Glaucoma, Hanoi, Vietnam
| | - Prem Subramanian
- University of Colorado School of Medicine, Department of Ophthalmology, Aurora, USA
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Greatbatch CJ, Lu Q, Hung S, Barnett AJ, Wing K, Liang H, Han X, Zhou T, Siggs OM, Mackey DA, Cook AL, Senabouth A, Liu GS, Craig JE, MacGregor S, Powell JE, Hewitt AW. High throughput functional profiling of genes at intraocular pressure loci reveals distinct networks for glaucoma. Hum Mol Genet 2024; 33:739-751. [PMID: 38272457 PMCID: PMC11031357 DOI: 10.1093/hmg/ddae003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 12/18/2023] [Accepted: 04/06/2024] [Indexed: 01/27/2024] Open
Abstract
INTRODUCTION Primary open angle glaucoma (POAG) is a leading cause of blindness globally. Characterized by progressive retinal ganglion cell degeneration, the precise pathogenesis remains unknown. Genome-wide association studies (GWAS) have uncovered many genetic variants associated with elevated intraocular pressure (IOP), one of the key risk factors for POAG. We aimed to identify genetic and morphological variation that can be attributed to trabecular meshwork cell (TMC) dysfunction and raised IOP in POAG. METHODS 62 genes across 55 loci were knocked-out in a primary human TMC line. Each knockout group, including five non-targeting control groups, underwent single-cell RNA-sequencing (scRNA-seq) for differentially-expressed gene (DEG) analysis. Multiplexed fluorescence coupled with CellProfiler image analysis allowed for single-cell morphological profiling. RESULTS Many gene knockouts invoked DEGs relating to matrix metalloproteinases and interferon-induced proteins. We have prioritized genes at four loci of interest to identify gene knockouts that may contribute to the pathogenesis of POAG, including ANGPTL2, LMX1B, CAV1, and KREMEN1. Three genetic networks of gene knockouts with similar transcriptomic profiles were identified, suggesting a synergistic function in trabecular meshwork cell physiology. TEK knockout caused significant upregulation of nuclear granularity on morphological analysis, while knockout of TRIOBP, TMCO1 and PLEKHA7 increased granularity and intensity of actin and the cell-membrane. CONCLUSION High-throughput analysis of cellular structure and function through multiplex fluorescent single-cell analysis and scRNA-seq assays enabled the direct study of genetic perturbations at the single-cell resolution. This work provides a framework for investigating the role of genes in the pathogenesis of glaucoma and heterogenous diseases with a strong genetic basis.
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Affiliation(s)
- Connor J Greatbatch
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania 7000, Australia
| | - Qinyi Lu
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania 7000, Australia
| | - Sandy Hung
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, 32 Gisborne St, East Melbourne 3002, Australia
| | - Alexander J Barnett
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania 7000, Australia
| | - Kristof Wing
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania 7000, Australia
| | - Helena Liang
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, 32 Gisborne St, East Melbourne 3002, Australia
| | - Xikun Han
- QIMR Berghofer Medical Research Institute, 300 Herston Rd, Herston, Brisbane 4006, Australia
| | - Tiger Zhou
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, 1 Flinders Dr, Bedford Park, South Australia 5042, Australia
| | - Owen M Siggs
- Garvan Institute of Medical Research, 384 Victoria St, Darlinghurst, Sydney, NSW 2010, Australia
- School of Clinical Medicine, Faculty of Medicine and Health, Short Street, St George Hospital KOGARAH UNSW, Sydney 2217, Australia
| | - David A Mackey
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania 7000, Australia
- Lions Eye Institute, Centre for Vision Sciences, University of Western Australia, 2 Verdun Street Nedlands WA 6009, Australia
| | - Anthony L Cook
- Wicking Dementia Research and Education Centre, University of Tasmania, 17 Liverpool Street, Hobart, TAS 7000, Australia
| | - Anne Senabouth
- Garvan-Weizmann Centre for Cellular Genomics, Garvan Institute of Medical Research, 384 Victoria St, Darlinghurst, Sydney, NSW 2010, Australia
| | - Guei-Sheung Liu
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania 7000, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, 1 Flinders Dr, Bedford Park, South Australia 5042, Australia
| | - Stuart MacGregor
- QIMR Berghofer Medical Research Institute, 300 Herston Rd, Herston, Brisbane 4006, Australia
| | - Joseph E Powell
- Garvan-Weizmann Centre for Cellular Genomics, Garvan Institute of Medical Research, 384 Victoria St, Darlinghurst, Sydney, NSW 2010, Australia
- UNSW Cellular Genomics Futures Institute, University of New South Wales, 384 Victoria St, Darlinghurst, Sydney, NSW 2010, Australia
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania 7000, Australia
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, 32 Gisborne St, East Melbourne 3002, Australia
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Lüke JN, Gietzelt C, Enders P, Dietlein J, Lappa A, Lüke V, Widder RA, Dietlein TS. Susceptibility of optic nerve head in children with posture-related elevation of intraocular pressure. Int Ophthalmol 2024; 44:182. [PMID: 38625418 PMCID: PMC11021221 DOI: 10.1007/s10792-024-03109-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/24/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND/AIMS This work aimed to investigate changes in optic nerve head (ONH) morphometry based on Bruch membrane opening in children with extensive nocturnal intraocular pressure (IOP) elevations. METHODS The course of Bruch membrane opening-based optic nerve head (ONH) morphometry was analysed in thirty-two patients younger than 18 years with evaluable SD-OCT examinations of the ONH and nocturnal posture-dependent IOP elevation above 25 mmHg. Longitudinal changes in neuroretinal rim tissue, as measured by Bruch Membrane opening minimum rim width (BMO-MRW) and peripapillary retinal nerve fiber layer (RNFL) thickness, were assessed. RESULTS One year after the 24 h IOP measurement, global BMO-MRW (- 1.61 ± 16.8 µm, n.s.; p = 0.611) and RNFL (+ 0.64 ± 3.17 µm; n.s.; p = 0.292) measurements were not significantly different from the baseline. No significant BMO-MRW reduction (- 3.91 ± 24.3 µm; n.s. p = 0.458) or deviation in RNFL thickness (+ 1.10 ± 3.52 µm) was observed at the four-year follow-up. Absolute IOP values measured in the supine position did not correlate with changes in global BMO-MRW or RNFL thickness. CONCLUSION Posture-dependent IOP elevations do not seem to influence retinal nerve fibre layer thickness or Bruch membrane opening-based morphometric data in childhood.
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Affiliation(s)
- Jan Niklas Lüke
- Department of Ophthalmology, Medical Faculty and University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
| | - Caroline Gietzelt
- Department of Ophthalmology, Medical Faculty and University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Philip Enders
- Department of Ophthalmology, Medical Faculty and University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Johanna Dietlein
- Department of Ophthalmology, Medical Faculty and University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Alexandra Lappa
- Department of Ophthalmology, Medical Faculty and University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Vincent Lüke
- Department of Ophthalmology, Medical Faculty and University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Randolf Alexander Widder
- Department of Ophthalmology, St. Martinus-Krankenhaus Düsseldorf, Gladbacher Str. 26, 40219, Düsseldorf, Germany
| | - Thomas S Dietlein
- Department of Ophthalmology, Medical Faculty and University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
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Li X. Changes in corneal biomechanics in patients with glaucoma: a systematic review and meta-analysis. BMC Ophthalmol 2024; 24:168. [PMID: 38622519 PMCID: PMC11017643 DOI: 10.1186/s12886-024-03443-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 04/09/2024] [Indexed: 04/17/2024] Open
Abstract
INTRODUCTION Corneal biomechanics has been implicated in a variety of ocular diseases. The purpose of this study was to evaluate the relationship between the glaucoma and corneal biomechanical properties, and exploring the value of corneal biomechanics in the diagnosis and follow-up of glaucoma diseases. METHODS We searched studies in PubMed, EMBASE, Web of Science and clinicaltrials.gov., as of October 8, 2022. Only English studies were included, without publication time limit. We also searched the reference lists of published reviews. This meta-analysis was conducted with random-effects models, we used mean difference(MD) to evaluate the outcome, and the heterogeneity was assessed with the I2 statistic. Subgroup analyses were performed under the appearance of high heterogeneity. We used 11 items to describe the characteristics of included studies, publication bias was performed through the Egger's test. The quality assessment were evaluated by Newcastle-Ottawa Scale(NOS) items. RESULTS A total of 27 eligible studies were identified for data synthesis and assessment. The result of meta-analysis showed that in the comparison of included indicators, the corneal biomechanics values of glaucoma patients were statistically lower than those of normal subjects in a similar age range. The covered indicators included central corneal thickness(CCT) (MD = -8.34, 95% CI: [-11.74, -4.94]; P < 0.001), corneal hysteresis(CH)(MD = -1.54, 95% CI: [-1.88, -1.20]; P < 0.001), corneal resistance factor(CRF)( MD = -0.82, 95% CI: [-1.21, -0.44]; P < 0.001), and intraocular pressure(IOP)( corneal-compensated intraocular pressure (IOPcc): MD = 2.45, 95% CI: [1.51, 3.38]; P < 0.001); Goldmann-correlated intraocular pressure (IOPg): MD = 1.30, 95% CI: [0.41, 2.20]; P = 0.004), they all showed statistical difference. While the value of axial length(AL) did not show statistically different(MD = 0.13, 95% CI: [-0.24, 0.50]; P = 0.48). CONCLUSION Corneal biomechanics are associated with glaucoma. The findings can be useful for the design of glaucoma screening, treatment and prognosis.
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Affiliation(s)
- Xinru Li
- Department of Ophthalmology, The First People's Hospital of Yongkang Affiliated to Hangzhou Medical College, Yongkang, 321300, Zhejiang, P. R. China.
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Tang J, Lin Z, Liu X, Li B, Wu X, Lv J, Qi X, Lin S, Dai C, Li T. Analyzing the changing trend of corneal biomechanical properties under different influencing factors in T2DM patients. Sci Rep 2024; 14:8160. [PMID: 38589521 PMCID: PMC11001873 DOI: 10.1038/s41598-024-59005-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/05/2024] [Indexed: 04/10/2024] Open
Abstract
To analyze the changing trend of CH and CRF values under different influencing factors in T2DM patients. A total of 650 patients with T2DM were included. We discovered that the course of T2DM, smoking history, BMI, and FBG, DR, HbA1c, TC, TG, and LDL-C levels were common risk factors for T2DM, while HDL-C levels were a protective factor. Analyzing the CH and CRF values according to the course of diabetes, we discovered that as T2DM continued to persist, the values of CH and CRF gradually decreased. Moreover, with the increase in FBG levels and the accumulation of HbA1c, the values of CH and CRF gradually decreased. In addition, in patients with HbA1c (%) > 12, the values of CH and CRF decreased the most, falling by 1.85 ± 0.33 mmHg and 1.28 ± 0.69 mmHg, respectively. Compared with the non-DR group, the CH and CRF values gradually decreased in the mild-NPDR, moderate-NPDR, severe-NPDR and PDR groups, with the lowest CH and CRF values in the PDR group. In patients with T2DM, early measurement of corneal biomechanical properties to evaluate the change trend of CH and CRF values in different situations will help to identify and prevent diabetic keratopathy in a timely manner.
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Affiliation(s)
- Juan Tang
- Department of Endocrinology, Ziyang Central Hospital, Sichuan, China
| | - Zhiwu Lin
- Department of Cardiothoracic Surgery, Ziyang Central Hospital, Sichuan, China
| | - Xingde Liu
- Department of Ophthalmology, Ziyang Central Hospital, Sichuan, China
| | - Biao Li
- Department of Ophthalmology, Ziyang Central Hospital, Sichuan, China
| | - Xiaoli Wu
- Department of Ophthalmology, Ziyang Central Hospital, Sichuan, China
| | - Jing Lv
- Department of Orthopedics, Ziyang Central Hospital, Sichuan, China
| | - Xing Qi
- Department of Experimental Medicine, Ziyang Central Hospital, Sichuan, China
| | - Sheng Lin
- Department of Experimental Medicine, Ziyang Central Hospital, Sichuan, China
| | - Chuanqiang Dai
- Department of Orthopedics, Ziyang Central Hospital, Sichuan, China.
| | - Tao Li
- Department of Ophthalmology, Ziyang Central Hospital, Sichuan, China.
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Da Silva F, Linhares JMM, Lira M. The influence of the tear film on the intraocular pressure and the corneal biomechanical properties analyzed with the Ocular Response Analyzer. J Optom 2024; 17:100488. [PMID: 37918060 PMCID: PMC10641536 DOI: 10.1016/j.optom.2023.100488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/11/2023] [Accepted: 07/25/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE As ocular dryness and glaucoma are more prevalent with increasing age, understanding how the tear film affects tonometry is important. The present study aims to understand the impact that changes in the tear film have on intraocular pressure (IOP), corneal hysteresis, and corneal resistance factor measurements. METHODS Cross-sectional research was conducted and 37 patients were assessed. The tear film lipid layer and the non-invasive break-up time (NIBUT) were evaluated using the Tearscope Plus (Keeler, Windsor, UK). Dry eye symptoms were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire. IOP was measured using rebound tonometry and the Ocular Response Analyzer (ORA, Reichert). Corneal biomechanical properties were measured using ORA. RESULTS It was found that an increase in the IOP measured with the iCare was directly correlated with the subclass that evaluated symptomatology associated with environmental factors (r = 0.414, p<0.05, Spearman). Goldmann-correlated IOP (IOPg) and Corneal-compensated IOP (IOPcc) values were statistically significantly different between the various interferometric patterns (p<0.05). It was also found that an increase in the corneal biomechanical properties measured with ORA was directly correlated with the overall scores obtained when using the OSDI and some of its subclasses. CONCLUSIONS Tear film interferometric patterns were shown to have some impact on the IOP measured using ORA. The IOP measured with iCare seems to be related to the symptomatology obtained from OSDI. Corneal biomechanical properties were related to the OSDI total score and some of its subclasses. An increase in symptomatology was associated with an increase in the measured biomechanical properties of the cornea.
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Affiliation(s)
- Filipe Da Silva
- Physics Center of Minho and Porto Universities (CF-UM-UP), School of Sciences, University of Minho, Braga, Portugal.
| | - João M M Linhares
- Physics Center of Minho and Porto Universities (CF-UM-UP), School of Sciences, University of Minho, Braga, Portugal
| | - Madalena Lira
- Physics Center of Minho and Porto Universities (CF-UM-UP), School of Sciences, University of Minho, Braga, Portugal
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Terauchi R, Wada T, Fukai K, Tatemichi M, Sano K, Nishijima E, Ogawa S, Noro T, Ito K, Kato T, Kato K, Nakano T. Association Between Days of the Week and Intraocular Pressure: Japan Ningen Dock Study. J Glaucoma 2024; 33:262-269. [PMID: 37974321 DOI: 10.1097/ijg.0000000000002333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 10/25/2023] [Indexed: 11/19/2023]
Abstract
PRCIS The analysis of intraocular pressure (IOP) by day of the week using the mega database showed a periodic weekly pattern with the highest value on Monday. PURPOSE To evaluate IOP by the day of the week. PATIENTS AND METHODS Annual health checkup examinees between April 2014 and March 2015 were cross-sectionally evaluated. As a result, 655,818 participants [51.5±10.5 (range: 20-96) years, 40.1% women] from 103 medical centers were included. IOP was measured using a noncontact tonometer. The mean IOPs of each day of the week were compared using multiple comparison test and multiple linear regression analysis. Wednesday was set as the reference. Moreover, weekly IOP variations stratified by sex and age were also evaluated. RESULTS Mean IOPs from Monday to Sunday were 13.19±2.97, 13.06±2.92, 13.05±2.91, 13.05±2.92, 13.12±2.94, 13.10±2.96, and 13.16±2.78 mm Hg. IOP was significantly higher on Monday, Friday, and Saturday than those on Wednesday ( P <0.001, <0.001, 0.002). After adjusting for factors affecting IOP, the IOPs on Monday and Saturday were higher than those on Wednesday [β=0.097 (95% CI: 0.074-0.121), P <0.001; β=0.032 (95% CI: 0.005-0.059), P =0.019]. Men had significantly higher IOPs on Monday and Saturday than on Wednesday [β=0.142 (95% CI: 0.110-0.173), P <0.001; β=0.053 (95% CI: 0.017-0.089), P =0.004], whereas women did not have a significant trend. Participants aged below 65 years had higher IOPs on Monday ( P <0.001 in under 60 years; P =0.003 in 60-64 years), while those aged 65 years or older did not ( P =0.856). CONCLUSION IOP values may have a periodic weekly pattern. The high IOP on Monday was more pronounced in men aged less than 65 years.
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Affiliation(s)
| | - Takashi Wada
- Health Science, The Jikei University Graduate School of Medicine, Tokyo
| | - Kota Fukai
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara
| | - Masayuki Tatemichi
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara
| | | | | | | | | | - Kyoko Ito
- Centre for Preventive Medicine, The Jikei University School of Medicine
| | - Tomohiro Kato
- Centre for Preventive Medicine, The Jikei University School of Medicine
| | - Kiminori Kato
- Department of Prevention of Noncommunicable Diseases and promotion of Health Checkup, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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11
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Beres H, Scharioth GB, Ferreira Rios I, Scarfone HA. Comment on: Experimental study comparing 2 different phacoemulsification systems with intraocular pressure control during steady-state flow and occlusion break surge events. J Cataract Refract Surg 2024; 50:436-437. [PMID: 38523281 DOI: 10.1097/j.jcrs.0000000000001416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Affiliation(s)
- Hanga Beres
- From the Aurelios Augenzentrum Recklinghausen, Recklinghausen, Germany (Beres, Scharioth); University of Medicine, Pharmacy, Science and Technology of Targu Mures, Romania (Beres); UNAM University, Mexico City, México (Rios); Clinica de Ojos Tandil, Argentina, Tandil (Scarfone)
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12
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Redaelli E, Nana M, Calvo B, Rodríguez Matas JF, Luraghi G, Rozema J, Grasa J. Improving early detection of keratoconus by Non Contact Tonometry. A computational study and new biomarkers proposal. J Mech Behav Biomed Mater 2024; 152:106413. [PMID: 38281439 DOI: 10.1016/j.jmbbm.2024.106413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/08/2024] [Accepted: 01/17/2024] [Indexed: 01/30/2024]
Abstract
Keratoconus is a progressive ocular disorder affecting the corneal tissue, leading to irregular astigmatism and decreased visual acuity. The architectural organization of corneal tissue is altered in keratoconus, however, data from ex vivo testing of biomechanical properties of keratoconic corneas are limited and it is unclear how their results relate to true mechanical properties in vivo. This study explores the mechanical properties of keratoconic corneas through numerical simulations of non-contact tonometry (NCT) reproducing the clinical test of the Corvis ST device. Three sensitivity analyses were conducted to assess the impact of corneal material properties, size, and location of the pathological area on NCT results. Additionally, novel asymmetry-based indices were proposed to better characterize corneal deformations and improve the diagnosis of keratoconus. Our results show that the weakening of corneal material properties leads to increased deformation amplitude and altered biomechanical response. Furthermore, asymmetry indices offer valuable information for locating the pathological tissue. These findings suggest that adjusting the Corvis ST operation, such as a camera rotation, could enhance keratoconus detection and provide insights into the relative position of the affected area. Future research could explore the application of these indices in detecting early-stage keratoconus and assessing the fellow eye's risk for developing the pathology.
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Affiliation(s)
- Elena Redaelli
- Aragón Institute of Engineering Research (I3A), Universidad de Zaragoza, Zaragoza, Spain.
| | - Michael Nana
- LaBS, Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy
| | - Begoña Calvo
- Aragón Institute of Engineering Research (I3A), Universidad de Zaragoza, Zaragoza, Spain; Centro de Investigación Biomecánica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza, Spain
| | - José Félix Rodríguez Matas
- LaBS, Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy
| | - Giulia Luraghi
- LaBS, Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy
| | - Jos Rozema
- Visual Optics Lab Antwerp (VOLANTIS), Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium; Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium
| | - Jorge Grasa
- Aragón Institute of Engineering Research (I3A), Universidad de Zaragoza, Zaragoza, Spain; Centro de Investigación Biomecánica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza, Spain
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13
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Dick HB, Mackert MJ, Ahmed IIK, Denis P, Hirneiß C, Flowers BE, Singh IP, Mansouri K, Fea AM. Two-Year Performance and Safety Results of the MINIject Supraciliary Implant in Patients With Primary Open-Angle Glaucoma: Meta-Analysis of the STAR-I, II, III Trials. Am J Ophthalmol 2024; 260:172-181. [PMID: 38109951 DOI: 10.1016/j.ajo.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/07/2023] [Accepted: 12/10/2023] [Indexed: 12/20/2023]
Abstract
PURPOSE To evaluate the performance and safety of minimally invasive glaucoma surgery with a supraciliary drainage device (MINIject; iSTAR Medical, Wavre, Belgium) in primary open-angle glaucoma (POAG) as a stand-alone procedure. DESIGN Meta-analysis. METHODS At 11 sites in Colombia, France, Germany, India, Panama, and Spain, 82 patients were treated in 3 prospective, multicenter, interventional, nonrandomized trials (STAR-I, II, III). Data were pooled in a meta-analysis of up to 2 years of follow-up postimplantation. The main outcome measures were mean relative and absolute reduction in diurnal intraocular pressure (IOP) compared to baseline. Secondary outcomes included patients with IOP ≤18 mmHg, patients with IOP reduction ≥20%, number of IOP-lowering medications, adverse events, and endothelial cell density loss. RESULTS At the 2-year follow-up (n = 66), mean IOP was reduced from 23.8 ± 3.3 mmHg at baseline to 14.4 ± 4.5 mmHg (-39.3%; P < 0.0001). An IOP reduction of ≥20% was achieved in 89.4% of patients, with 84.8% having an IOP ≤18 mmHg. IOP-lowering medications were reduced from a mean of 2.4 ± 1.1 to 1.4 ± 1.4 (P < 0.0001), with 37.9% of patients being medication-free at 2 years. Mean endothelial cell density loss at 2 years was 6.2 ± 9.1% compared to baseline and no patient had a loss >30%. CONCLUSIONS This meta-analysis demonstrates the favorable safety and efficacy profile of a supraciliary device implanted in a stand-alone, ab-interno procedure in patients with mild-to-moderate POAG. The data demonstrate that MINIject is a safe and effective, bleb-free treatment option for patients requiring low target IOP up to 2 years.
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Affiliation(s)
| | - Marc J Mackert
- Department of Ophthalmology, LMU University Hospital, LMU Munich (M.J.M., C.H.), Munich, Germany
| | - Iqbal Ike K Ahmed
- John Moran Eye Center, University of Utah (I.I.K.A.), Salt Lake City, Utah, USA
| | - Philippe Denis
- Department of Ophthalmology, Hôpital de la Croix-Rousse (P.D.), Lyon, France
| | - Christoph Hirneiß
- Department of Ophthalmology, LMU University Hospital, LMU Munich (M.J.M., C.H.), Munich, Germany
| | | | - I Paul Singh
- Eye Centers of Racine & Kenosha (I.P.S.), Racine, Wisconsin, USA
| | - Kaweh Mansouri
- Swiss Visio Glaucoma Research Center, Montchoisi Clinic (K.M.), Lausanne, Switzerland; Glaucoma Department, University of Colorado Denver (K.M.), Denver, Colorado, USA.
| | - Antonio M Fea
- Struttura Complessa Oculistica, Città Della Salute e Della Scienza di Torino, Dipartimento di Scienze Chirurgiche - Università Degli Studi di Torino (A.M.F.), Torino, Italy
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14
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Fanney D, Seibel BS. Reply: Experimental study comparing 2 different phacoemulsification systems with intraocular pressure control during steady-state flow and occlusion break surge events. J Cataract Refract Surg 2024; 50:437-438. [PMID: 38523282 DOI: 10.1097/j.jcrs.0000000000001417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
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15
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Jin G, Zou M, Li L, Liu Z, Young C, Qi H, Zheng D. Corneal biomechanics and their association with severity of lens dislocation in Marfan syndrome. Int Ophthalmol 2024; 44:148. [PMID: 38502381 DOI: 10.1007/s10792-024-03079-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/16/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE To investigate corneal biomechanical properties and its associations with the severity of lens dislocation in patients with Marfan syndrome. METHODS A total of 30 patients with Marfan syndrome and 30 age-, sex- and axial length (AL)-matched controls were recruited. Corneal biomechanical parameters of both groups were measured by CorVis ST and were compared between groups. Potential associations between corneal biomechanical parameters and severity of lens dislocation were also investigated. RESULTS Lower applanation 1 velocity (A1V) (0.13 ± 0.004 vs. 0.15 ± 0.003, P = 0.016), shorter applanation 2 time (A2T)(22.64 ± 0.11 vs. 22.94 ± 0.11, P = 0.013), longer peak distance (PD) (5.03 ± 0.07 vs. 4.81 ± 0.05, P = 0.008), longer radius (R) of highest concavity (7.44 ± 0.16 vs. 6.93 ± 0.14, P = 0.012), greater Ambrosio relational thickness horizontal (ARTh) (603 ± 20 vs. 498 ± 12, P < 0.001), and integrated radius (IR) (8.32 ± 0.25 vs. 8.95 ± 0.21, P = 0.033) were detected among Marfan eyes compared with controls (all P < 0.05). Marfan individuals with more severe lens dislocation tended to have increased stiffness parameter as longer A1T, slower A1V, shorter A2T, slower application 2 velocity (A2V), smaller PD and smaller Distance Amplitude (DA) (P < 0.05). CONCLUSION Marfan patients were detected to have increased corneal stiffness compared with normal subjects. Corneal biomechanical parameters were significantly associated with the severity of lens dislocation in Marfan patients.
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Affiliation(s)
- Guangming Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Minjie Zou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Longhui Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Charlotte Young
- Albany Medical College, 49 New Scotland Ave, Albany, NY, USA
| | - Haotian Qi
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Danying Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.
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16
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Wu THY, Lau HKC, Lai CHY, Wong RWL, Wong AKW, Lam AKC. Effect of digital ocular massage on intraocular pressure and Schlemm's canal dimensions. Sci Rep 2024; 14:6112. [PMID: 38480777 PMCID: PMC10937985 DOI: 10.1038/s41598-024-56748-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 03/11/2024] [Indexed: 03/17/2024] Open
Abstract
Digital ocular massage has been reported to temporarily lower intraocular pressure (IOP). This could be related to an enhanced aqueous humor outflow; however, the mechanism is not clearly understood. Using anterior segment optical coherence tomography, the Schlemm's canal (SC) and trabecular meshwork (TM) can be imaged and measured. Here, 66 healthy adults underwent digital ocular massage for 10 min in their right eyes. The IOP and dimensions of the SC and TM were measured before and after ocular massage. All subjects demonstrated IOP reduction from 15.7 ± 2.5 mmHg at baseline to 9.6 ± 2.2 mmHg immediately after, and median of 11.6 mmHg 5-min after ocular massage (Friedman's test, p < 0.001). There was significant change in SC area (median 10,063.5 μm2 at baseline to median 10,151.0 μm2 after ocular massage, Wilcoxon test, p = 0.02), and TM thickness (median 149.8 μm at baseline to 144.6 ± 25.3 μm after ocular massage, Wilcoxon test, p = 0.036). One-third of the subjects demonstrated collapse of the SC area (-2 to -52%), while two-thirds showed expansion of the SC area (2 to 168%). There were no significant changes in SC diameter (270.4 ± 84.1 μm vs. 276.5 ± 68.7 μm, paired t-test, p = 0.499), and TM width (733.3 ± 110.1 μm vs. 733.5 ± 111.6 μm, paired t-test, p = 0.988). Eyes with a higher baseline IOP demonstrated a greater IOP reduction (Pearson correlation coefficient r = -0.521, p < 0.001). Eyes with smaller SC area at baseline showed greater SC area expansion (Pearson correlation coefficient = -0.389, p < 0.001). Greater IOP reduction appeared in eyes with greater SC area expansion (Pearson correlation coefficient r = -0.306, p = 0.01). Association between change in IOP and change in TM thickness was not significant (Spearman's ρ = 0.015, p = 0.902). Simple digital ocular massage is an effective method to lower IOP values, and change in the SC area was significantly associated with IOP changes.
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Affiliation(s)
- Tiffany H Y Wu
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Henry K C Lau
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Carmelo H Y Lai
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Ruby W L Wong
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Antonia K W Wong
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Andrew Kwok-Cheung Lam
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
- Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
- Centre for Eye and Vision Research, 17W Hong Kong Science Park, Science Park, Hong Kong.
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17
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El Sayed YM, Mettias NM, Elghonemy HME, Mostafa YSE. Phacoemulsification with gonioscopy-assisted transluminal trabeculotomy versus phacoemulsification alone in primary angle closure glaucoma: A randomized controlled study. Acta Ophthalmol 2024; 102:e195-e203. [PMID: 37435985 DOI: 10.1111/aos.15733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 05/26/2023] [Accepted: 06/24/2023] [Indexed: 07/13/2023]
Abstract
PURPOSE To assess the safety and efficacy of combining phacoemulsification with gonioscopy-assisted transluminal trabeculotomy (GATT) compared to phacoemulsification alone in the management of primary angle closure glaucoma (PACG). METHODS Prospective, institutional study in which eyes requiring surgery for PACG were randomized to undergo phacoemulsification followed by GATT (phaco-GATT group) or phacoemulsification alone. Success was defined as having a final IOP of 6-20 mmHg with no subsequent glaucoma surgery or vision-threatening complications. RESULTS Thirty-six eyes underwent phaco-GATT with 360° angle incision and 38 eyes underwent phacoemulsification alone. IOP and glaucoma medications were significantly lower in the phaco-GATT group at 1, 3, 6, 9 and 12 months. The success rate in the phaco-GATT group was 94.4% after 12.16 ± 2.03 months, with 75% of eyes being off medications compared to 86.8% after 12.47 ± 4.27 months in the phaco group, with 42.1% off medications. (p = 0.008). Hyphema and fibrinous anterior chamber reaction were the most common complications in the phaco-GATT group and resolved with conservative treatment or required YAG capsulotomy. Although this delayed visual rehabilitation in the phaco-GATT group, it did not affect the final visual outcome with no significant difference in the final best-corrected visual acuity between both groups (p = 0.25). CONCLUSION Combining phacoemulsification with GATT in PACG yielded more favourable outcomes in terms of IOP, glaucoma medications and surgical success. Although the postoperative hyphema and fibrinous reaction may delay visual rehabilitation, GATT further lowers the IOP by breaking residual peripheral anterior synechiae and removing the dysfunctional trabeculum circumferentially, while avoiding the risks inherent in more invasive filtering procedures.
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18
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Shajiei TD, Iadanza S, Bachmann LM, Kniestedt C. Inventory of Ocular Pulse Amplitude Values in Healthy Subjects and Patients With Ophthalmologic Illnesses: Systematic Review and Meta-analysis. Am J Ophthalmol 2024; 259:151-165. [PMID: 37898282 DOI: 10.1016/j.ajo.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE Many studies have examined the ocular pulse amplitude (OPA) to better understand its physiology and clinical relevance, but the papers are scattered, not consistently indexed, and sometimes difficult to locate. We aimed to identify and summarize the relevant published evidence on OPA and, in a meta-analysis, outline specific differences of this parameter between healthy individual, primary open-angle glaucoma, normal-tension glaucoma, ocular hypertension, and cataract patients. DESIGN Systematic review and meta-analysis. METHODS A thorough literature search and data extraction were conducted by 2 reviewers independently. Reports on OPA measured by the dynamic contour tonometry in conjunction with different ocular and systemic diseases or potential influencing factors were included. RESULTS Of the 527 initially found reports, 97 met the inclusion criteria assessing 31 clinical conditions. A meta-analysis based on 6850 eyes and 106 study arms (68.8%) revealed differences in mean OPA values in millimeters of mercury between various entities. Among healthy eyes, the OPA was 2.58 mm Hg (95% CI: 2.45-2.71), whereas OPA values were higher in glaucoma (unspecified glaucoma 2.73 mm Hg, 95% CI: 2.38-3.08; normal-tension glaucoma 2.66 mm Hg, 95% CI: 2.36-2.97; and primary open-angle glaucoma 2.92 mm Hg, 95% CI: 2.75-3.08). Although ocular hypertension showed the highest OPA values (3.53 mm Hg, 95% CI: 3.05-4.01), the lowest values were found in cataract eyes (2.26 mm Hg, 95% CI: 1.57-2.94). CONCLUSION We found different OPA values characteristic of different clinical entities, with above-normal values in glaucoma and ocular hypertension and lower values in cataract patients. Our work is intended for clinicians and researchers who want to get a quick overview of the available evidence or who need statistical data on OPA distributions in individual diseases.
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Affiliation(s)
- Tania D Shajiei
- From the Talacker Augen Zentrum Zürich (TAZZ), Department of Ophthalmology, University Hospital Zurich (T.D.S.), Zurich, Switzerland
| | - Sandro Iadanza
- Talacker Augen Zentrum Zürich (S.I., C.K.), Zurich, Switzerland
| | - Lucas M Bachmann
- Medignition Inc, Research Consultants (L.M.B.), Zurich, Switzerland.
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Şenocak MG, Yanmaz LE. Effects of propofol alone or in combination with ketamine on intraocular pressure in unpremedicated dogs. Vet Ophthalmol 2024; 27:139-147. [PMID: 37395174 DOI: 10.1111/vop.13127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/12/2023] [Accepted: 06/14/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVE To determine the effects of propofol (P) alone and in combination with ketamine (KP) at ratios of 1:1, 1:2, and 1:3 on intraocular pressure (IOP) in unpremedicated dogs. ANIMALS STUDIED A total of 28 cross-bred healthy dogs. PROCEDURES Dogs were randomly assigned to one of four groups (n = 7 per group) to receive intravenous P or KP at 1:1, 1:2, and 1:3 ratios, respectively. The infusion was administered at 0.6 mg/kg/min for 60 min. IOP, cardiorespiratory variables, rectal temperature (RT), and pedal reflex were recorded every 5 min for 60 min, starting from baseline (BL). RESULTS There was a statistically significant increase in IOP in all groups: P (p = .011), KP 1:1 (p = .003), KP 1:2 (p = .023), and KP 1:3 (p = .008). The IOP increase was less pronounced in the KP 1:2 group and was only significant (p = .023) at T45 compared with BL. A significant correlation was observed between IOP and SpO2 in P (r = -.215, p = .02), KP 1:2 (r = -.579, p < .01), and KP 1:3 (r = -.402, p < .01) groups. IOP significantly increased due to decreased SpO2 below 86.5% (p < .05). CONCLUSIONS Propofol alone and in combination with ketamine may increase preexisting IOP in unpremedicated dogs. SpO2 levels below 86.5% may trigger an increase in IOP. Administering KP in a 1:2 ratio at an infusion rate of 0.6 mg/kg/min does not significantly alter IOP for under 45 min in unpremedicated dogs with sufficient oxygenation.
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Affiliation(s)
- Mümin Gökhan Şenocak
- Department of Surgery, Faculty of Veterinary Medicine, Atatürk University, Erzurum, Turkey
| | - Latif Emrah Yanmaz
- Department of Surgery, Faculty of Veterinary Medicine, Burdur Mehmet Akif Ersoy University, Burdur, Turkey
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Braga-Mele R. Comment on: Experimental study comparing 2 different phacoemulsification systems with intraocular pressure control during steady-state flow and occlusion break surge events. J Cataract Refract Surg 2024; 50:312. [PMID: 38192058 PMCID: PMC10878451 DOI: 10.1097/j.jcrs.0000000000001391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 12/18/2023] [Indexed: 01/10/2024]
Affiliation(s)
- Rosa Braga-Mele
- From the Department of Ophthalmology, University of Toronto, Toronto, Ontario, Canada
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Wang SY, Yen CY, Kuo BI, Yen JC, Liou SW, Chen CC. Efficacy and safety of transscleral cyclophotocoagulation versus cyclocryotherapy in the treatment of intractable glaucoma: A systematic review and meta-analysis. Acta Ophthalmol 2024; 102:e156-e167. [PMID: 37712302 DOI: 10.1111/aos.15754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 07/29/2023] [Accepted: 08/29/2023] [Indexed: 09/16/2023]
Abstract
To perform a meta-analysis to compare the efficacy and safety of diode laser transscleral cyclophotocoagulation (TSCPC) and cyclocryotherapy (CCT) in the treatment of intractable glaucoma. Systemic searches of the Ovid MEDLINE, EMBASE, and Cochrane Library databases yielded experimental and observational comparative studies. TSCPC and CCT efficacy and safety outcomes were compared. Subgroup analyses of participant ethnicity, preoperative intraocular pressure (IOP) level, and underlying causes of glaucoma were conducted. The pooled effects were computed using the random-effects model. The meta-analysis included nine studies totalling 668 eyes. There was no statistically significant difference between the TSCPC and CCT groups in the IOP reduction (IOPR%), decrease in antiglaucoma medications, the operative success rate with or without medications, or retreatment rate in the efficacy analysis. In the subgroup analysis, CCT had a better IOP-lowering effect among non-Asian participants and a non-inferior IOPR% to TSCPC among Asian participants. TSCPC and CCT were associated with similar rates of deterioration in visual acuity, postoperative visual analog scale, and other analysed postoperative complications in the safety analysis. In both groups, severe complications were uncommon. Diode laser TSCPC and CCT had nearly equivalent clinical efficacy in treating intractable glaucoma, while CCT demonstrated a better IOP-lowering effect in non-Asian. Both cyclodestructive procedures have a comparable safety profile.
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Affiliation(s)
- Shih-Yi Wang
- Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan
| | - Chu-Yu Yen
- Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan
| | - Bo-I Kuo
- Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ju-Chuan Yen
- Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Shiow-Wen Liou
- Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Ophthalmology, Shin Kong Memorial Wu Ho-Su Hospital, Taipei, Taiwan
| | - Chun-Chen Chen
- Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
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Dada T, Gwal RS, Mahalingam K, Chandran DS, Angmo D, Gupta S, Velpandian T, Deepak KK. Effect of "365 Breathing Technique" on Intraocular Pressure and Autonomic Functions in Patients With Glaucoma: A Randomized Controlled Trial. J Glaucoma 2024; 33:149-154. [PMID: 38194285 DOI: 10.1097/ijg.0000000000002356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/25/2023] [Indexed: 01/10/2024]
Abstract
PRCIS Patients with primary open angle glaucoma were advised to follow the "365 breathing technique" for 6 weeks in addition to their pharmacological glaucoma treatment. It helped to reduce intraocular pressure (IOP), stress biomarker-cortisol, and improve autonomic dysfunction. OBJECTIVE To study the effect of the "365 breathing technique" on IOP, autonomic functions, and stress biomarkers in patients with primary open angle glaucoma. METHODS In this randomized, controlled, interventional trial, after randomization, 40 patients in the intervention group followed "365 breathing" (three times a day, breathing rate: 6 cycles/min for 5 min) in addition to their pharmacological glaucoma treatment and 40 patients in the control group continued only with their pharmacological glaucoma treatment. IOP, serum cortisol, heart rate variability (HRV), and heart rate response to deep breathing test (DBT) were recorded at preintervention and 6 weeks postintervention. RESULTS The mean IOP, serum cortisol, parameters of the HRV test, and DBT were comparable between the two groups at baseline. At the 6-week follow-up, in the intervention group, mean IOP was significantly lower (16.09 ± 2.24 vs 18.38 ± 1.58 mm Hg, P = 0.03) and serum cortisol were significantly lower (13.20 ± 3.11 vs 14.95 ± 2.60 mcg/dL, P = 0.038) compared with the control group. In the HRV test, time domain analysis showed a significant difference in the root mean square of the successive difference between RR interval values between both groups at 6 weeks ( P = 0.015) pointing towards higher postintervention parasympathetic activation in the intervention group. In frequency domain analysis (HRV test), the ratio of the low-frequency component to the high-frequency component was significantly lower in the intervention group at 6 weeks (1.65 vs 1.79, P = 0.019) indicating a shift in sympathovagal balance towards greater vagal modulation.There was a significant increase in delta heart rate ( P = 0.019) and expiratory:inspiratory ratio ( P = 0.011) in the intervention group at 6 weeks when compared with baseline values, indicating improved parasympathetic reactivity to DBT. CONCLUSION "365 breathing" technique can reduce IOP and serum cortisol, and improve autonomic dysfunction in patients with glaucoma.
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Affiliation(s)
| | | | | | - Dinu Santha Chandran
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | - Kishore K Deepak
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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23
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Gómez C, Piñero DP, Alió JL, Cavas F. Comparative evaluation of methods for obtaining the stress-free geometry of keratoconus corneas with different levels of severity. Comput Biol Med 2024; 170:107870. [PMID: 38217971 DOI: 10.1016/j.compbiomed.2023.107870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/07/2023] [Accepted: 12/17/2023] [Indexed: 01/15/2024]
Abstract
A biomechanical model that simulates the physiological pressure load on the cornea without considering the stresses in vivo will result in an overstress or underestimation of the stress field and incorrect deformation of the corneal structure. Therefore, it is essential to propose numerical models that consider the stress-free geometry of the cornea. In this study, the Displacement and Pre-stress methods were compared to obtain the stress-free geometry (S-FG) and the physiological estimated geometry (P-EG), based on the patient-specific geometric behavior and the computational time required to reach each geometry. The same shape and contour conditions were considered in the models obtained from both methods for each of the pathological scenarios analyzed. Both methods behaved differently to obtain the free geometry, and this difference increased with the severity grade of the disease. However, they behaved in a similar way to reach the physiological estimated geometry. The Displacement method required a lower computational cost to reach the free geometry, with both methods presenting a similar computational cost to obtain the physiological geometry. The stress-free geometries obtained by both methods allowed to characterize the existing biomechanical decompensation during the progression of the diseases. In conclusion, the calculation of the stress-free corneal geometry associated to the clinically measured intraocular pressure with the Displacement and Prestress Methods in keratoconus eyes allows the development of accurate and useable models in clinical practice in real time. This displacement method shows some benefits in terms of computational cost.
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Affiliation(s)
- Carmelo Gómez
- International School of Doctorate, Technical University of Cartagena, 30202, Cartagena, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690, Alicante, Spain
| | - Jorge L Alió
- Cornea, Cataract and Refractive Surgery Department, VISSUM, Alicante, Spain; Division of Ophthalmology, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernández University, Alicante, Spain
| | - Francisco Cavas
- Department of Structures, Construction and Graphic Expression, Technical University of Cartagena, 30202, Cartagena, Spain.
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24
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Zhang F, Li R, Li Y, Zhu Z, Zhou Q, Chen Z. Quantitative Optical Coherence Elastography of the Optic Nerve Head In Vivo. IEEE Trans Biomed Eng 2024; 71:732-737. [PMID: 37721876 DOI: 10.1109/tbme.2023.3316606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
OBJECTIVE Optical coherence elastography (OCE) was used to demonstrate the relationship between the elasticity of the optic nerve head (ONH) and different intraocular pressure (IOP) levels in an in-vivo rabbit model for the first time. METHOD Both ex-vivo and in-vivo rabbit ONH were imaged using OCE system. A mechanical shaker initiated the propagation of elastic waves, and the elasticity of the ONH was determined by tracking the wave propagation speed. The elasticity of the ONH under varying IOP levels was reconstructed based on the wave speed. Notably, the ONH exhibited increased stiffness with elevated IOP. RESULTS In the in-vivo rabbit models, the Young's modulus of ONH increased from 14 kPa to 81 kPa with the IOP increased from 15 mmHg to 35 mmHg. This revealed a positive correlation between the Young's modulus of the ONH and intraocular pressure. CONCLUSION The OCE system proved effective in measuring the mechanical properties of ONH at different IOP levels, with validation in an in-vivo rabbit model. SIGNIFICANCE Considering ONH plays a critical role in vision and eye diseases, the capability to image and quantify in vivo ONH biomechanical properties has great potential to advance vision science research and improve the clinical management of glaucoma patients.
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25
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Karthikeyan SK, Sundaram SM, Ve RS, Souza DD, Biswas S, Shetty MU. Design and development of a noninvasive ocular pressure estimator. Optom Vis Sci 2024; 101:164-172. [PMID: 38546758 DOI: 10.1097/opx.0000000000002114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
SIGNIFICANCE A snapshot intraocular pressure (IOP) is ineffective in identifying the IOP peak and fluctuation, especially during sleep. Because IOP variability plays a significant role in the progression of glaucoma, monitoring the IOP, especially during sleep, is essential to capture the dynamic nature of IOP. PURPOSE We aimed to design an ocular pressure estimator (OPE) that can reliably and accurately measure the IOP noninvasively over closed-eyelid condition. METHODS Ocular pressure estimator works on the principle that the external pressure applied by raising the IOP of the eyeball is transmitted through a compressible septum to the pressure sensor, thus recording the IOP. A fluid-filled pouch with a pressure sensor was placed over a rubber glove mimicking the eyelid (septum), covering the cornea of enucleated goat eyeballs. A pressure-controlled setup was connected to a goat cadaver eye, which was validated by a rebound tonometer. Cannulation of eyeballs through the lower limbus had the least difference from the control setup values documented using rebound tonometer, compared with cannulation through the optic nerve. Intraocular pressures ranging from 3 to 30 mmHg was induced, and the outputs recorded using OPE were amplified and recorded for 10 minutes (n = 10 eyes). We stratified the randomization of the number of times and the induced pressures. RESULTS The measurements recorded were found to be linear when measured against an IOP range of 3 to 30 mmHg. The device has excellent reliability (intraclass correlation coefficient, 0.998). The repeatability coefficient and coefficient of variations were 4.24 (3.60 to 4.87) and 8.61% (7.33 to 9.90), respectively. The overall mean difference ± SD between induced IOP and the OPE was 0.22 ± 3.50 (95% confidence interval, -0.35 to 0.79) mmHg across all IOP ranges. CONCLUSIONS Ocular pressure estimator offers a promising approach for reliably and accurately measuring IOP and its fluctuation noninvasively under a condition mimicking a closed eye.
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Affiliation(s)
- Siddharth K Karthikeyan
- Department of Optometry, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | | | - Ramesh S Ve
- Department of Optometry, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Donson D Souza
- Blackfrog Technologies Pvt Ltd, Manipal, Karnataka, India
| | | | - Mayur U Shetty
- Blackfrog Technologies Pvt Ltd, Manipal, Karnataka, India
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26
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Singh K, Singh A, Jain D, Verma V. Factors affecting adherence to glaucoma medication: Patient perspective from North India. Indian J Ophthalmol 2024; 72:391-396. [PMID: 38099369 PMCID: PMC11001247 DOI: 10.4103/ijo.ijo_806_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 07/14/2023] [Accepted: 08/01/2023] [Indexed: 12/19/2023] Open
Abstract
PURPOSE Adherence to glaucoma medical therapy is a key factor in achieving target intraocular pressure to prevent glaucoma progression. To determine factors affecting medication adherence in glaucoma patients in an urban population belonging to poor socioeconomic status. METHODS A cross-sectional study was conducted on 200 patients attending glaucoma services in a tertiary referral hospital of North India. Adherence to medication was determined subjectively by questionnaire and objectively by counting the number of used bottles at the end of a month or during refill, whichever was earlier. Patient-related parameters in adherence toward glaucoma medication were studied based on demography, knowledge, attitudes, and practices (KAP). The statistical techniques of bivariate and multivariate logistic regression were adopted to test the objective. RESULTS The population was statistically homogeneous based on gender and income in both groups. A large proportion of patients had bilateral disease (87%) and were on two or more medications (62.5%). Adherence to glaucoma medical therapy was seen in 68% of patients, with knowledge about glaucoma present in 58% of patients. Deterrents to drug adherence were identified as forgetfulness (71%), unavailability of drugs (19%) or funds to purchase the same (26%), polypharmacy (21%), and side effects (5%). Dependence on an escort by 44% and dependence on hospital supply of medications by 60% emerged as the contextual factors requiring scrutiny while prescribing lifelong glaucoma medications. Disease misconceptions (53%) were prevalent and drug instillation practices were unsatisfactory (57%). CONCLUSION The study offers insight into patients' perspectives regarding the lifetime use of antiglaucoma medications and focuses on key issues linked to drug nonadherence.
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Affiliation(s)
- Kirti Singh
- Professor of Ophthalmology and Director GNEC, Maulana Azad Medical College and Assoc Hosp, New Delhi, India
| | - Arshi Singh
- Department of Ophthalmology, Guru Nanak Eye Center, Maulana Azad Medical College and Assoc Hosp, New Delhi, India
| | - Divya Jain
- Department of Ophthalmology, Postgraduate Institute of Child Health, Noida, Uttar Pradesh, India
| | - Vivek Verma
- Department of Statistics, Assam University, Silchar, Assam, India
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Kalyuzhner Z, Agdarov S, Beiderman Y, Bennet A, Beiderman Y, Zalevsky Z. Remote and low-cost intraocular pressure monitoring by deep learning of speckle patterns. J Biomed Opt 2024; 29:037003. [PMID: 38560532 PMCID: PMC10979815 DOI: 10.1117/1.jbo.29.3.037003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 01/17/2024] [Accepted: 02/28/2024] [Indexed: 04/04/2024]
Abstract
Significance Glaucoma, a leading cause of global blindness, disproportionately affects low-income regions due to expensive diagnostic methods. Affordable intraocular pressure (IOP) measurement is crucial for early detection, especially in low- and middle-income countries. Aim We developed a remote photonic IOP biomonitoring method by deep learning of the speckle patterns reflected from an eye sclera stimulated by a sound source. We aimed to achieve precise IOP measurements. Approach IOP was artificially raised in 24 pig eyeballs, considered similar to human eyes, to apply our biomonitoring method. By deep learning of the speckle pattern videos, we analyzed the data for accurate IOP determination. Results Our method demonstrated the possibility of high-precision IOP measurements. Deep learning effectively analyzed the speckle patterns, enabling accurate IOP determination, with the potential for global use. Conclusions The novel, affordable, and accurate remote photonic IOP biomonitoring method for glaucoma diagnosis, tested on pig eyes, shows promising results. Leveraging deep learning and speckle pattern analysis, together with the development of a prototype for human eyes testing, could enhance diagnosis and management, particularly in resource-constrained settings worldwide.
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Affiliation(s)
- Zeev Kalyuzhner
- Bar-Ilan University, Faculty of Engineering and the Nanotechnology Center, Ramat-Gan, Israel
| | - Sergey Agdarov
- Bar-Ilan University, Faculty of Engineering and the Nanotechnology Center, Ramat-Gan, Israel
| | - Yevgeny Beiderman
- Holon Institute of Technology, Faculty of Electrical and Electronics Engineering, Holon, Israel
| | - Aviya Bennet
- Bar-Ilan University, Faculty of Engineering and the Nanotechnology Center, Ramat-Gan, Israel
| | - Yafim Beiderman
- Bar-Ilan University, Faculty of Engineering and the Nanotechnology Center, Ramat-Gan, Israel
| | - Zeev Zalevsky
- Bar-Ilan University, Faculty of Engineering and the Nanotechnology Center, Ramat-Gan, Israel
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28
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Evers C, Anton A, Böhringer D, Kallee S, Keye P, Neß T, Philippin H, Reinhard T, Lübke J. XEN ®-45 implantation for refractory uveitic glaucoma. Graefes Arch Clin Exp Ophthalmol 2024; 262:937-948. [PMID: 37855957 PMCID: PMC10907455 DOI: 10.1007/s00417-023-06254-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 08/22/2023] [Accepted: 09/08/2023] [Indexed: 10/20/2023] Open
Abstract
PURPOSE To evaluate the efficacy of XEN®-45 gel stent ab interno implantation for medically uncontrolled uveitic glaucoma. METHODS Retrospective analysis of 25 eyes receiving XEN® gel stent for medically uncontrolled uveitic glaucoma from February 2019 to February 2023 with recording of intraocular pressure (IOP) values, ocular hypotensive medication, requirement for revision or secondary surgery and complications. Prerequisites for XEN® implantation were a clear cornea, an open iridocorneal angle and an unscarred, mobile conjunctiva at the implantation site. Minimum follow-up required for inclusion was 3 months. The primary outcome measure was IOP compared to baseline. Complete and qualified success were defined as final IOP of ≤ 18 mmHg without or with topical antiglaucomatous treatment, respectively. Failure was defined as IOP > 18 mmHg on two consecutive visits, IOP reduction < 20%, persisting complications from hypotony and open conjunctival bleb revision. Further glaucoma surgical intervention was defined as complete failure. RESULTS Mean preoperative IOP was 35.3 ± 10.9 mmHg on 2.9 ± 0.9 topical antiglaucomatous agents. 19 of 25 patients (76%) received additional oral acetazolamide. 19 eyes were pseudophakic, 5 eyes phakic and 1 aphakic. Early postoperatively, mean IOP reduced to 7.7 ± 3.0 mmHg (75.8% reduction). At final follow-up (mean 17.7 months) mean IOP was 12.0 ± 3.8 mmHg (62.5% reduction) on 0.2 ± 0.6 medications. Six eyes (24%) required bleb revision at mean 28 weeks and therefore were categorized as failure. One eye failed despite bleb revision and restart of topical ocular hypotensive medication. Three other eyes (12%) had IOP spikes with uveitis flare-ups. Transient hypotony complications occurred in 32%. At final follow-up, 18 eyes (72%) achieved complete success and one eye (4%) qualified success. CONCLUSION The XEN® gel stent effectively reduced IOP in uncontrolled uveitic glaucoma, with 72% complete success. Bleb revision was required in 24%. IOP spikes occurred in 12% despite functioning blebs. Further follow-up is needed to determine long-term outcomes.
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Affiliation(s)
- Charlotte Evers
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Killianstraße 5, 79106, Freiburg, Germany.
| | | | - Daniel Böhringer
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Killianstraße 5, 79106, Freiburg, Germany
| | - Sara Kallee
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Killianstraße 5, 79106, Freiburg, Germany
| | - Philip Keye
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Killianstraße 5, 79106, Freiburg, Germany
| | - Thomas Neß
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Killianstraße 5, 79106, Freiburg, Germany
| | - Heiko Philippin
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Killianstraße 5, 79106, Freiburg, Germany
| | - Thomas Reinhard
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Killianstraße 5, 79106, Freiburg, Germany
| | - Jan Lübke
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Killianstraße 5, 79106, Freiburg, Germany
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Ural Fatihoğlu Ö, Vural E, Çelebi ARC. The Short-Term Effect of 1% Tropicamide Drop on Pupillary Diameter and Intraocular Pressure Change in Patients With Pseudoexfoliation Material. J Glaucoma 2024; 33:206-210. [PMID: 37523644 DOI: 10.1097/ijg.0000000000002278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 07/16/2023] [Indexed: 08/02/2023]
Abstract
PRCIS In this study, in patients with pseudoexfoliation syndrome (PXS) or glaucoma, changes in intraocular pressure (IOP) and pupil size after 1% tropicamide used for pupil dilation, compared with healthy patients were quantitatively demonstrated up to 4 hours after dilation. PURPOSE The purpose of this study was to evaluate pharmacological dilatation with one drop of 1% tropicamide on pupillary diameter and IOP changes in patients with PXS and glaucoma (PXG). MATERIALS AND METHODS Eighty-two patients with PXS, 78 Patients with PXG, and 35 healthy subjects were included in the study. PXG and PXS were diagnosed based on IOP assessment, corneal pachymetry, optic disc examination, visual field testing, and peripapillary retinal nerve fiber analysis. IOP and the diameter of pupil size were measured before dilatation and at postdilatation first, second, and fourth hours. RESULTS The mean pupillary diameter values at postdilatation second and fourth hours were statistically significantly different between the patients with PXS and PXG ( P <0.001, for each). Also, there were significant differences between the PXS group and the control group in terms of the mean pupillary diameter values at predilatation and postdilatation at the first hour and postdilatation second hour ( P =0.007, <0.001, respectively). The mean pupillary diameter at all times was statistically significantly different between PXG and control groups ( P <0.001 for each). Significant IOP increases were observed in all groups after dilatation. The mean IOP at predilatation and postdilatation fourth hour was statistically significantly different between PXG and PXS groups ( P =0.042, <0.001, respectively). Whereas the mean IOP at predilatation, postdilatation first hour, postdilatation second hour, and postdilatation fourth hour were statistically significantly different between PXG and control group ( P <0.001 for each). CONCLUSIONS Significant IOP increases have been observed in our study with 1% tropicamide in the PXG and PXS groups, with the peak effect at the second hour in the postdilatation period. Furthermore, the mean pupil diameter was found to be significantly lower in PXG patients compared with the control group.
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Affiliation(s)
| | - Esra Vural
- Ophthalmology Department, Başakşehir Çam Sakura Hospital
| | - Ali Riza Cenk Çelebi
- Ophthalmology Department, Medical Faculty, Acibadem University, Istanbul, Turkey
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30
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Srivastava RM, Agrawal S, Amrin N, Bharti D. Intraocular Pressure Changes While Reading Smartphone Digital Text Versus Printed Text in Healthy Individuals and those with Glaucoma. J Glaucoma 2024; 33:189-194. [PMID: 37851972 DOI: 10.1097/ijg.0000000000002314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 09/18/2023] [Indexed: 10/20/2023]
Abstract
PRCIS Reading results in a rise in intraocular pressure (IOP) which is greater while using smartphones compared with printed text among healthy and individuals with medically controlled primary open angle glaucoma (POAG). PURPOSE To compare the effect of reading for 30 minutes using smartphone and printed text on IOP. PATIENTS AND METHODS Sixty healthy volunteers and 22 patients with medically controlled POAG were asked to perform reading tasks using printed text followed by digital (smartphone) text under standardized conditions. IOP assessment was done using a rebound tonometer at baseline and subsequently at 10, 20, and 30 minutes of reading and 10 and 20 minutes post completion of reading tasks. IOP variations from baseline were measured and compared. Paired and independent ' T ' test analysis was performed to study IOP variations, and a P -value <0.05 was considered statistically significant. RESULTS The mean baseline IOP among volunteers and patients withPOAG was 14.58 (±2.91) and 15.02 (±2.18) mmHg, respectively. There was a rise in IOP in all participants with reading using either of the modalities, which normalized after 20 minutes of cessation. There was a statistically significant difference in rise in IOP from baseline between the 2 modalities (printed text reading and smartphone reading) at 20 minutes {+0.78 & +2.01 ( P =0.002)} and 30 minutes {+0.64 & +1.72 ( P =0.004)} among healthy volunteers and at 20 minutes {+0.78 & +2.01 ( P =0.002)} among POAG patients. CONCLUSION Reading is associated with the rise in IOP in both healthy volunteers and POAG individuals. The IOP rise is more marked with smartphone compared with printed text reading.
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Rabiolo A, Toscani R, Sacchi M, Destefanis P, Bettin P, Ciampi C, Clemente A, Cutolo CA, Mercieca K, Iester M, Traverso CE, Di Maita M, Li Calzi G, Nucci P, Bandello F, Triolo G, De Cillà S. Risk Factors for Failure in Glaucoma Patients Undergoing Microshunt Implantation. Am J Ophthalmol 2024; 259:117-130. [PMID: 37979601 DOI: 10.1016/j.ajo.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 11/20/2023]
Abstract
PURPOSE To evaluate risk factors for failure of Microshunt in glaucoma patients. DESIGN Multicenter retrospective cohort study. METHODS The study included 220 eyes from 220 consecutive glaucoma patients undergoing Microshunt implantation at six glaucoma units. Four intraocular pressure (IOP) success criteria were defined: (A) IOP ≤21 mm Hg with ≥20% IOP reduction; (B) IOP ≤18 mm Hg with ≥20% IOP reduction; (C) IOP ≤15 mm Hg with ≥25% IOP reduction; and (D) IOP ≤12 mm Hg with ≥30% IOP reduction from baseline. Kaplan-Meier analysis was used to estimate success rates according to the criteria above, and multivariable Cox models were used to identified risk factors for failure according to criterion A. RESULTS Success rates varied based on different criteria, ranging from 43.3% to 62.5% (overall success for criteria D and A, respectively) and from 35.3% to 44.4% (complete success for criteria D and A, respectively) at 1-year follow-up. Higher intraoperative MMC concentration was associated with reduced risk of failure to maintain complete (0.4 vs 0.2 mg/mL: hazard ratio [HR] = 0.441, P < .001) and overall (0.4 vs 0.2 mg/mL: HR = 0.360, P = .004) success. For complete success, other risk factors for failure were pseudoexfoliation glaucoma/pigmentary glaucoma (HR = 1.641, P = .004), primary angle closure glaucoma (HR = 1.611, P < .001), and previous non-glaucomatous ocular surgeries (HR = 2.301, P = .002). For overall success, other risk factors for failure were lower preoperative IOP (for 1-mm Hg increase, HR = 0.934, P = .005), higher number of preoperative antiglaucoma agents (HR = 1.626, P < .001), and Microshunt combined with cataract surgery (HR = 1.526, P = .033). CONCLUSIONS This study identified risk factors for Microshunt failure, highlighting the importance of high intraoperative MMC dose and careful patient selection to optimize surgical success.
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Affiliation(s)
- Alessandro Rabiolo
- From the Department of Ophthalmology (A.R., P.D., A.C., S.D.C.), University Hospital Maggiore della Carità, Novara, Italy; Department of Health Sciences (A.R., S.D.C.), Università del Piemonte Orientale "Amedeo Avogadro", Novara, Italy.
| | - Rebecca Toscani
- Department of Ophthalmology (R.T., P.B., C.C., F.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Matteo Sacchi
- Department of Ophthalmology (M.S., G.L.C., P.N.), San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | - Pietro Destefanis
- From the Department of Ophthalmology (A.R., P.D., A.C., S.D.C.), University Hospital Maggiore della Carità, Novara, Italy
| | - Paolo Bettin
- Department of Ophthalmology (R.T., P.B., C.C., F.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carlo Ciampi
- Department of Ophthalmology (R.T., P.B., C.C., F.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Clemente
- From the Department of Ophthalmology (A.R., P.D., A.C., S.D.C.), University Hospital Maggiore della Carità, Novara, Italy
| | - Carlo Alberto Cutolo
- DiNOGMI (C.A.C., M.I., C.E.T.), Università di Genova, Genova, Italy; IRCCS Ospedale Policlinico San Martino (C.A.C., M.I., C.E.T.), Genova, Italy
| | - Karl Mercieca
- Department of Ophthalmology (K.M.), University Hospital Bonn, Bonn, Germany; Faculty of Biology (K.M.), Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Michele Iester
- DiNOGMI (C.A.C., M.I., C.E.T.), Università di Genova, Genova, Italy; IRCCS Ospedale Policlinico San Martino (C.A.C., M.I., C.E.T.), Genova, Italy
| | - Carlo Enrico Traverso
- DiNOGMI (C.A.C., M.I., C.E.T.), Università di Genova, Genova, Italy; IRCCS Ospedale Policlinico San Martino (C.A.C., M.I., C.E.T.), Genova, Italy
| | - Marco Di Maita
- Department of Ophthalmology (M.D.M.), Policlinico G.B. Morgagni, Catania, Italy
| | - Gaia Li Calzi
- Department of Ophthalmology (M.S., G.L.C., P.N.), San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | - Paolo Nucci
- Department of Ophthalmology (M.S., G.L.C., P.N.), San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | - Francesco Bandello
- Department of Ophthalmology (R.T., P.B., C.C., F.B.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giacinto Triolo
- Department of Ophthalmology (G.T.), Fatebenefratelli and Ophthalmic Hospital, ASST-Fatebenefratelli-Sacco, Milan, Italy
| | - Stefano De Cillà
- From the Department of Ophthalmology (A.R., P.D., A.C., S.D.C.), University Hospital Maggiore della Carità, Novara, Italy; Department of Health Sciences (A.R., S.D.C.), Università del Piemonte Orientale "Amedeo Avogadro", Novara, Italy
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Fanney D, Layser GS, R.K. A, Kohlhammer S, Kübler C, Seibel BS. Reply : Experimental study comparing 2 different phacoemulsification systems with intraocular pressure control during steady-state flow and occlusion break surge events. J Cataract Refract Surg 2024; 50:312-313. [PMID: 38212949 PMCID: PMC10878437 DOI: 10.1097/j.jcrs.0000000000001390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 01/13/2024]
Affiliation(s)
| | | | - Akhil R.K.
- From the Carl Zeiss Meditec AG, Oberkochen, Germany
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Jo JJ, Pasquale LR. Recent developments of telemedicine in glaucoma. Curr Opin Ophthalmol 2024; 35:116-123. [PMID: 38295153 DOI: 10.1097/icu.0000000000001019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
PURPOSE OF REVIEW Telemedicine has an increasingly significant role in the fields of ophthalmology and glaucoma. This review covers recent advancements in the development and optimization of teleglaucoma techniques and applications. RECENT FINDINGS Glaucoma monitoring and diagnosis via remote tonometry, perimetry, and fundus imaging have become a possibility based on recent developments. Many applications work in combination with smart devices, virtual reality, and artificial intelligence and have been tested in patient populations against conventional "reference-standard" measurement tools, demonstrating promising results. Of note, there is still much progress to be made in teleglaucoma and telemedicine at large, such as accessibility to internet, broadband, and smart devices, application affordability, and reimbursement for remote services. However, continued development and optimization of these applications suggest that the implementation of remote monitoring will be a mainstay for glaucoma patient care. SUMMARY Especially since the beginning of the COVID-19 pandemic, remote patient care has taken on an important role in medicine and ophthalmology. Remote versions of tonometry, perimetry, and fundus imaging may allow for a more patient-centered and accessible future for glaucoma care.
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Affiliation(s)
- Jason J Jo
- Department of Medical Education
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Louis R Pasquale
- Department of Medical Education
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Killer HE, Pircher A, Fleischman D. Intraocular Pressure and Cerebrospinal Fluid: An Intricate Relationship. J Neuroophthalmol 2024; 44:e205. [PMID: 36729869 DOI: 10.1097/wno.0000000000001750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Hanspeter E Killer
- Department of Biomedicine, University Hospital Basel & University Basel, Basel, Switzerland , Department of Surgical Sciences/Ophthalmology, Uppsala University, Uppsala, Sweden; and Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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35
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Scofield-Kaplan SM, Mancini R. Intraocular Pressure and Cerebrospinal Fluid: An Intricate Relationship: Response. J Neuroophthalmol 2024; 44:e206. [PMID: 36729875 DOI: 10.1097/wno.0000000000001751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Stacy M Scofield-Kaplan
- Department of Ophthalmology, Northwestern Regional Medical Group, Naperville, Illinois; and Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas
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36
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Martínez-de-la-Casa JM, Marcos-Parra MT, Millá-Griñó E, Laborda T, Giménez-Gomez R, Larrosa JM, Urcola A, Teus MÁ, Perucho-Martínez S. Effectiveness and safety of XEN63 in patients with primary-open-angle glaucoma. Sci Rep 2024; 14:4561. [PMID: 38402310 PMCID: PMC10894194 DOI: 10.1038/s41598-024-55287-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 02/22/2024] [Indexed: 02/26/2024] Open
Abstract
This paper evaluates the effectiveness and safety of XEN63 stent, either standalone or in combination with phacoemulsification, in patients with primary open-angle glaucoma (POAG). Eighty eyes from 80 patients with medically uncontrolled POAG were assigned to undergo XEN63 implant. The primary outcome was the surgical success, defined as an intraocular pressure (IOP) lowering from preoperative values ≥ 20% and an IOP absolute value between 6 and 18 mmHg, with or without antiglaucoma medications. Forty-three (53.7%) eyes underwent XEN63-standalone and 37(46.2%) eyes a XEN63 + Phacoemulsification procedure. Success rate was 68.8% (55/80) eyes in the overall study sample, 69.8% (30/43) eyes in the XEN63-standalone group; and 67.6% (25/37) eyes in the XEN63 + Phaco group (p = 0.6133). Preoperative IOP was significantly lowered from 22.1 ± 4.9 mmHg and 19.8 ± 3.7 mmHg to 14.7 ± 5.3 mmHg and 13.8 ± 3.4 mmHg in the XEN63-standalone and XEN63 + Phaco groups, respectively (p < 0.0001 each, respectively); without significant differences between them at any of the time-points measured. Preoperative number of ocular-hypotensive drugs was significantly reduced from 2.3 ± 0.8 to 0.3 ± 0.7 drugs, from 2.5 ± 0.7 to 0.3 ± 0.7 drugs; and from 2.0 ± 0.8 to 0.3 ± 0.7 drugs, in the overall, XEN63-standalone, and XEN63 + Phaco groups, respectively. Regarding safety, 3(42.5%) eyes had transient hypotony at some point during the study, although only in one (1.2%) eye was clinically significant. Four (5.0%) eyes underwent a needling, 4 (5.0%) eyes underwent surgical-bleb-revision, 1 (1.2%) eye required a device replacement and 1 (1.2%) eye a device removal due to maculopathy. XEN63, either alone or in combination with phacoemulsification, significantly lowered IOP and reduced the number of ocular hypotensive medications. The rate of ocular hypotony was relatively high, although it was clinically relevant only in one eye.
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Affiliation(s)
- José María Martínez-de-la-Casa
- Ophthalmology Unit, Department of Ophthalmology and ORL, Faculty of Medicine, Hospital Clinico San-Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San-Carlos (IdISSC), Universidad Complutense de Madrid, Calle del Prof Martín Lagos, s/n, 28040, Madrid, Spain.
| | | | | | - Teresa Laborda
- Glaucoma Department. Hospital La Arruzafa, Córdoba, Spain
| | | | | | - Aritz Urcola
- Ophthalmology Department, Araba University Hospital, Álava, Spain
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Gniesmer S, Sonntag SR, Gapeeva A, Cojocaru A, Kaps S, Adelung R, Sewing J, Tura A, Grisanti S, Grisanti S. In vivo evaluation of a nanotechnology-based microshunt for filtering glaucoma surgery. Sci Rep 2024; 14:4452. [PMID: 38396005 PMCID: PMC10891163 DOI: 10.1038/s41598-024-54960-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/19/2024] [Indexed: 02/25/2024] Open
Abstract
To carry out the preclinical and histological evaluation of a novel nanotechnology-based microshunt for drainage glaucoma surgery. Twelve New Zealand White rabbits were implanted with a novel microshunt and followed up for 6 weeks. The new material composite consists of the silicone polydimethylsiloxane (PDMS) and tetrapodal Zinc Oxide (ZnO-T) nano-/microparticles. The microshunts were inserted ab externo to connect the subconjunctival space with the anterior chamber. Animals were euthanized after 2 and 6 weeks for histological evaluation. Ocular health and implant position were assessed at postoperative days 1, 3, 7 and twice a week thereafter by slit lamp biomicroscopy. Intraocular pressure (IOP) was measured using rebound tonometry. A good tolerability was observed in both short- and medium-term follow-up. Intraocular pressure was reduced following surgery but increased to preoperative levels after 2 weeks. No clinical or histological signs of inflammatory or toxic reactions were seen; the fibrotic encapsulation was barely noticeable after two weeks and very mild after six weeks. The new material composite PDMS/ZnO-T is well tolerated and the associated foreign body fibrotic reaction quite mild. The new microshunt reduces the IOP for 2 weeks. Further research will elucidate a tube-like shape to improve and prolong outflow performance and longer follow-up to exclude medium-term adverse effects.
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Affiliation(s)
- Stefanie Gniesmer
- Department of Ophthalmology, University of Luebeck, Luebeck, Germany.
| | | | - Anna Gapeeva
- Institute for Materials Science, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Ala Cojocaru
- Institute for Materials Science, Christian-Albrechts-University of Kiel, Kiel, Germany
- Phi-Stone AG, Kiel, Germany
| | - Sören Kaps
- Institute for Materials Science, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Rainer Adelung
- Institute for Materials Science, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Judith Sewing
- Department of Ophthalmology, University of Luebeck, Luebeck, Germany
| | - Aysegül Tura
- Department of Ophthalmology, University of Luebeck, Luebeck, Germany
| | | | - Swaantje Grisanti
- Department of Ophthalmology, University of Luebeck, Luebeck, Germany
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Liang G, Kai JY, Li DL, Yin ZJ, Li YZ, Ma R, Zheng YJ, Qin Y, Pan CW. Distribution and determinants of corneal volume among healthy young Chinese adults: a cross-sectional study. BMC Ophthalmol 2024; 24:59. [PMID: 38342901 PMCID: PMC10860269 DOI: 10.1186/s12886-024-03342-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/07/2024] [Indexed: 02/13/2024] Open
Abstract
BACKGROUND Several studies have previously reported the normal values of corneal volume (CV) in various populations, whereas little is known about the CV distribution in healthy young Chinese adults. Our study aimed to investigate the distribution of CV and its relationships with other ocular biometric parameters among healthy young Chinese adults. METHODS A total of 1645 eyes from 1645 students at Dali University in Yunnan Province, China, were analyzed. Pentacam was used to measure CV. Central corneal thickness (CCT) and biomechanically corrected intraocular pressure (bIOP) were evaluated by Corvis-ST. Other biometrical parameters, including axial length (AL), keratometry, and white-to-white (WTW) distance, were measured using IOL Master. RESULTS The mean age of the study population was 19.01 ± 0.92 years, and 68.81% of them were women. The CV was normally distributed in the whole sample, with a mean value of 61.23 ± 3.22 mm3. CV and CCT were significantly smaller in the Yi ethnic group than in the Han ethnic group (p < 0.01). CCT (coefficient: 0.085; p < 0.001) and keratometry (coefficient: 0.422; p < 0.001) were positively correlated with CV, while AL (coefficient: -0.204; p < 0.001), WTW distance (coefficient: -0.236; p < 0.001) and bIOP (coefficient: -0.06; p < 0.001) were inversely associated with CV. CONCLUSIONS Our study provides an age-specific distribution of CV among healthy young Chinese adults. CCT, keratometry, AL, WTW distance and bIOP were important factors associated with CV.
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Affiliation(s)
- Gang Liang
- Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China
- Department of Ophthalmology, The Second People's Hospital of Yunnan Province, Kunming, China
| | - Jia-Yan Kai
- School of Public Health, Suzhou Medical College of Soochow University, 199 Ren Ai Road, Suzhou, 215123, China
| | - Dan-Lin Li
- School of Public Health, Suzhou Medical College of Soochow University, 199 Ren Ai Road, Suzhou, 215123, China
| | - Zhi-Jian Yin
- Department of Ophthalmology, the First Affiliated Hospital of Dali University, Dali, China
| | - Yue-Zu Li
- Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China
- Department of Ophthalmology, The Second People's Hospital of Yunnan Province, Kunming, China
| | - Rong Ma
- Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China
- Department of Ophthalmology, The Second People's Hospital of Yunnan Province, Kunming, China
| | - Ya-Jie Zheng
- Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China
- Department of Ophthalmology, The Second People's Hospital of Yunnan Province, Kunming, China
| | - Yu Qin
- Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China
- Department of Ophthalmology, The Second People's Hospital of Yunnan Province, Kunming, China
| | - Chen-Wei Pan
- School of Public Health, Suzhou Medical College of Soochow University, 199 Ren Ai Road, Suzhou, 215123, China.
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Seo H, Hong YM, Chung WG, Park W, Lee J, Kim HK, Byeon SH, Kim DW, Park JU. Real-time in vivo monitoring of intraocular pressure distribution in the anterior chamber and vitreous chamber for diagnosis of glaucoma. Sci Adv 2024; 10:eadk7805. [PMID: 38324695 PMCID: PMC10851251 DOI: 10.1126/sciadv.adk7805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 01/05/2024] [Indexed: 02/09/2024]
Abstract
Glaucoma causes irreversible vision loss due to optic nerve damage and retinal cell degeneration. Since high intraocular pressure (IOP) is a major risk factor for glaucoma development, accurate IOP measurement is crucial, especially intravitreal IOP affecting the optical nerve and cells. However, conventional methods have limits in selectively and directly detecting local retina pressure. Here, we present continuous measurements of local IOP values in the anterior chamber and vitreous chamber of living animals using minimally invasive probes with pressure-sensitive transistors. After inducing glaucoma in animal models, we compared the local IOP distribution between normal and glaucomatous eyes. We also compared IOP values detected in the cornea using tonometry measurements. Our findings revealed that glaucoma induced higher IOP in the vitreous chamber than in the anterior chamber, indicating that measuring IOP in the vitreous chamber is key to the glaucoma model. This progress offers future directions for diagnosis and treatment of glaucoma.
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Affiliation(s)
- Hunkyu Seo
- Department of Materials Science and Engineering, Yonsei University College of Engineering, Seoul 03722, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Yonsei University, Seoul 03722, Republic of Korea
| | - Yeon-Mi Hong
- Department of Materials Science and Engineering, Yonsei University College of Engineering, Seoul 03722, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Yonsei University, Seoul 03722, Republic of Korea
| | - Won Gi Chung
- Department of Materials Science and Engineering, Yonsei University College of Engineering, Seoul 03722, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Yonsei University, Seoul 03722, Republic of Korea
| | - Wonjung Park
- Department of Materials Science and Engineering, Yonsei University College of Engineering, Seoul 03722, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Yonsei University, Seoul 03722, Republic of Korea
| | - Jakyoung Lee
- Department of Materials Science and Engineering, Yonsei University College of Engineering, Seoul 03722, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Yonsei University, Seoul 03722, Republic of Korea
| | - Hong Kyun Kim
- Department of Ophthalmology, Kyungpook National University School of Medicine, Daegu 41944, Republic of Korea
| | - Suk Ho Byeon
- Department of Ophthalmology, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Dai Woo Kim
- Department of Ophthalmology, Kyungpook National University School of Medicine, Daegu 41944, Republic of Korea
| | - Jang-Ung Park
- Department of Materials Science and Engineering, Yonsei University College of Engineering, Seoul 03722, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Yonsei University, Seoul 03722, Republic of Korea
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Graduate Program of Nano Biomedical Engineering (NanoBME), Advanced Science Institute, Yonsei University, Seoul 03722, Republic of Korea
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Espinoza G, Justiniano MJ, Rodriguez-Una I, Godin F, Arango A, Villamizar S. Twelve-month outcomes of Kahook dual blade goniotomy combined with cataract surgery in Latino patients. Int Ophthalmol 2024; 44:44. [PMID: 38337081 DOI: 10.1007/s10792-024-03024-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/11/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE To evaluate 12 month surgical outcome of Kahook Dual Blade (KDB) goniotomy in combination with cataract surgery in Latino patients with open angle glaucoma (OAG) and ocular hypertension (OHT). METHODS This retrospective study included 45 eyes of 40 patients who underwent KDB goniotomy combined with cataract extraction from January 2016 to September 2020 at two centers in South America. Primary outcome was surgical success defined as ≥ 20% intraocular pressure (IOP) reduction or ≥ 1 medication reduction from preoperative without additional IOP-lowering procedures and an IOP ≥ 5 mmHg or ≤ 21 mmHg. Additionally, we used 2 cutoffs values for success of IOP ≤ 18 and ≤ 15 mmHg. Secondary outcomes included: IOP, medication use, best corrected visual acuity, complications and failure-associated factors. RESULTS Success rates at 12 months with cutoff limits of 21, 18 and 15 mmHg were 84.3%, 75.6% and 58.7%, respectively. At 12 months, mean preoperative IOP significantly decreased from 19.23 ± 0.65 mmHg on 2.3 ± 1.0 medications to 14.33 ± 0.66 mmHg on 0.6 ± 0.9 medications (p < 0.001) , with 62% of eyes free of hypotensive medication. Eyes that developed postoperative IOP spikes showed a higher risk for failure using the cutoff limit of IOP ≤ 18 mmHg with a hazard ratio of 3.6 (95% confidence interval [CI], 1.80-7.13; p < 0.001). There were no serious ocular adverse events. CONCLUSIONS KDB combined with cataract extraction showed safety and efficacy for decreasing IOP in OAG and OHT Latino patients. Additionally, dependence on medications was reduced significantly after surgery.
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Affiliation(s)
- Gustavo Espinoza
- Centro Oftalmológico Virgilio Galvis, Bucaramanga, Santander, Colombia.
- Fundación Oftalmológica de Santander FOSCAL, Ave. El No 23-60, TMS, Cañaveral, Tv. El Bosque Floridablanca, Bucaramanga, Santander, Colombia.
| | | | | | - Fernando Godin
- Grupo de investigación Salud Visual y ocular Unbosque, Universidad del Bosque, Bogotá D.C., Colombia
| | - Andres Arango
- Centro Oftalmológico Virgilio Galvis, Bucaramanga, Santander, Colombia
| | - Sylvia Villamizar
- Centro Oftalmológico Virgilio Galvis, Bucaramanga, Santander, Colombia
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Sedaghat MR, Ostadi-Moghaddam H, Momeni-Moghaddam H, Motaei S, Roberts CJ, Belin MW, Oladi Abbas Abadi S. Comparison of corneal biomechanical parameters in healthy corneas with symmetric and asymmetric bow-tie topographic pattern with inferior and superior steepening. Int Ophthalmol 2024; 44:22. [PMID: 38324098 DOI: 10.1007/s10792-024-02921-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/18/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE To compare the corneal biomechanical parameters in healthy corneas with symmetric and asymmetric bow-tie topographic patterns. METHODS In this cross-sectional study, 144 eyes were divided based on inferior-superior asymmetry value (I-S) into symmetric (zero I-S: - 0.50 to + 0.50 D) and asymmetric bow-tie topographic patterns with inferior (positive I-S: + 0.51 to + 1.4 D) or superior (negative I-S: - 2.5 to - 0.51 D) steepening. The biomechanical assessment was performed using Corvis ST and ocular response analyzer (ORA). A general linear model univariate analysis was used to compare the parameters, while the central corneal thickness, intraocular pressure, and age were considered covariates. RESULTS Only the peak distance (PD) at the highest concavity phase (P = 0.007) and tomographic biomechanical index (TBI, P = 0.001) showed statistically significant differences between the three groups. For TBI, this difference was statistically significant between the positive I-S group separately with the zero I-S group (P < 0.001), and with the negative I-S group (P = 0.022). For PD, the significant difference was between the negative I-S group separately with zero I-S (P = 0.019), and positive I-S groups (P = 0.018). There was a statistically significant correlation between the I-S value with PD (r = 0.281, P = 0.001) and TBI (r = 0.170, P = 0.044). CONCLUSIONS Most corneal biomechanical parameters are not statistically significant compared to the zero I-S group. However, superior steepening is associated with a stiffer response based solely on the shorter PD values seen in this group, and the group with the inferior steepening shows the highest or more suspicious values based on TBI.
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Affiliation(s)
| | - Hadi Ostadi-Moghaddam
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamed Momeni-Moghaddam
- Rehabilitation Sciences Research Center, Zahedan University of Medical Sciences, Kafami Str., Zahedan, Iran.
| | - Soulmaz Motaei
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Cynthia J Roberts
- Ophthalmology & Visual Sciences and Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Michael W Belin
- Department of Ophthalmology & Vision Science, University of Arizona, Tucson, AZ, USA
| | - Samin Oladi Abbas Abadi
- Student Research Committee, Rehabilitation Sciences Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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Chen J, Tang Y, Lin Z, Tao Z, Deng H. Effect and safety posterior scleral reinforcement on controlling myopia in children: a meta-analysis. Int Ophthalmol 2024; 44:8. [PMID: 38319543 PMCID: PMC10847067 DOI: 10.1007/s10792-024-02929-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 12/17/2023] [Indexed: 02/07/2024]
Abstract
PURPOSE The aim of this meta-analysis was to assess the efficacy of posterior scleral reinforcement (PSR) on the control of pediatric myopia. Electronic databases were systematically searched. METHODS Standardized mean differences (SMDs) of outcomes were calculated. Eight studies with 357 patients with pediatric myopia were included. The SMD for the increase in mean axial length (AL) in the PSR and control group was - 1.19 (95% CI - 1.71, - 0.68). RESULTS The SMD for decrease of best-corrected visual acuity (BCVA) LogMAR in the PSR and control group was 0.85 (95% CI 0.28, 1.43). The SMD for change in intraocular pressure (IOP) at the time of surgery and at the end of the follow-up period in the PSR group was - 0.01 (95% CI - 0.48, 0.47). CONCLUSION This meta-analysis indicates that PSR surgery may be an effective therapeutic strategy to control the progression of myopia in childhood with acceptable adverse effects.
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Affiliation(s)
- Jing Chen
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Jinan University, No. 18 Zetian Road, Futian District, Shenzhen, 518040, Guangdong, China
| | - Yu Tang
- The Second Clinical Medical College, Jinan University, Shenzhen, China
| | - Zhihong Lin
- The Second Clinical Medical College, Jinan University, Shenzhen, China
| | - Zhengyang Tao
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Jinan University, No. 18 Zetian Road, Futian District, Shenzhen, 518040, Guangdong, China
| | - Hongwei Deng
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Jinan University, No. 18 Zetian Road, Futian District, Shenzhen, 518040, Guangdong, China.
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Meyer JJ. Comment on: A Systematic Review and Meta-Analysis of Systemic Antihypertensive Medications with Intraocular Pressure and Glaucoma. Am J Ophthalmol 2024; 258:219. [PMID: 37898284 DOI: 10.1016/j.ajo.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 10/22/2023] [Indexed: 10/30/2023]
Affiliation(s)
- Jay J Meyer
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand.
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44
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Nicou CM, Passaglia CL. Characterization of intraocular pressure variability in conscious rats. Exp Eye Res 2024; 239:109757. [PMID: 38123009 PMCID: PMC10922224 DOI: 10.1016/j.exer.2023.109757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/10/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023]
Abstract
Elevation of mean intraocular pressure (IOP) has long been recognized as a leading risk factor for glaucoma. Less is known about the possible contribution of moment-to-moment variations in IOP to disease development and progression due to limitations of tonometry, the prevailing method of IOP measurement. Tonometry provides good estimates of mean IOP but not IOP variance. The aim of this study was to quantitatively characterize IOP variability via round-the-clock IOP telemetry in conscious unrestrained rats. The anterior chamber of one eye was implanted with a microcannula connected to a wireless backpack telemetry system, and IOP data were collected every 4 s for one week. The cannula was then repositioned under the conjunctiva, and control data were collected for an additional week. IOP statistics were computed in 30-min intervals over a 24-h period and averaged across days. All animals exhibited a diurnal variation in mean IOP, while deviations about the mean were independent of time of day. Correlation analysis of the deviations revealed transient and sustained components, which were respectively extracted from IOP records using an event detection algorithm. The amplitude and interval distributions of transient and sustained events were characterized, and their energy content was estimated based on outflow tissue resistance of rat eyes. Transient IOP events occurred ∼231 times per day and were typically ≤5 mmHg in amplitude and 2-8 min in duration, while sustained IOP events occurred ∼16 times per day and were typically ≤5 mmHg in amplitude and 20-60 min in duration. Both persisted but were greatly reduced in control recordings, implying minor contamination of IOP data by motion-induced telemetry noise. Sustained events were also often synchronous across implanted animals, indicating that they were driven by autonomic startle and stress responses or other physiological processes activated by sensory signals in the animal housing environment. Not surprisingly, the total daily fluidic energy applied to resistive outflow pathways was determined primarily by basal IOP level. Nevertheless, transient and sustained fluctuations collectively contributed 6% and diurnal fluctuations contributed 9% to daily IOP energy. It is therefore important to consider the cumulative impact of biomechanical stress that IOP fluctuations apply over time to ocular tissues.
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Affiliation(s)
- Christina M Nicou
- Medical Engineering Department, University of South Florida, Tampa, FL, 33620, USA
| | - Christopher L Passaglia
- Medical Engineering Department, University of South Florida, Tampa, FL, 33620, USA; Ophthalmology Department, University of South Florida, Tampa, FL, 33620, USA.
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Zhang P, Wu J, Jiang J, Zhang X, Ran Z, Jiang F, Zheng X, Wang J, Elsheikh A, Bao F. Evaluation of changes in corneal biomechanics after orthokeratology using Corvis ST. Cont Lens Anterior Eye 2024; 47:102100. [PMID: 38072740 DOI: 10.1016/j.clae.2023.102100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/25/2023] [Accepted: 11/27/2023] [Indexed: 01/22/2024]
Abstract
PURPOSE To investigate the alterations in corneal biomechanical metrics induced by orthokeratology (ortho-k) using Corvis ST and to determine the factors influencing these changes. METHOD A prospective observational study was conducted to analyze various Corvis ST parameters in 32 children with low to moderate myopia who successfully underwent ortho-k lens fitting. Corneal biomechanical measurements via Corvis ST were acquired at six distinct time points: baseline (pre) and 2 h (pos2h), 6 h (pos6h), and 10 h (pos10h) following the removal of the first overnight wear ortho-k, one week (pos1w) and one month (pos1m) subsequent to the initiation of ortho-k. RESULT Significant differences were observed in Corvis ST Biomechanical parameters DAR2, IIR, CBI, and cCBI post ortho-k intervention. The integration of covariates (CCT, SimK, and bIOP) mitigated the differences in DAR2, IIR, and cCBI, but not in CBI. Initially, the stiffness parameter at first applanation, SP-A1, did not demonstrate significant variations, but after adjusting for covariates, noticeable differences over time were observed. The Stress-Strain Indeces, SSIv1 and SSIv2, did not manifest considerable changes over time, irrespective of the adjustment for covariates. No significant disparities were identified among different ortho-k lens brands. CONCLUSION Corneal biomechanics remained consistent throughout the one-month period of ortho-k lens wear. The observed changes in Corvis ST parameters subsequent ortho-k are primarily attributable to alterations in corneal pachymetry and morphology, rather than actual alterations in corneal biomechanics. The stability of corneal biomechanics post ortho-k treatment suggests the safety of this approach for adolescents from a corneal biomechanics perspective.
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Affiliation(s)
- PeiPei Zhang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University, Wenzhou 325027, China
| | - JinFang Wu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
| | - Jun Jiang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University, Wenzhou 325027, China
| | - XinYu Zhang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University, Wenzhou 325027, China
| | - ZiYing Ran
- School of Engineering, University of Liverpool, Liverpool L69 3GH, UK
| | - Fan Jiang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University, Wenzhou 325027, China.
| | - XiaoBo Zheng
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University, Wenzhou 325027, China; National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; The Institute of Ocular Biomechanics, Wenzhou Medical University, Wenzhou 325027, China
| | - JunJie Wang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University, Wenzhou 325027, China; National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; The Institute of Ocular Biomechanics, Wenzhou Medical University, Wenzhou 325027, China
| | - Ahmed Elsheikh
- School of Engineering, University of Liverpool, Liverpool L69 3GH, UK; National Institute for Health Research (NIHR) Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK; Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100083, China
| | - FangJun Bao
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University, Wenzhou 325027, China; National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; The Institute of Ocular Biomechanics, Wenzhou Medical University, Wenzhou 325027, China.
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Hackett DA, Li J, Wang B, Way KL, Cross T, Tran DL. Acute Effects of Resistance Exercise on Intraocular Pressure in Healthy Adults: A Systematic Review. J Strength Cond Res 2024; 38:394-404. [PMID: 38090981 DOI: 10.1519/jsc.0000000000004668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
ABSTRACT Hackett, DA, Li, J, Wang, B, Way, KL, Cross, T, and Tran, DL. Acute effects of resistance exercise on intraocular pressure in healthy adults: A systematic review. J Strength Cond Res 38(2): 394-404, 2024-Intraocular pressure (IOP) tends to fluctuate during a resistance exercise (RE). This systematic review examines the acute effects of RE on IOP in healthy adults and factors that influence changes in IOP. Five electronic databases were searched using terms related to RE and IOP. A strict inclusion criterion was applied, which included being 55 years or younger with no medical conditions and RE intensity needing to be quantifiable (e.g., based on a maximal effort). Thirty-four studies met the inclusion criteria for this review. Isometric and isotonic contractions produced similar changes in IOP during RE up to 28.7 mm Hg. Exercises that involved larger muscle mass, such as squats and leg press, were found to produce changes in IOP during exercise ranging from 3.1 to 28.7 mm Hg. Smaller changes in IOP during RE were found for exercises engaging less muscle mass (e.g., handgrip and bicep curls). Intraocular pressure was found to increase during RE when lifting heavier loads and with longer exercise durations (e.g., greater repetitions). The Valsalva maneuver (VM) and breath-hold during RE accentuated the change in IOP, with more extreme changes observed with the VM. However, most studies showed that postexercise IOP returned to baseline after approximately 1 minute of recovery. An acute increase in IOP is observed during RE in healthy adults with fluctuations of varying magnitude. Factors that independently increase IOP during RE include exercises involving larger muscle mass, heavy loads, greater set duration, and when the VM or breath-hold is performed.
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Affiliation(s)
- Daniel A Hackett
- Discipline of Exercise and Sports Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Jiuzhang Li
- Discipline of Exercise and Sports Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Boliang Wang
- Discipline of Exercise and Sports Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Kimberley L Way
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Troy Cross
- Discipline of Exercise and Sports Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Derek L Tran
- Discipline of Exercise and Sports Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
- The University of Sydney School of Medicine, Central Clinical School, Camperdown, Australia; and
- Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, Australia
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Zhang Y, Li Q, Jiang J, Ouyang Z, Shen X, Qian Y, Liu Y, Wang Z. Modified technique for reconstruction of large cyclodialysis cleft with capsular tension ring and continuous and cerclage sutures without scleral flaps. Indian J Ophthalmol 2024; 72:S327-S330. [PMID: 38271432 DOI: 10.4103/ijo.ijo_1736_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 10/22/2023] [Indexed: 01/27/2024] Open
Abstract
To present a modified technique for the reconstruction of a large cyclodialysis cleft with capsular tension ring (CTR) and continuous and cerclage sutures without scleral flaps in 12 cases. The mean visual acuity was 0.75 ± 0.47 logarithm of the minimal angle of resolution (logMAR), and the average intraocular pressure (IOP) was 3.35 ± 0.41 mmHg before surgery. Ultrasound biomicroscopy (UBM) revealed a ciliary cleft of 4.3 ± 3.5 clock hours. We performed the modified technique for the reconstruction of a large cyclodialysis cleft. Postoperative visual acuity improved to 0.48 ± 0.26 logMAR, and the IOP improved to 15.88 ± 3.81 mmHg. Postoperative UBM showed that cyclodialysis disappeared in the whole circumference of 12 eyes. The postoperative complications included 42% (5 eyes) with a temporary elevation of IOP and 16% (2 eyes) with a posterior shift of the ciliary body. No other complications were detected during the follow-up. Based on the results, our modified technique might be useful for most cyclodialysis clefts.
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Affiliation(s)
- Yu Zhang
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai, China
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Rajsrinivas D, Dubey S, Pegu J, Majumdar A. Consensual eye intraocular pressure rise following unilateral glaucoma surgery. Indian J Ophthalmol 2024; 72:292. [PMID: 38273688 PMCID: PMC10941936 DOI: 10.4103/ijo.ijo_2651_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Affiliation(s)
- Divya Rajsrinivas
- Department of Glaucoma, Dr. Shroff’s Charity Eye Hospital, Daryaganj, New Delhi, India
| | - Suneeta Dubey
- Department of Glaucoma, Dr. Shroff’s Charity Eye Hospital, Daryaganj, New Delhi, India
| | - Julie Pegu
- Department of Glaucoma, Dr. Shroff’s Charity Eye Hospital, Daryaganj, New Delhi, India
| | - Atanu Majumdar
- Department of Glaucoma, Dr. Shroff’s Charity Eye Hospital, Daryaganj, New Delhi, India
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Leung G, Grant A, Li G, Freeman EE. Reply to Comment on A systematic review and meta-analysis of systemic antihypertensive medications with intraocular pressure and glaucoma. Am J Ophthalmol 2024; 258:220. [PMID: 37898283 DOI: 10.1016/j.ajo.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 10/20/2023] [Indexed: 10/30/2023]
Affiliation(s)
- Gareth Leung
- School of Epidemiology and Public Health,University of Ottawa, Ontario, Canada
| | - Alyssa Grant
- School of Epidemiology and Public Health,University of Ottawa, Ontario, Canada
| | - Gisele Li
- Maisonneuve-Rosemont Hospital,Montreal, Quebec, Canada
| | - Ellen E Freeman
- School of Epidemiology and Public Health, University of Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Bruyere Research Institute, Ottawa, Ontario, Canada.
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Miao YY, Ma XM, Qu ZX, Eliasy A, Wu BW, Xu H, Wang P, Zheng XB, Wang JJ, Ye YF, Chen SH, Elsheikh A, Bao FJ. Performance of Corvis ST Parameters Including Updated Stress-Strain Index in Differentiating Between Normal, Forme-Fruste, Subclinical, and Clinical Keratoconic Eyes. Am J Ophthalmol 2024; 258:196-207. [PMID: 37879454 DOI: 10.1016/j.ajo.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 10/27/2023]
Abstract
PURPOSE This study seeks to evaluate the ability of the updated stress strain index (SSIv2) and other Corvis ST biomechanical parameters in distinguishing between keratoconus at different disease stages and normal eyes. DESIGN Diagnostic accuracy analysis to distinguish disease stages. METHODS 1084 eyes were included and divided into groups of normal (199 eyes), forme fruste keratoconus (FFKC, 194 eyes), subclinical keratoconus (SKC, 113 eyes), mild clinical keratoconus (CKC-Ⅰ, 175 eyes), moderate clinical keratoconus (CKC-Ⅱ, 204 eyes), and severe clinical keratoconus (CKC-Ⅲ, 199 eyes). Each eye was subjected to a Corvis ST examination to determine the central corneal thickness (CCT), biomechanically corrected intraocular pressure (bIOP), SSIv2 (updated stress-strain index), and other 8 Corvis parameters including the stress-strain index (SSIv1), stiffness parameter at first applanation (SP-A1), first applanation time (A1T), Ambrósio relational thickness to the horizontal profile (ARTh), integrated inverse radius (IIR), maximum deformation amplitude (DAM), ratio between deformation amplitude at the apex and at 2 mm nasal and temporal (DARatio2), and Corvis biomechanical index (CBI). The sensitivity and specificity of these parameters in diagnosing keratoconus were analyzed through receiver operating characteristic curves. RESULTS Before and after correction for CCT and bIOP, SSIv2 and ARTh were significantly higher and IIR and CBI were significantly lower in the normal group than in the FFKC group, SKC group and the 3 CKC groups (all P < .05). There were also significant correlations between the values of SSIv2, ARTh, IIR, CBI, and the CKC severity (all P < .05). AUC of SSIv2 was significantly higher than all other Corvis parameters in distinguishing normal eyes from FFKC, followed by IIR, ARTh and CBI. CONCLUSION Corvis ST's updated stress-strain index, SSIv2, demonstrated superior performance in differentiating between normal and keratoconic corneas, and between corneas with different keratoconus stages. Similar, but less pronounced, performance was demonstrated by the IIR, ARTh and CBI.
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Affiliation(s)
- Yuan-Yuan Miao
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University (Y.-Y.M., Z.-X.Q., B.-W.W., H.X., P.W., X.-B.Z., J.-J.W., Y.-F.Y., S.-H.C., F.-J.B), Wenzhou, Zhejiang, China
| | - Xiao-Min Ma
- Shanghai Eighth People's Hospital (X.-M.M.), Shanghai, China
| | - Zhan-Xin Qu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University (Y.-Y.M., Z.-X.Q., B.-W.W., H.X., P.W., X.-B.Z., J.-J.W., Y.-F.Y., S.-H.C., F.-J.B), Wenzhou, Zhejiang, China
| | - Ashkan Eliasy
- School of Engineering, University of Liverpool (A.Eli., A.Els.), Liverpool, United Kingdom
| | - Bo-Wen Wu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University (Y.-Y.M., Z.-X.Q., B.-W.W., H.X., P.W., X.-B.Z., J.-J.W., Y.-F.Y., S.-H.C., F.-J.B), Wenzhou, Zhejiang, China
| | - Hui Xu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University (Y.-Y.M., Z.-X.Q., B.-W.W., H.X., P.W., X.-B.Z., J.-J.W., Y.-F.Y., S.-H.C., F.-J.B), Wenzhou, Zhejiang, China
| | - Pu Wang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University (Y.-Y.M., Z.-X.Q., B.-W.W., H.X., P.W., X.-B.Z., J.-J.W., Y.-F.Y., S.-H.C., F.-J.B), Wenzhou, Zhejiang, China
| | - Xiao-Bo Zheng
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University (Y.-Y.M., Z.-X.Q., B.-W.W., H.X., P.W., X.-B.Z., J.-J.W., Y.-F.Y., S.-H.C., F.-J.B), Wenzhou, Zhejiang, China; The Institute of Ocular Biomechanics, Wenzhou Medical University (X.-B.Z., J.-J.W., S.-H.C., F.-J.B.), Wenzhou, Zhejiang, China
| | - Jun-Jie Wang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University (Y.-Y.M., Z.-X.Q., B.-W.W., H.X., P.W., X.-B.Z., J.-J.W., Y.-F.Y., S.-H.C., F.-J.B), Wenzhou, Zhejiang, China; The Institute of Ocular Biomechanics, Wenzhou Medical University (X.-B.Z., J.-J.W., S.-H.C., F.-J.B.), Wenzhou, Zhejiang, China
| | - Yu-Feng Ye
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University (Y.-Y.M., Z.-X.Q., B.-W.W., H.X., P.W., X.-B.Z., J.-J.W., Y.-F.Y., S.-H.C., F.-J.B), Wenzhou, Zhejiang, China
| | - Shi-Hao Chen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University (Y.-Y.M., Z.-X.Q., B.-W.W., H.X., P.W., X.-B.Z., J.-J.W., Y.-F.Y., S.-H.C., F.-J.B), Wenzhou, Zhejiang, China; The Institute of Ocular Biomechanics, Wenzhou Medical University (X.-B.Z., J.-J.W., S.-H.C., F.-J.B.), Wenzhou, Zhejiang, China.
| | - Ahmed Elsheikh
- School of Engineering, University of Liverpool (A.Eli., A.Els.), Liverpool, United Kingdom; National Institute for Health Research (NIHR) Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology (A.Els.), London, United Kingdom; Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University (A.Els.), Beijing, China
| | - Fang-Jun Bao
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University (Y.-Y.M., Z.-X.Q., B.-W.W., H.X., P.W., X.-B.Z., J.-J.W., Y.-F.Y., S.-H.C., F.-J.B), Wenzhou, Zhejiang, China; The Institute of Ocular Biomechanics, Wenzhou Medical University (X.-B.Z., J.-J.W., S.-H.C., F.-J.B.), Wenzhou, Zhejiang, China.
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