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Sample records for intraocular pressure iop

  1. Intraocular pressure (IOP) in relation to four levels of daily geomagnetic and extreme yearly solar activity.

    PubMed

    Stoupel, E; Goldenfeld, M; Shimshoni, M; Siegel, R

    1993-02-01

    The link between geomagnetic field activity (GMA), solar activity and intraocular pressure (IOP) in healthy individuals was investigated. The IOP of 485 patients (970 eyes) was recorded over three nonconsecutive years (1979, 1986, 1989) which were characterized by maximal solar activity (1979, 1989) or minimal solar activity (1986). The measurements were also correlated with four categories of GMA activity: quiet (level I0), unsettled (II0), active (III0), and stormy (IV0). Participants were also differentiated by age and sex. We found that IOP was lowest on days of level IV0 (stromy) GMA. The drop in IOP concomitant with a decrease in GMA level was more significant during periods of low solar activity and in persons over 65 years of age. There was a trend towards higher IOP values on days of levels II0 and IV0 GMA in years of high solar activity. Differences between the sexes and among individuals younger than 65 years were not significant. Our results show an interesting aspect of environmental influence on the healthy population. PMID:8468099

  2. Cataract surgery and intraocular pressure.

    PubMed

    Melancia, Diana; Abegão Pinto, Luis; Marques-Neves, Carlos

    2015-01-01

    Cataract surgery is one of the most performed surgeries in the developed world. In addition to its significant impact on visual acuity, phacoemulsification has been hailed as a potential intraocular pressure (IOP)-lowering procedure. While current evidence suggests an overall significant and sustained decrease in IOP to exist after cataract surgery, the specific ocular characteristics that could help predict which patients are likely to benefit from this IOP-lowering effect remain unclear. This definition is important in glaucoma patients if this surgery is to be used in the treatment for this disease. Our review aims to summarize the literature on the subject, depicting possible mechanisms behind this IOP decrease, which type of patients are more likely to benefit from this surgery for IOP-lowering purposes and ultimately help optimizing disease management for the increasing number of patients with concomitant glaucoma and cataract. PMID:25765255

  3. [Intraocular pressure measurement in children].

    PubMed

    Bresson-Dumont, H

    2009-03-01

    Intraocular pressure (IOP) measurement in children is often difficult to perform because younger children are non-compliant and resisting the examination. Normal IOP in children is not well established yet because in the studies reporting about IOP, the instruments used and clinical conditions have varied. Non contact tonometer often overestimates IOP in blinking children and is not always reliable. But all the others measurement techniques use contact (GAT, Perkins, Tono-Pen, ORA, RBT), and are not always suitable and easy-touse. Under general anaesthesia, mean IOP measured with Perkins applanation tonometer is under 8 mmHg before age of 3 months and under 12 mmHg between ages of 6 and 9 months. After, IOP shows an increasing trend with age of 1 mmHg per year up to 12 years. Some studies have proposed as normal pediatric IOP: To=0.71 x age (years) +10, up to age 10. Then, IOP tends to approach adult levels by 12 years of age. However pediatric glaucoma is rare: congenital glaucoma, before age of 3 years, autosomal dominant juvenile glaucoma, with family history of glaucoma and elevated IOP, or secondary glaucoma with special context. Thus, hypertony has to be confirmed by another measurement technique, correlated to central corneal thickness, and clinical examination (optic nerve head and visual field). PMID:19515328

  4. Noninvasive intraocular pressure monitoring: current insights

    PubMed Central

    De Smedt, Stefan

    2015-01-01

    Glaucoma is the second leading cause of blindness worldwide and intraocular pressure (IOP) is currently its only modifiable risk factor. Peak IOP has for a long time been considered as a major contributor to glaucoma progression, but its effects may depend not only on its magnitude, but also on its time course. The IOP is nowadays considered to be a dynamic parameter with a circadian rhythm and spontaneous changes. The current practice of punctual measuring the IOP during office hours is therefore a suboptimal approach, which does not take into account the natural fluctuation of IOP. Because of its static nature a single IOP measurement in sitting position fails to document the true range of an individual’s IOP, peak IOP, or variation throughout the day. Phasing means monitoring a patient’s IOP during the daytime or over a 24-hour period. This can provide additional information in the management of glaucoma patients. This review focuses on the current insight of non-invasive IOP monitoring as a method of obtaining more complete IOP profiles. Invasive techniques using an implantable sensor are beyond the scope of this review. PMID:26257509

  5. Intraocular Pressure, Ethnicity, and Refractive Error

    PubMed Central

    Manny, Ruth E.; Mitchell, G. Lynn; Cotter, Susan A.; Jones-Jordan, Lisa A.; Kleinstein, Robert N.; Mutti, Donald O.; Twelker, J. Daniel; Zadnik, Karla

    2011-01-01

    Purpose The ethnically-diverse Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study cohort provides a unique opportunity to explore associations among intraocular pressure (IOP), ethnicity, and refractive error while adjusting for potential confounding variables. Methods Mixed linear models were used to examine the effect of age, refractive error (cycloplegic autorefraction), ethnicity, sex, and measurement protocol on IOP (Tono-pen) in 3,777 children, aged 6-14 years at their first CLEERE visit (1995-2009). Children who became myopic during follow-up were used to examine the relationship between time since myopia onset and IOP. Clinically meaningful differences in IOP were preset at > 2 mm Hg. Results IOP differed among refractive error categories with higher IOP in children with low/moderate myopia than those with high hyperopia (differences < 1 mm Hg). There was a statistically significant relationship between age and IOP that depended on ethnicity (interaction p<0.0001) and measurement protocol (interaction p<0.0001). The relationship between sex and IOP depended on measurement protocol (interaction p=0.0004). For children who became myopic during follow-up, the adjusted mean IOP showed a significant decline for only Asian (p=0.024) and White children (p=0.004). As with other statistically significant results, these changes in mean adjusted IOPs from two years before to two years after myopia onset were < 2 mm Hg. Conclusions Small but significant differences in IOP by refractive error category were found in this ethnically diverse cohort of children. Relationships between IOP and age, ethnicity, sex, and measurement protocol were complicated by significant interactions between these parameters. Longitudinal analysis of children before and after myopia onset showed changes in IOP over time that varied by ethnicity. Higher IOPs before and at myopia onset were not present in all ethnic groups, with differences before and after

  6. The preoperative intraocular pressure level predicts the amount of underestimated intraocular pressure after LASIK for myopia

    PubMed Central

    Chihara, E; Takahashi, H; Okazaki, K; Park, M; Tanito, M

    2005-01-01

    Aims: To evaluate the statistical significance of the parameters that affect underestimation of intraocular pressure (IOP) after laser in situ keratomileusis (LASIK) for myopia. Methods: In this prospective case series study, patient age, axial length, preoperative corneal curvature, preoperative central corneal thickness (CCT), preoperative IOP, and ablation depth were studied to determine whether they affect the underestimation of IOP in the right eyes of 100 consecutive patients who underwent LASIK. Results: The preoperative IOP was the most important parameter for an amount of underestimated Goldmann applanation tonometric IOP (GAT) and non-contact tonometric IOP (ncIOP) at 1 month (r = 0.654, p<0.0001, R2 = 0.427, and r = 0.694, p<0.0001, R2 = 0.481, respectively) and 3 months (r = 0.637, p<0.0001, R2 = 0.406, and r = 0.726, p<0.0001, R2 = 0.527, respectively). Patient age was statistically significant for underestimating the GAT at 1 month, and both the ablation depth and CCT were statistically significant parameters for underestimating the ncIOP at 1 month and at 3 months by stepwise multiple regression analysis (F>4.000). However, these parameters had small bivariate correlation coefficients, and were considered as minor parameters. Conclusion: Preoperative IOP is the most important parameter that affects an underestimation of IOP after LASIK for myopia. Eyes with a higher true IOP have a larger underestimation of the IOP after LASIK for myopia. From these results, the importance of the modulus of elasticity on IOP measurements was discussed. PMID:15665345

  7. Change in intraocular pressure during scleral depression

    PubMed Central

    Trevino, Richard; Stewart, Brandi

    2014-01-01

    Purpose Manometric studies have found that intraocular pressure (IOP) rises 116–350 mmHg during scleral depression in surgical settings. No information is available regarding the effect of scleral depression on IOP in routine clinical settings. The aim of this study is to quantify the change in IOP that occurs when scleral depression is performed on normal eyes in a routine clinical setting. Methods A total of 28 eyes from 28 normal subjects were included. Tono-Pen tonometry was performed while scleral depression was performed in each of the two quadrants: superotemporal (ST) and inferonasal (IN). A post-procedure IOP measurement was obtained following each scleral depression examination. Both ST and IN quadrants were tested on all eyes, with the quadrant tested first chosen at random (15 ST, 13 IN). Results The mean IOP during scleral depression was 65.3 mmHg ST and 47.8 mmHg IN, with a maximum recorded IOP of 88 mmHg. The mean change in IOP for the ST quadrant was 51.9 ± 17.3 mmHg and 46.4 ± 16.0 mmHg for the right and left eyes, respectively. The mean change in IOP for the IN quadrant was 45.3 ± 22.7 mmHg and 16.8 ± 15.8 mmHg for the right and left eyes, respectively. Conclusions Scleral depression as performed in a routine office setting produces wide fluctuations in IOP and may impair ocular perfusion. Additional studies are needed to determine the long-term consequences of routine scleral depression. PMID:25444648

  8. Blood Pressure Modifies Retinal Susceptibility to Intraocular Pressure Elevation

    PubMed Central

    He, Zheng; Nguyen, Christine T. O.; Armitage, James A.; Vingrys, Algis J.; Bui, Bang V.

    2012-01-01

    Primary open angle glaucoma affects more than 67 million people. Elevated intraocular pressure (IOP) is a risk factor for glaucoma and may reduce nutrient availability by decreasing ocular perfusion pressure (OPP). An interaction between arterial blood pressure and IOP determines OPP; but the exact contribution that these factors have for retinal function is not fully understood. Here we sought to determine how acute modifications of arterial pressure will affect the susceptibility of neuronal function and blood flow to IOP challenge. Anaesthetized (ketamine:xylazine) Long-Evan rats with low (∼60 mmHg, sodium nitroprusside infusion), moderate (∼100 mmHg, saline), or high levels (∼160 mmHg, angiotensin II) of mean arterial pressure (MAP, n = 5–10 per group) were subjected to IOP challenge (10–120 mmHg, 5 mmHg steps every 3 minutes). Electroretinograms were measured at each IOP step to assess bipolar cell (b-wave) and inner retinal function (scotopic threshold response or STR). Ocular blood flow was measured using laser-Doppler flowmetry in groups with similar MAP level and the same IOP challenge protocol. Both b-wave and STR amplitudes decreased with IOP elevation. Retinal function was less susceptible to IOP challenge when MAP was high, whereas the converse was true for low MAP. Consistent with the effects on retinal function, higher IOP was needed to attenuated ocular blood flow in animals with higher MAP. The susceptibility of retinal function to IOP challenge can be ameliorated by acute high BP, and exacerbated by low BP. This is partially mediated by modifications in ocular blood flow. PMID:22359566

  9. Prognostic Factor Analysis of Intraocular Pressure with Neovascular Glaucoma.

    PubMed

    Nakano, Satoko; Nakamuro, Takako; Yokoyama, Katsuhiko; Kiyosaki, Kunihiro; Kubota, Toshiaki

    2016-01-01

    Purpose. To perform multivariate analysis for identifying independent predictors of elevated intraocular pressure (IOP) with neovascular glaucoma (NVG), including antivascular endothelial growth factor (VEGF) intravitreal injections. Methods. We retrospectively reviewed 142 NVG patients (181 eyes) with ischemic retinal diseases [proliferative diabetic retinopathy (PDR) in 134 eyes, retinal vein occlusion (RVO) in 29, and ocular ischemic syndrome in 18]. We analyzed age, gender, initial/final LogMAR VA, initial/final IOP, extent of iris and/or angle neovascularization, treatments, preexisting complications, concurrent medications, and follow-up duration. Results. The mean follow-up duration was 23.8 ± 18.8 months. At the final follow-up, 125 (72.3%) eyes had IOP ≤ 21 mmHg. NVG patients with RVO had a higher degree of angle closure and higher IOP. NVG with PDR had better IOP and LogMAR VA. Angle closure had the greatest impact on final IOP. Greater than 90% of patients treated with trabeculectomy with mitomycin C (LEC) had persistent declines in IOP (≤21 mmHg). Stand-alone and combination anti-VEGF therapies were not associated with improved long-term prognosis of IOP. Conclusions. Angle closure was found to have the greatest effect on NVG-IOP prognosis. When target IOP values are not obtained after adequate PRP with or without anti-VEGF, early LEC may improve the prognosis of IOP. PMID:27579175

  10. Prognostic Factor Analysis of Intraocular Pressure with Neovascular Glaucoma

    PubMed Central

    Nakamuro, Takako; Yokoyama, Katsuhiko; Kiyosaki, Kunihiro

    2016-01-01

    Purpose. To perform multivariate analysis for identifying independent predictors of elevated intraocular pressure (IOP) with neovascular glaucoma (NVG), including antivascular endothelial growth factor (VEGF) intravitreal injections. Methods. We retrospectively reviewed 142 NVG patients (181 eyes) with ischemic retinal diseases [proliferative diabetic retinopathy (PDR) in 134 eyes, retinal vein occlusion (RVO) in 29, and ocular ischemic syndrome in 18]. We analyzed age, gender, initial/final LogMAR VA, initial/final IOP, extent of iris and/or angle neovascularization, treatments, preexisting complications, concurrent medications, and follow-up duration. Results. The mean follow-up duration was 23.8 ± 18.8 months. At the final follow-up, 125 (72.3%) eyes had IOP ≤ 21 mmHg. NVG patients with RVO had a higher degree of angle closure and higher IOP. NVG with PDR had better IOP and LogMAR VA. Angle closure had the greatest impact on final IOP. Greater than 90% of patients treated with trabeculectomy with mitomycin C (LEC) had persistent declines in IOP (≤21 mmHg). Stand-alone and combination anti-VEGF therapies were not associated with improved long-term prognosis of IOP. Conclusions. Angle closure was found to have the greatest effect on NVG-IOP prognosis. When target IOP values are not obtained after adequate PRP with or without anti-VEGF, early LEC may improve the prognosis of IOP. PMID:27579175

  11. The Road Ahead to Continuous 24-Hour Intraocular Pressure Monitoring in Glaucoma

    PubMed Central

    Mansouri, Kaweh

    2014-01-01

    Intraocular pressure (IOP) is the only treatable risk factor for glaucoma. Yet, current glaucoma management usually relies on single IOP measurements during clinic hours despite the fact that IOP is a dynamic parameter with individual rhythms. Single IOP measurements underpin all major clinical guidelines on treatment of glaucoma. Other potentially informative parameters, such as IOP fluctuations and peak IOP, have been neglected, and effects of IOP-lowering interventions on such measures are largely unknown. The search for continuous 24-hour IOP monitoring started over 50 years ago, but only recent technological advances have provided clinician-researchers with devices for continuous IOP monitoring. Herein, we discuss innovative approaches with permanent and temporary devices for 24-hour IOP monitoring, such as a contact lens sensor. Despite being in their infancy, these devices may soon enable clinicians to use 24-hour IOP data to improve glaucoma management and reduce the glaucoma-related burden of disease. PMID:25279129

  12. Correlation between short-term and long-term intraocular pressure fluctuation in glaucoma patients

    PubMed Central

    Tojo, Naoki; Abe, Shinya; Miyakoshi, Mari; Hayashi, Atsushi

    2016-01-01

    Purpose We investigated correlations between short-term and long-term intraocular pressure (IOP) fluctuations. Methods We examined 50 eyes of glaucoma patients who were followed for >2 years. We measured short-term IOP fluctuation using a Triggerfish® contact lens sensor (CLS). The short-term IOP fluctuation (mVeq) was defined as the difference between the maximum value and the minimum value measured during the 24-hour course with CLS. The long-term IOP fluctuation was defined by four parameters: 1) the mean IOP (mmHg) determined during follow-up; 2) the IOP difference, which was defined as the difference between the maximum IOP and the minimum IOP; 3) the standard deviation of IOP; and 4) the peak IOP, which was defined as the maximum IOP. Correlations between these parameters and the short-term IOP fluctuation were examined. Results The mean follow-up period was 5.4 years. The average IOP was 15.0±4.0 mmHg. The range of short-term IOP fluctuation identified with CLS was significantly correlated with all the four long-term IOP fluctuation parameters. Conclusion Short-term IOP fluctuations were found to be associated with long-term IOP fluctuations. Examination of 24-hour IOP fluctuations with the CLS might be useful for predicting the long-term IOP fluctuation.

  13. Intraocular pressure reduction and regulation system

    NASA Technical Reports Server (NTRS)

    Baehr, E. F.; Burnett, J. E.; Felder, S. F.; Mcgannon, W. J.

    1979-01-01

    An intraocular pressure reduction and regulation system is described and data are presented covering performance in: (1) reducing intraocular pressure to a preselected value, (2) maintaining a set minimum intraocular pressure, and (3) reducing the dynamic increases in intraocular pressure resulting from external loads applied to the eye.

  14. Change in Intraocular Pressure During Point-of-Care Ultrasound

    PubMed Central

    Berg, Cameron; Doniger, Stephanie J.; Zaia, Brita; Williams, Sarah R.

    2015-01-01

    Introduction Point-of-care ocular ultrasound (US) is a valuable tool for the evaluation of traumatic ocular injuries. Conventionally, any maneuver that may increase intraocular pressure (IOP) is relatively contraindicated in the setting of globe rupture. Some authors have cautioned against the use of US in these scenarios because of a theoretical concern that an US examination may cause or exacerbate the extrusion of intraocular contents. This study set out to investigate whether ocular US affects IOP. The secondary objective was to validate the intraocular pressure measurements obtained with the Diaton® as compared with standard applanation techniques (the Tono-Pen®). Methods We enrolled a convenience sample of healthy adult volunteers. We obtained the baseline IOP for each patient by using a transpalpebral tonometer. Ocular US was then performed on each subject using a high-frequency linear array transducer, and a second IOP was obtained during the US examination. A third IOP measurement was obtained following the completion of the US examination. To validate transpalpebral measurement, a subset of subjects also underwent traditional transcorneal applanation tonometry prior to the US examination as a baseline measurement. In a subset of 10 patients, we obtained baseline pre-ultrasound IOP measurements with the Diaton® and Tono-Pen®, and then compared them. Results The study included 40 subjects. IOP values during ocular US examination were slightly greater than baseline (average +1.8mmHg, p=0.01). Post-US examination IOP values were not significantly different than baseline (average −0.15mmHg, p=0.42). In a subset of 10 subjects, IOP values were not significantly different between transpalpebral and transcorneal tonometry (average +0.03mmHg, p=0.07). Conclusion In healthy volunteer subjects, point-of-care ocular US causes a small and transient increase in IOP. We also showed no difference between the Diaton® and Tono-Pen® methods of IOP measurement

  15. Intraocular pressure reduction and regulation

    NASA Technical Reports Server (NTRS)

    Baehr, E. F.; Mcgannon, W. J.

    1979-01-01

    System designed to reduce intraocular pressure hydraulically to any level desired by physician over set time and in controlled manner has number of uses in ophthalmology. Device may be most immediately useful in treatment of glaucoma.

  16. [The neuroanatomical and physiological bases of variations in intraocular pressure].

    PubMed

    Chiquet, C; Denis, P

    2004-09-01

    Intraocular pressure displays a distinct circadian rhythm in animals and humans, with an increase at night and a decrease during the daytime. In animals, the IOP rhythm has been reported to be synchronized by environmental light and to persist in constant darkness, demonstrating a circadian component controlled by an endogenous pacemaker. The structures involved in the rhythmic regulation of intraocular pressure include the suprachiasmatic nucleus, which controls the activity of sympathetic and parasympathetic ocular innervation. These effectors are responsible for controlling the production (beta-adrenergic system) and the outflow (alpha1-adrenergic, parasympathetic system, prostaglandin) of aqueous humor. The production of aqueous humor is under adrenergic control (alpha1- and beta-receptors). Many neuropeptides such as vasoactive intestinal peptide, substance P, and the atrial natriuretic peptide are also involved in the regulation of intraocular pressure. A better understanding of the circadian regulation of intraocular pressure is needed for an appropriate treatment of ocular hypertension and glaucoma. PMID:15314570

  17. Using the Electroretinogram to Understand How Intraocular Pressure Elevation Affects the Rat Retina

    PubMed Central

    Bui, Bang V.; He, Zheng; Vingrys, Algis J.; Nguyen, Christine T. O.; Wong, Vickie H. Y.; Fortune, Brad

    2013-01-01

    Intraocular pressure (IOP) elevation is a key risk factor for glaucoma. Our understanding of the effect that IOP elevation has on the eye has been greatly enhanced by the application of the electroretinogram (ERG). In this paper, we describe how the ERG in the rodent eye is affected by changes in IOP magnitude, duration, and number of spikes. We consider how the variables of blood pressure and age can modify the effect of IOP elevation on the ERG. Finally, we contrast the effects that acute and chronic IOP elevation can have on the rodent ERG. PMID:23431417

  18. An ultralow power wireless intraocular pressure monitoring system

    NASA Astrophysics Data System (ADS)

    Demeng, Liu; Niansong, Mei; Zhaofeng, Zhang

    2014-10-01

    This paper describes an ultralow power wireless intraocular pressure (IOP) monitoring system that is dedicated to sensing and transferring intraocular pressure of glaucoma patients. Our system is comprised of a capacitive pressure sensor, an application-specific integrated circuit, which is designed on the SMIC 180 nm process, and a dipole antenna. The system is wirelessly powered and demonstrates a power consumption of 7.56 μW at 1.24 V during continuous monitoring, a significant reduction in active power dissipation compared to existing work. The input RF sensitivity is -13 dBm. A significant reduction in input RF sensitivity results from the reduction of mismatch time of the ASK modulation caused by FM0 encoding. The system exhibits an average error of ± 1.5 mmHg in measured pressure. Finally, a complete IOP system is demonstrated in the real biological environment, showing a successful reading of the pressure of an eye.

  19. Noninvasive Intraocular Pressure Measurements in Mice by Pneumotonometry

    PubMed Central

    Avila, Marcel Y.; Múnera, Alejandro; Guzmán, Arcadio; Do, Chi Wai; Wang, Zhao; Stone, Richard A.; Civan, Mortimer M.

    2005-01-01

    Purpose To develop a reliable, noninvasive, continuous, and easily implemented system for measuring intraocular pressure (IOP) in mice. Methods Pneumotonometry was adapted for measurement of mouse IOP. Measurements were compared with those obtained with the servo-null micropipette system (SNMS) and with direct anterior chamber cannulation. Heart rate was monitored by the precordial pulse, EKG, or tail pulse in anesthetized mice. The characteristic ocular hypotensive response to mannitol was assessed as an additional validation of the method. Results Measurements of IOP obtained using pneumotonometry agreed closely with values measured by SNMS or by direct cannulation. IOP oscillations were synchronous with the heart rate, with a coherence peak between them of ~2 Hz, equal to the pulse frequency. Hypertonic mannitol reduced IOP from 13.7 ± 0.9 mm Hg by 7.7 ± 0.7 mm Hg after 15 minutes. Conclusions Pneumotonometry is a reliable and noninvasive method for the measurement of IOP in mice and may permit comparisons of IOP to hemodynamic factors. This system is simpler and more adaptable for glaucoma research than previously reported methodologies for measuring IOP in mice. PMID:16123429

  20. Causes of elevated intraocular pressure following implantation of phakic intraocular lenses for myopia.

    PubMed

    Almalki, Salem; Abubaker, Abdullah; Alsabaani, Nasser A; Edward, Deepak P

    2016-04-01

    The purpose of this study is to present the causes and visual acuity outcomes in patients with elevated intraocular pressure (IOP) following implantable collamer lens (ICL) implantation. A chart review identified patients who developed high IOP at any postoperative examination and a minimum follow-up period of 3 months after ICL implantation. Data are reported out to 6 months postoperatively. Outcome measures included causes of elevated IOP, best-corrected visual acuity (BCVA) at last visit, number of glaucoma medications, other interventions, and glaucomatous damage. Elevated IOP occurred in 58 (10.8 %) of 534 eyes that received ICL. The mean age was 28 ± 7.2 years. The preoperative IOP was 16.3 ± 1.2 mmHg. Elevated IOP most commonly occurred on the first postoperative day (23/58 (39.7 %) eyes) due to retained viscoelastic. This was followed by steroid response in 22/58 (37.9 %) eyes at 2-4 weeks postoperatively. IOP elevation in 6 (10.3 %) eyes was related to high ICL vault and pupillary block, and in 4 (6.9 %) eyes due to synechial angle closure. At last visit, BCVA was 20/40 or better in 56/58 (96.6 %) eyes, and 5/58 (8.6 %) eyes remained on glaucoma medications due to persistent steroid response (2 eyes), synechial angle closure glaucoma (1 eye), and other causes (2 eyes). One eye showed glaucomatous damage. Two eyes with high vault and elevated IOP underwent ICL explantation. There is a moderate risk of transiently developing elevated IOP after ICL implantation. Thorough removal of viscoelastic and use of anti-glaucoma medications during steroid use will reduce the majority of cases with postoperative IOP elevation. PMID:26265323

  1. Influence of various anesthetic drugs on the intraocular pressure of cats.

    PubMed

    Hahnenberger, R W

    1976-04-14

    Cats with one normal eye and one eye with experimental glaucoma were trained to tolerate tonometry while conscious. They were then given the general anesthetic agents pentobarbital, ketamine, and CI-744 in the lowest and twice the lowest dosages which permitted tonometry in untrained cats. Pentobarbital lowered intraocular pressure (IOP) by 20-50%. Ketamine raised IOP by about 10%. CI-744 had essentially no effect on IOP. The two conpoments of CI-744, tiletamine (CI-634) and zolazepam (CI-716) were given individually in the doses in which they had been given as part of CI-744. Tiletamine had no effect on IOP, while zolazepam lowered IOP by about 10%. PMID:1083696

  2. Increased Intraocular Pressure and Hyperglycemic Level in Diabetic Patients

    PubMed Central

    Hymowitz, Maggie B.; Chang, Donny; Feinberg, Edward B.; Roy, Sayon

    2016-01-01

    Purpose To determine whether hyperglycemic levels as determined from high hemoglobin A1c (HbA1c) levels influence intraocular pressure (IOP) in patients with non-proliferative diabetic retinopathy (NPDR). Methods A retrospective chart review was performed on subjects with a diagnosis of NPDR and a corresponding HbA1c level measured within 90 days before or after an IOP measurement over a two-year period. Exclusion criteria included a diagnosis of glaucoma or treatment with IOP lowering medications or oral or topical steroids. Results Using 14.5mmHg as a baseline mean value for IOP, 42 subjects had an IOP < 14.5mmHg and mean HbA1c of 8.1±1.1, while 72 subjects had an IOP ≥ 14.5mmHg and a mean HbA1c of 9.0±2.1. Although there was an overlap in the confidence intervals, a significant difference (P = 0.01) in the mean HbA1c level was observed in regression analysis between the two groups. Importantly, diabetic subjects with elevated HbA1c levels rarely (<1%) exhibited reduced IOP levels. Conclusions Diabetic subjects with elevated HbA1c levels exhibited significantly higher IOPs compared to those with lower HbA1c levels. Findings from this study indicate an association between hyperglycemia and elevated IOP and that poor glycemic control may contribute to increased IOP levels in long-term diabetic patients. PMID:27002725

  3. Prevention of intraocular pressure rise following intravitreal injection.

    PubMed Central

    Morlet, N; Young, S H

    1993-01-01

    The intraocular pressure change produced by an intravitreal injection of ganciclovir, 2 mg in 0.1 ml, was studied in patients with cytomegalovirus retinitis. Using a Tono-pen XL to measure the intraocular pressure (IOP) of four patients (six eyes) we found the mean pressure immediately following injection was 44.5 mm Hg. Measurements taken on separate occasions after a 30 mm Hg decompression of the eye for 15 minutes before the injection showed a mean IOP of only 20.6 mm Hg after the injection. Mercury bag decompression of the eye significantly reduced the rise in IOP following intravitreal injection (difference in the mean IOP rise = 26.4 mm Hg, df = 54, t = 7.67, p < 0.001). Without ocular decompression before injection, all patients complained of temporary loss of vision, and reflux of the injection solution was frequently observed. Use of ocular decompression also reduced the discomfort of the injection. Throughout the full course of treatment by this means there were no adverse effects on the visual acuity. This technique is recommended to those performing intravitreal injections. Images PMID:8218055

  4. INTRAOCULAR PRESSURE IN SOUTHERN ROCKHOPPER (EUDYPTES CHRYSOCOME) AND MACARONI PENGUINS (EUDYPTES CHRYSOLOPHUS): EVALUATION OF INFLUENCING FACTORS.

    PubMed

    Woodhouse, Sarah J; Peterson, Edward L; Schmitt, Todd; Aquino, Susette

    2016-03-01

    Ophthalmic examinations were performed on 160 macaroni penguins (Eudyptes chrysolophus) and 90 southern rockhopper penguins (Eudyptes chrysocome) at eight North American zoos and aquaria. Intraocular pressure (IOP) was measured using rebound tonometry while penguins were held in two different body positions. Correlations between IOP and factors including age, body position, eye pathology, and housing parameters were evaluated. Normal macaroni penguins had a mean IOP of 42.0 ± 9.7 mm Hg. Normal rockhopper penguins had a mean IOP of 32.9 ± 6.2 mm Hg. Neither species had significantly different IOP between sexes or between left and right eyes of the same penguin. In both species, there was a negative linear correlation between age and IOP. In the macaroni population, IOP was significantly higher when IOP measurement was performed before ophthalmic exam; this was not true in rockhoppers. In both species, IOP measured in a horizontal body position was significantly higher than IOP measured in a vertical body position. In both species, eyes with corneal lesions had significantly lower IOP than normal eyes. In the macaroni penguin, eyes with rubeosis iridis had significantly lower IOP than normal eyes. In macaroni penguins, eyes with cataracts had significantly lower mean IOP than normal eyes; this was not true for rockhoppers. PMID:27010282

  5. Reference intervals for intraocular pressure measured by rebound tonometry in ten raptor species and factors affecting the intraocular pressure.

    PubMed

    Reuter, Anne; Müller, Kerstin; Arndt, Gisela; Eule, Johanna Corinna

    2011-09-01

    Intraocular pressure (IOP) was measured with the TonoVet rebound tonometer in 10 raptor species, and possible factors affecting IOP were investigated. A complete ophthalmic examination was performed, and IOP was assessed in 2 positions, upright and dorsal recumbency, in 237 birds belonging to the families Accipitridae, Falconidae, Strigidae, and Tytonidae. Mean IOP values of healthy eyes were calculated for each species, and differences between families, species, age, sex, left and right eye, as well as the 2 body positions were evaluated. Physiologic fluctuations of IOP were assessed by measuring IOP serially for 5 days at the same time of day in 15 birds of 3 species. Results showed IOP values varied by family and species, with the following mean IOP values (mm Hg +/- SD) determined: white-tailed sea eagle (Haliaeetus albicilla), 26.9 +/- 5.8; red kite (Milvus milvus), 13.0 +/- 5.5; northern goshawk (Accipiter gentilis), 18.3 +/- 3.8; Eurasian sparrowhawk (Accipiter nisus), 15.5 +/- 2.5; common buzzard (Buteo buteo), 26.9 +/- 7.0; common kestrel (Falco tinnunculus), 9.8 +/- 2.5; peregrine falcon, (Falco peregrinus), 12.7 +/- 5.8; tawny owl (Strix aluco), 9.4 +/- 4.1; long-eared owl (Asio otus), 7.8 +/- 3.2; and barn owl (Tyto alba), 10.8 +/- 3.8. No significant differences were found between sexes or between left and right eyes. In goshawks, common buzzards, and common kestrels, mean IOP was significantly lower in juvenile birds than it was in adult birds. Mean IOP differed significantly by body position in tawny owls (P = .01) and common buzzards (P = .04). By measuring IOP over several days, mean physiologic variations of +/- 2 mm Hg were detected. Differences in IOP between species and age groups should be considered when interpreting tonometric results. Physiologic fluctuations of IOP may occur and should not be misinterpreted. These results show that rebound tonometry is a useful diagnostic tool in measuring IOP in birds of prey because it provides rapid

  6. Effect of a tight necktie on intraocular pressure

    PubMed Central

    Teng, C; Gurses-Ozden, R; Liebmann, J M; Tello, C; Ritch, R

    2003-01-01

    Aim: To evaluate the effect of a tight necktie on intraocular pressure (IOP) measurement using Goldmann applanation tonometry. Methods: 40 eyes of 20 normal subjects and 20 open angle glaucoma patients (all male) were enrolled. IOP was measured with an open shirt collar, 3 minutes after placing a tight necktie, and 3 minutes after loosening it. All measurements were made by the same examiner. Results: Mean IOP in normal subjects increased by 2.6 (SD 3.9) mm Hg (p=0.008, paired t test; range −3 to +14 mm Hg) and in glaucoma patients by 1.0 (1.8) mm Hg (p=0.02, paired t test; range −2 to +4.5 mm Hg). In normal subjects, IOP in 12 eyes was increased by ⩾2 mm Hg and in seven eyes by ⩾4 mm Hg. In glaucoma patients, IOP in six eyes was increased by ⩾2 mm Hg and in two eyes by ⩾4 mm Hg. Conclusion: A tight necktie increases IOP in both normal subjects and glaucoma patients and could affect the diagnosis and management of glaucoma. PMID:12881330

  7. Correlation between Intraocular Pressure Fluctuation with Postural Change and Postoperative Intraocular Pressure in Relation to the Time Course after Trabeculectomy

    PubMed Central

    Tenkumo, Kaori; Nitta, Eri; Sato, Shino

    2014-01-01

    Background. To investigate the correlation between intraocular pressure (IOP) fluctuation with postural change and IOP in relation to the time course after trabeculectomy. Methods. A total of 29 patients who had previously undergone primary trabeculectomy with mitomycin C were examined. IOP was obtained at 1, 2, 3, 6, and 12 months and then every 6 months postoperatively. Results. The postural IOP difference before surgery was 3.0 ± 1.8 mmHg, which was reduced to 0.9 ± 1.1 mmHg at 1 month, 1.0 ± 1.0 mmHg at 2 months, 1.3 ± 2.0 mmHg at 3 months, 1.3 ± 1.4 mmHg at 6 months, 1.4 ± 1.5 mmHg at 12 months, and 1.1 ± 0.7 mmHg at 18 months after trabeculectomy (P < 0.01 each visit). The filtering surgery failed in 7 out of 29 eyes. Postural IOP changes were less than 3 mmHg in those patients who did not require needle revision at every visit. However, in patients who did require needle revision, the increase in the posture-induced IOP was greater than 3 mmHg prior to the increase in the sitting position IOP. Conclusions. Assessment of postural IOP changes after trabeculectomy might be potentially useful for predicting IOP changes after trabeculectomy. PMID:25136454

  8. The Increase of Intra-Abdominal Pressure Can Affect Intraocular Pressure

    PubMed Central

    Ece, Ilhan; Vatansev, Celalettin; Kucukkartallar, Tevfik; Tekin, Ahmet; Kartal, Adil; Okka, Mehmet

    2015-01-01

    Objective. This study aims to explore the usage of intraocular pressure measurements as the early indicator of the increase in intra-abdominal pressure. Methods. In this prospective study, 40 patients undergoing elective surgery were included. Patients were divided into four groups of 10 patients. The control group (Group C) was not subjected to laparoscopic intervention. Laparoscopic surgery was, respectively, performed with an intra-abdominal pressure of 9, 12, and 15 mmHg in Groups L (low), M (medium), and H (high pressure). Intraocular pressure was measured binocularly in each patient at three different times (before, during, and end of surgery) using a contact tonometer. Results. Patients' gender, age, body mass index (BMI), American Society of Anesthesiology (ASA) class, and operative times were not different among the groups. No complications occurred with either the surgery or measurement of intraocular pressure. Intubation was associated with a severe rise in IOP (P < 0.05). An increase in intraocular pressure was seen in groups M and H (P < 0.05). Conclusion. Intraocular pressure was increased in the groups with an intra-abdominal pressure of 12 mmHg or more. Measuring the intraocular pressure might be a useful method to estimate the intra-abdominal pressure. This trial is registered with NCT02319213. PMID:25648230

  9. Impact factors on intraocular pressure measurements in healthy subjects

    PubMed Central

    Theelen, T; Meulendijks, C F M; Geurts, D E M; van Leeuwen, A; Voet, N B M; Deutman, A F

    2004-01-01

    Aim: To evaluate whether intraocular pressure (IOP) calculation by applanation tonometry is determined more essentially by the subject’s neck position or by neck constriction. Methods: 23 right eyes of 23 healthy subjects (12 male, 11 female) were included. IOP was measured by applanation tonometry with the TonoPen on sitting participants under four different conditions: with open collar upright (A) or with the head in the headrest of a slit lamp (B), with a tight necktie upright (C) or in slit lamp position (D). All measurements with neck constriction were performed 3 minutes after placing the necktie. Results: Mean IOP was 16.9 (SD 2.3) mm Hg (range 11–21 mm Hg) (A), 18.1 (SD 2.2) mm Hg (range 14–22 mm Hg) (B), 17.9 (SD 2.9) mm Hg (range 12–25 mm Hg) (C) and 18.7 (SD 2.7) mm Hg (range 13–24 mm Hg) (D). Mean IOP increased by 1.3 (SD 2.6) mm Hg (p = 0.028, paired t test, range +0.2 to +2.4 mm Hg) if subjects changed position from A to B. There was no statistically significant difference between measurements with or without neck constriction. Conclusion: Applanation tonometry may be inaccurate if performed in slit lamp position. In contrast, tight neckties do not significantly affect IOP evaluation in healthy subjects. PMID:15548801

  10. The effect of long-term use of intranasal steroids on intraocular pressure

    PubMed Central

    Şimşek, Ali; Bayraktar, Cem; Doğan, Sedat; Karataş, Mehmet; Sarıkaya, Yasin

    2016-01-01

    Long-term use of topical nasal steroids (especially older generation steroids) has been shown to elevate intraocular pressure (IOP), but newer intranasal steroids are thought to have a minimal effect on IOP because of their low bioavailability. This study aimed to investigate alterations in IOP with two commonly used intranasal steroids for a 6-month period of time. One-hundred allergic rhinitis patients, divided equally into two groups, used mometasone furoate and fluticasone furoate intranasal steroids for 6 months. IOPs were measured before treatment and repeated at the 3rd, 6th, 12th, and 24th weeks of treatment. The IOPs of the groups were then compared. No statistically significant alteration was observed between the groups during the treatment time period. It was found that new generation intranasal steroids can be used safely, and there may not be an increased risk of IOP elevation in prolonged use in normal healthy people. PMID:27354761

  11. A time-delay calibrated method for cornea hysteresis and intraocular pressure measurement

    NASA Astrophysics Data System (ADS)

    Wang, Kuo-Jen; Tsai, Che-Liang; Wang, Wai; Hsu, Long; Hsu, Ken-Yuh

    2016-04-01

    The presence of cornea hysteresis (CH) in characterizing the intraocular pressure (IOP) of a human eye deteriorates the accuracy of IOP. To suppress CH, the pressure gauge of a tonometer must be located as close as possible to the cornea. However, this arrangement is unpractical because appropriate working distance to the cornea is required. In this paper, a time-delay calibrated (TDC) method is proposed to counteract the undesired effect of CH in characterizing the IOP. Employing this TDC method, the CH approaches to zero for most eyes measured.

  12. [What to do if the intraocular pressure measurement does not appear reliable].

    PubMed

    Hamard, P

    2010-04-01

    Among the various intraocular pressure (IOP) measurement methods available today, Goldmann applanation tonometry (GAT) remains the gold standard for in-office routine IOP measurement. However, numerous factors may affect IOP measurement with GAT, namely corneal features. Before any interpretation of an IOP value, the measurement conditions should be checked and the central corneal thickness evaluated, since GAT overestimates IOP in thick corneas and underestimates IOP in thin ones. When GAT is not applicable, other IOP measurement devices, which have their own limits, are available. For example, the ocular response analyzer (ORA) and dynamic contour tonometry (DCT) provide IOP readings that are less influenced by corneal properties and may be useful after refractive surgery. Regardless of the choice of tonometer, the IOP value must not be considered alone but from a clinical point of view, including, namely, multiple IOP measurements over a day since the IOP fluctuates over a 24-h time period. A complete clinical examination is necessary in each case to search for glaucomatous neuropathy. PMID:20347507

  13. The Application of a Contact Lens Sensor in Detecting 24-Hour Intraocular Pressure-Related Patterns

    PubMed Central

    2016-01-01

    Glaucoma is one of the leading causes of blindness worldwide. Recent studies suggest that intraocular pressure (IOP) fluctuations, peaks, and rhythm are important factors in disease advancement. Yet, current glaucoma management remains hinged on single IOP measurements during clinic hours. To overcome this limitation, 24-hour IOP monitoring devices have been employed and include self-tonometry, permanent IOP, and temporary IOP monitoring. This review discusses each IOP measuring strategy and focuses on the recently FDA-approved contact lens sensor (CLS). The CLS records IOP-related ocular patterns for 24 hours continuously. Using the CLS, IOP-related parameters have been found to be associated with the rate of visual field progression in primary open-angle glaucoma, disease progression in primary angle-closure glaucoma, and various clinical variables in ocular hypertension. The CLS has been used to quantify blink rate and limbal strain and measure the circadian rhythm in a variety of disease states including normal-tension glaucoma and thyroid eye disease. The effects of various IOP-lowering interventions were also characterized using the CLS. CLS provides a unique, safe, and well-tolerated way to study IOP-related patterns in a wide range of disease states. IOP-related patterns may help identify patients most at risk for disease progression and assist with the development of tailored treatments. PMID:27525110

  14. The Application of a Contact Lens Sensor in Detecting 24-Hour Intraocular Pressure-Related Patterns.

    PubMed

    Xu, Sarah C; Gauthier, Angela C; Liu, Ji

    2016-01-01

    Glaucoma is one of the leading causes of blindness worldwide. Recent studies suggest that intraocular pressure (IOP) fluctuations, peaks, and rhythm are important factors in disease advancement. Yet, current glaucoma management remains hinged on single IOP measurements during clinic hours. To overcome this limitation, 24-hour IOP monitoring devices have been employed and include self-tonometry, permanent IOP, and temporary IOP monitoring. This review discusses each IOP measuring strategy and focuses on the recently FDA-approved contact lens sensor (CLS). The CLS records IOP-related ocular patterns for 24 hours continuously. Using the CLS, IOP-related parameters have been found to be associated with the rate of visual field progression in primary open-angle glaucoma, disease progression in primary angle-closure glaucoma, and various clinical variables in ocular hypertension. The CLS has been used to quantify blink rate and limbal strain and measure the circadian rhythm in a variety of disease states including normal-tension glaucoma and thyroid eye disease. The effects of various IOP-lowering interventions were also characterized using the CLS. CLS provides a unique, safe, and well-tolerated way to study IOP-related patterns in a wide range of disease states. IOP-related patterns may help identify patients most at risk for disease progression and assist with the development of tailored treatments. PMID:27525110

  15. Intraocular pressure determination in clinically normal red-footed tortoise (Geochelone carbonaria).

    PubMed

    Selmi, André L; Mendes, Guilherme M; McManus, Concepta; Arrais, Patrícia

    2002-03-01

    Intraocular pressure (IOP) reflects a balance between aqueous humor production and outflow and is often an essential ophthalmic diagnostic procedure in animals. The objective of this study was to estimate IOP in clinically normal red-footed tortoises (Geochelone carbonaria) of various sizes by using applanation tonometry. Intraocular pressures were estimated for 25 captive red-footed tortoises (10 males, 10 females, and 5 animals of unknown sex) by using an applanation tonometer after topical anesthesia. Body length ranged from 5.1 to 54.9 cm, measured from nuchal to anal scutes. Five measurements from each eye were obtained by a single observer in an ambient temperature of approximately 30 degrees C. Observer's reliability was good (intraclass r = 0.75), and IOP did not change over the ordered sequence of five replicate measurements. For individual tortoises the correlation for IOP between the left and right eyes was low (r = 0.20). The paired t-test did not show any statistical effect (P = 0.426) for the difference in IOP between the left and right eyes. Mean IOP determined for 10 confirmed males and 10 confirmed females did not differ between sexes (P = 0.244). The mean IOP of five small tortoises (< 10 cm long) was not significantly different (P = 0.244) from that of 20 large tortoises (> 10 cm long). In red-footed tortoises there does not appear to be any relation between carapace length and IOP. PMID:12216794

  16. Glaucoma Surgery Calculator: Limited Additive Effect of Phacoemulsification on Intraocular Pressure in Ab Interno Trabeculectomy

    PubMed Central

    Schuman, Joel S.; Brown, Eric N.

    2016-01-01

    Purpose To compare intraocular pressure (IOP) reduction and to develop a predictive surgery calculator based on the results between trabectome-mediated ab interno trabeculectomy in pseudophakic patients versus phacoemulsification combined with trabectome-mediated ab interno trabeculectomy in phakic patients. Methods This observational surgical cohort study analyzed pseudophakic patients who received trabectome-mediated ab interno trabeculectomy (AIT) or phacoemulsification combined with AIT (phaco-AIT). Follow up for less than 12 months or neovascular glaucoma led to exclusion. Missing data was imputed by generating 5 similar but non-identical datasets. Groups were matched using Coarsened Exact Matching based on age, gender, type of glaucoma, race, preoperative number of glaucoma medications and baseline intraocular pressure (IOP). Linear regression was used to examine the outcome measures consisting of IOP and medications. Results Of 949 cases, 587 were included consisting of 235 AIT and 352 phaco-AIT. Baseline IOP between groups was statistically significant (p≤0.01) in linear regression models and was minimized after Coarsened Exact Matching. An increment of 1 mmHg in baseline IOP was associated with a 0.73±0.03 mmHg IOP reduction. Phaco-AIT had an IOP reduction that was only 0.73±0.32 mmHg greater than that of AIT. The resulting calculator to determine IOP reduction consisted of the formula -13.54+0.73 × (phacoemulsification yes:1, no:0) + 0.73 × (baseline IOP) + 0.59 × (secondary open angle glaucoma yes:1, no:0) + 0.03 × (age) + 0.09 × (medications). Conclusions This predictive calculator for minimally invasive glaucoma surgery can assist clinical decision making. Only a small additional IOP reduction was observed when phacoemulsification was added to AIT. Patients with a higher baseline IOP had a greater IOP reduction. PMID:27077914

  17. Design, synthesis, and evaluation of NO-donor containing carbonic anhydrase inhibitors to lower intraocular pressure.

    PubMed

    Huang, Qinhua; Rui, Eugene Y; Cobbs, Morena; Dinh, Dac M; Gukasyan, Hovhannes J; Lafontaine, Jennifer A; Mehta, Saurabh; Patterson, Brian D; Rewolinski, David A; Richardson, Paul F; Edwards, Martin P

    2015-03-26

    The antiglaucoma drugs dorzolamide (1) and brinzolamide (2) lower intraocular pressure (IOP) by inhibiting the carbonic anhydrase (CA) enzyme to reduce aqueous humor production. The introduction of a nitric oxide (NO) donor into the alkyl side chain of dorzolamide (1) and brinzolamide (2) has led to the discovery of NO-dorzolamide 3a and NO-brinzolamide 4a, which could lower IOP through two mechanisms: CA inhibition to decrease aqueous humor secretion (reduce inflow) and NO release to increase aqueous humor drainage (increase outflow). Compounds 3a and 4a have shown improved efficacy of lowering IOP in both rabbits and monkeys compared to brinzolamide (2). PMID:25728019

  18. Sustained intraocular pressure reduction throughout the day with travoprost ophthalmic solution 0.004%

    PubMed Central

    Dubiner, Harvey B; Noecker, Robert

    2012-01-01

    Background The purpose of this study was to characterize intraocular pressure (IOP) reduction throughout the day with travoprost ophthalmic solution 0.004% dosed once daily in the evening. Methods The results of seven published, randomized clinical trials including at least one arm in which travoprost 0.004% was dosed once daily in the evening were integrated. Means (and standard deviations) of mean baseline and on-treatment IOP, as well as mean IOP reduction and mean percent IOP reduction at 0800, 1000, and 1600 hours at weeks 2 and 12 were calculated. Results From a mean baseline IOP ranging from 25.0 to 27.2 mmHg, mean IOP on treatment ranged from 17.4 to 18.8 mmHg across all visits and time points. Mean IOP reductions from baseline ranged from 7.6 to 8.4 mmHg across visits and time points, representing a mean IOP reduction of 30%. Results of the safety analysis were consistent with the results from the individual studies for travoprost ophthalmic solution 0.004%, with ocular hyperemia being the most common side effect. Conclusion Travoprost 0.004% dosed once daily in the evening provides sustained IOP reduction throughout the 24-hour dosing interval in subjects with ocular hypertension or open-angle glaucoma. No reduction of IOP-lowering efficacy was observed at the 1600-hour time point which approached the end of the dosing interval. PMID:22536047

  19. Regulation of optic nerve head blood flow during combined changes in intraocular pressure and arterial blood pressure

    PubMed Central

    Boltz, Agnes; Schmidl, Doreen; Werkmeister, René M; Lasta, Michael; Kaya, Semira; Palkovits, Stefan; Told, Reinhard; Napora, Katarzyna J; Popa-Cherecheanu, Alina; Garhöfer, Gerhard; Schmetterer, Leopold

    2013-01-01

    In the choroid, there is evidence that blood flow does not only depend on ocular perfusion pressure (OPP), but also on absolute mean arterial pressure (MAP) and intraocular pressure (IOP). The present study included 40 healthy subjects to investigate whether such behavior is also found in the optic nerve head (ONH). The ONH blood flow (ONHBF) was studied using laser Doppler flowmetry during a separate increase in IOP and MAP as well as during a combined elevation. Mean arterial pressure was increased by isometric exercise and IOP by the suction method. During both, the change in ONHBF was less pronounced than the change in OPP indicating autoregulation. Correlation analysis was performed for the combined experiments after pooling all data according to IOP and MAP values. A correlation between ONHBF and MAP was found at IOPs ⩽25 mm Hg (P<0.001), but not at IOPs>25 mm Hg (P=0.79). Optic nerve head blood flow and IOP were significantly correlated (P<0.001), and ONHBF was only slightly dependent on MAP. The data of the present study indicate a complex regulation of ONHBF during combined changes in MAP and IOP. Our results may be compatible with myogenic mechanisms underlying autoregulation, and indicate better ONHBF regulation during an increase in MAP than during an increase in IOP. PMID:23921903

  20. Regulation of optic nerve head blood flow during combined changes in intraocular pressure and arterial blood pressure.

    PubMed

    Boltz, Agnes; Schmidl, Doreen; Werkmeister, René M; Lasta, Michael; Kaya, Semira; Palkovits, Stefan; Told, Reinhard; Napora, Katarzyna J; Popa-Cherecheanu, Alina; Garhöfer, Gerhard; Schmetterer, Leopold

    2013-12-01

    In the choroid, there is evidence that blood flow does not only depend on ocular perfusion pressure (OPP), but also on absolute mean arterial pressure (MAP) and intraocular pressure (IOP). The present study included 40 healthy subjects to investigate whether such behavior is also found in the optic nerve head (ONH). The ONH blood flow (ONHBF) was studied using laser Doppler flowmetry during a separate increase in IOP and MAP as well as during a combined elevation. Mean arterial pressure was increased by isometric exercise and IOP by the suction method. During both, the change in ONHBF was less pronounced than the change in OPP indicating autoregulation. Correlation analysis was performed for the combined experiments after pooling all data according to IOP and MAP values. A correlation between ONHBF and MAP was found at IOPs 25 mm Hg (P<0.001), but not at IOPs>25 mm Hg (P=0.79). Optic nerve head blood flow and IOP were significantly correlated (P<0.001), and ONHBF was only slightly dependent on MAP. The data of the present study indicate a complex regulation of ONHBF during combined changes in MAP and IOP. Our results may be compatible with myogenic mechanisms underlying autoregulation, and indicate better ONHBF regulation during an increase in MAP than during an increase in IOP. PMID:23921903

  1. Nanosponge-Mediated Drug Delivery Lowers Intraocular Pressure

    PubMed Central

    Lambert, Wendi S.; Carlson, Brian J.; van der Ende, Alice E.; Shih, Grace; Dobish, Julia N.; Calkins, David J.; Harth, Eva

    2015-01-01

    Purpose We examined the efficacy of an extended-release drug delivery system, nanosponge (NS) encapsulated compounds, administered intravitreally to lower intraocular pressure (IOP) in mice. Methods Bilateral ocular hypertension was induced in mice by injecting microbeads into the anterior chamber. Hypertensive mice received NS loaded with ocular hypotensive drugs via intravitreal injection and IOP was monitored. Retinal deposition and retinal ganglion cell (RGC) uptake of Neuro-DiO were examined following intravitreal injection of Neuro-DiO-NS using confocal microscopy. Results Brimonidine-loaded NS lowered IOP 12% to 30% for up to 6 days (P < 0.02), whereas travoprost-NS lowered IOP 19% to 29% for up to 4 days (P < 0.02) compared to saline injection. Three bimatoprost NS were tested: a 400-nm NS and two 700-nm NS with amorphous (A-NS) or amorphous/crystalline (AC-NS) crosslinkers. A single injection of 400 nm NS lowered IOP 24% to 33% for up to 17 days compared to saline, while A-NS and AC-NS lowered IOP 22% to 32% and 18% to 26%, respectively, for up to 32 days (P < 0.046). Over time retinal deposition of Neuro-DiO increased from 19% to 71%; Neuro-DiO released from NS was internalized by RGCs. Conclusions A single injection of NS can effectively deliver ocular hypotensive drugs in a linear and continuous manner for up to 32 days. Also, NS may be effective at targeting RGCs, the neurons that degenerate in glaucoma. Translational Relevance Patient compliance is a major issue in glaucoma. The use of NS to deliver a controlled, sustained release of therapeutics could drastically reduce the number of patients that progress to vision loss in this disease. PMID:25599009

  2. Effect of oral administration of carprofen on intraocular pressure in normal dogs.

    PubMed

    Meekins, J M; Overton, T L; Rankin, A J; Roush, J K

    2016-08-01

    The aim of this study was to determine the effect of oral administration of carprofen on intraocular pressure in normal dogs. Twelve young adult beagle dogs were randomly assigned to treatment (n = 6) or control (n = 6) groups. After an 11-day acclimation period, the treatment group received approximately 2.2 mg/kg carprofen per os every 12 h for 7 days, and the control group received a placebo gel capsule containing no drug per os every 12 h for 7 days. Intraocular pressure (IOP) was measured by a rebound tonometer at three time points per day (8 am, 2 pm, and 8 pm) during the acclimation (days 1-11) and treatment (days 12-18) phases and for 48 h (days 19-20) after the completion of treatment. There was no statistically significant change in IOP for either eye in the dogs receiving oral carprofen during the treatment phase (days 12-18). After day 4, no significant daily IOP changes were seen in control group dogs. Carprofen administered orally every 12 h for 7 days had no effect on IOP in normal beagle dogs. An acclimation period to frequent IOP measurements of at least 5 days is necessary to establish baseline IOP values and minimize possible anxiety-related effects on IOP measurements. PMID:26923773

  3. Intraocular Pressure Regulation: Findings of Pulse-Dependent Trabecular Meshwork Motion Lead to Unifying Concepts of Intraocular Pressure Homeostasis

    PubMed Central

    2014-01-01

    Abstract Intraocular pressure (IOP) is the only treatable risk factor in glaucoma, one of the world's leading causes of blindness. Mechanisms that maintain IOP within a normal range have been poorly understood in contrast to intrinsic mechanisms that regulate systemic blood pressure. Vessel walls experience continuous pulse-induced cyclic pressure and flow. Pressure-dependent wall stress and flow-dependent shear stress provide sensory signals that initiate mechanotransduction responses. The responses optimize vessel wall elasticity, compliance and lumen size, providing a feedback loop to maintain intrinsic pressure homeostasis. Aqueous humor is part of a vascular circulatory loop, being secreted into the anterior chamber of the eye from the vasculature, then returning to the vasculature by passing through the trabecular meshwork (TM), a uniquely modified vessel wall interposed between the anterior chamber and a vascular sinus called Schlemm's canal (SC). Since pressure in circulatory loops elsewhere is modulated by cyclic stresses, one might predict similar pressure modulation in the aqueous outflow system. Recent laboratory evidence in fact demonstrates that cyclic IOP changes alter aqueous outflow while increasing cellularity and contractility of TM cells. Cyclic changes also lead to alterations in gene expression, changes in cytoskeletal networks and modulation of signal transduction. A new technology, phase-based optical coherence tomography, demonstrates in vivo pulse-dependent TM motion like that elsewhere in the vasculature. Recognition of pulse-dependent TM motion provides a linkage to well-characterized mechanisms that provide pressure homeostasis in the systemic vasculature. The linkage may permit unifying concepts of pressure control and provide new insights into IOP homeostatic mechanisms. PMID:24359130

  4. Mechanisms for vasopressin effects on intraocular pressure in anesthetized rats

    NASA Technical Reports Server (NTRS)

    Balaban, C. D.; Palm, D. E.; Shikher, V.; Searles, R. V.; Keil, L. C.; Severs, W. B.

    1997-01-01

    Continuous intracameral infusions of a balanced salt solution (0.175 microliter min-1) have been reported to raise intraocular pressure (IOP) in anesthetized rats. Palm et al. (1995) previously reported that this effect was attenuated significantly by inclusion of arginine-vasopressin (AVP, 10 ng 0.175 microliter-1) in the infusate. This study used experimental and computer simulation methods to investigate factors underlying these changes in IOP. First, constant intracameral infusions of artificial cerebrospinal fluid (aCSF) at different fixed rates (0.049-0.35 microliter min-1) were used to estimate the outflow resistance. Secondly, IOP responses were measured during an 2 hr intracameral infusion of either aCSF or AVP that was the sum of a small constant component (0.05 microliter min-1) and a larger periodic component (0.25 microliter min-1, cycling for 4 min on, then 4 min off); the mean infusion rate was 0.175 microliter min-1. As shown previously for 0.175 microliter min-1 constant infusions, the periodic aCSF infusion induced a significant rise in IOP that was attenuated by AVP administration. Complex demodulation analysis and the estimated gain parameter of a second order transfer function fit to the periodic responses indicated that outflow resistance increased significantly during the infusions in both aCSF and AVP groups, but that the indices of resistance did not differ significantly between aCSF and AVP infused eyes. This finding implies that changes in outflow resistance do not explain the difference in IOP responses to intracameral aCSF and AVP. The two responses differed significantly, though, in damping factors, such that the aCSF responses were considerably more underdamped than the AVP responses. It is hypothesized that aCSF-induced increase in IOP reflects both (1) a small component reflecting increased outflow resistance and (2) a larger non-resistive component. Since the non-resistive component is insensitive to pretreatment with acetazolamide

  5. Impact on intraocular pressure after 20-mg decanted triamcinolone acetonide (Kenalog) injection when utilizing prophylactic antiglaucoma therapy

    PubMed Central

    Ezon, Isaac C; Nezgoda, Joseph T; Cheng, Lingyun; Freeman, William R

    2014-01-01

    Purpose To analyze intraocular pressure (IOP) response after 20-mg decanted intravitreal triamcinolone acetonide (IVTA) followed by early prophylactic IOP-lowering therapy. Methods We retrospectively reviewed IOP results of 120 high-dose decanted IVTA injections from 58 non-glaucomatous patients with macular edema, with antiglaucoma therapy prescribed from week 1 regardless of baseline IOP. Results In cases of consistent compliance with IOP-lowering drugs (79.2%), IOP increased by 2 mmHg at 4 months (p=0.300) and returned to baseline at 6 months. In cases of non-compliance (20.8%), IOP increased by 7 mmHg at 1 month (p<0.001) and returned to baseline after starting treatment. Multivariate regression analysis showed that non-vitrectomized eyes and non-compliance with IOP-lowering drugs were independent predictors for IOP rise over 21 mmHg (p=0.0098 and p=0.0019, respectively). Non-vitrectomized eyes had a 46% greater chance to experience IOP rise compared to vitrectomized. Poor compliance with IOP-lowering drugs lead to a 45% greater likelihood of experiencing IOP rise compared to compliant patients. Multiple injections were not associated with increased risk for IOP rise over 21 mmHg (p=0.273). Out of 120 cases, 2 eyes (1.7%) developed uncontrolled IOP and required glaucoma surgery by 4 months, with good final IOP outcome. Conclusion 20-mg decanted IVTA can be safely used to treat macular edema in nonglaucomatous patients; IOP elevation can be adequately controlled with prophylactic antiglaucoma drugs. Non-compliance with prophylactic therapy creates an early spike in IOP, and vitreous status can significantly impact IOP rise. Compliance with IOP-lowering drugs should be stressed to patients receiving high-dose IVTA especially if non-vitrectomized. PMID:25077534

  6. A Circadian and Cardiac Intraocular Pressure Sensor for Smart Implantable Lens.

    PubMed

    Donida, Achille; Di Dato, Giuseppe; Cunzolo, Paolo; Sala, Marco; Piffaretti, Filippo; Orsatti, Paolo; Barrettino, Diego

    2015-12-01

    This paper presents a new system to measure the Intraocular Pressure (IOP) with very high accuracy (0.036 mbar) used for monitoring glaucoma. The system not only monitors the daily variation of the IOP (circadian IOP), but also allows to perform an spectral analysis of the pressure signal generated by the heartbeat (cardiac IOP). The system comprises a piezoresistive pressure sensor, an application-specific integrated circuit (ASIC) to read out the sensor data and an external reader installed on customized glasses. The ASIC readout electronics combines chopping modulation with correlated double sampling (CDS) in order to eliminate both the amplifier offset and the chopper ripple at the sampling frequency. In addition, programmable current sources are used to compensate for the atmospheric pressure ( 800-1200 mbar ) and the circadian component (± 7 mbar) thus allowing to read out the very weak cardiac signals (± 1.6 mbar) with a maximum accuracy of 0.036 mbar. PMID:26800549

  7. Intraocular pressure-lowering combination therapies with prostaglandin analogues.

    PubMed

    Aptel, Florent; Chiquet, Christophe; Romanet, Jean-Paul

    2012-07-01

    Intraocular pressure (IOP) reduction is currently the only therapeutic approach demonstrated to preserve visual function in patients with glaucoma. The first line of glaucoma treatment consists of topical IOP-lowering medications, usually initiated as monotherapy. A significant proportion of patients require more than one medication to reach a target IOP at which optic nerve damage will not progress. As prostaglandin analogues (PGAs) are the most effective class for reducing IOP, one of the other commonly used classes (β-adrenoceptor antagonist [β-blocker], carbonic anhydrase inhibitor or α(2)-adrenoceptor agonist) is frequently combined with a PGA. In the last decade, the use of fixed combinations containing two medications in a single bottle has steadily increased. Fixed combinations have the potential to simplify the dosing regimen, increase patient adherence, avoid the washout effect of the second drop on the first medication instilled, decrease exposure to preservatives and, sometimes, reduce the cost of treatment. Clinical trials have evaluated PGA-based fixed combinations versus unfixed combinations (individual components administered concomitantly) or versus individual monotherapies; however, any advantage that the fixed combinations may have in terms of IOP-lowering efficacy is still debated. For these reasons, the PGA-based fixed combinations are not approved by regulatory authorities in some countries, such as the US. We review the published studies evaluating the efficacy and tolerability of the IOP-lowering unfixed and fixed combination therapies with PGAs. Regarding unfixed combinations, the review shows that α(2)-adrenergic agonists-PGA and carbonic anhydrase inhibitor-PGA combinations seem to be at least as effective at reducing IOP as the β-blocker-PGA combinations. As for the fixed combinations, the review shows that the three PGA-timolol fixed combinations are more effective than their component medications used separately as monotherapy and

  8. Intra-Ocular Pressure Measurement in a Patient with a Thin, Thick or Abnormal Cornea

    PubMed Central

    Clement, Colin I.; Parker, Douglas G.A.; Goldberg, Ivan

    2016-01-01

    Accurate measurement of intra-ocular pressure is a fundamental component of the ocular examination. The most common method of measuring IOP is by Goldmann applanation tonometry, the accuracy of which is influenced by the thickness and biomechanical properties of the cornea. Algorithms devised to correct for corneal thickness to estimate IOP oversimplify the effects of corneal biomechanics. The viscous and elastic properties of the cornea influence IOP measurements in unpredictable ways, a finding borne out in studies of patients with inherently abnormal and surgically altered corneal biomechanics. Dynamic contour tonometry, rebound tonometry and the ocular response analyzer provide useful alternatives to GAT in patients with abnormal corneas, such as those who have undergone laser vision correction or keratoplasty. This article reviews the various methods of intra-ocular pressure measurement available to the clinician and the ways in which their utility is influenced by variations in corneal thickness and biomechanics. PMID:27014386

  9. Interface Fluid Syndrome Induced by Uncontrolled Intraocular Pressure Without Triggering Factors After LASIK in a Glaucoma Patient

    PubMed Central

    Shoji, Nobuyuki; Ishida, Akira; Haruki, Takahiro; Matsumura, Kazuhiro; Kasahara, Masayuki; Shimizu, Kimiya

    2015-01-01

    Abstract This study sought to describe a glaucoma patient with interface fluid syndrome (IFS) induced by uncontrolled intraocular pressure (IOP) without triggering factors after laser in situ keratomileusis (LASIK). Case report and review of the literature. A 23-year-old man with open-angle glaucoma underwent bilateral LASIK for myopia in 2009. Two years later, the patient reported sudden vision loss. The IOP in the right eye was not measurable using Goldmann applanation tonometry (GAT), but was determined to be 33.7 mm Hg using a noncontact tonometer. IFS was diagnosed based on the presence of space-occupying interface fluid on anterior segment optical coherence tomography images. After a trabeculectomy was performed, the IOP decreased to 10 mm Hg, and GAT measurement became possible. However, the corneal fold remained visible in the flap interface. Six months later, the IOP in the left eye increased, and a trabeculectomy was performed during the early stages of this increase in IOP. Following this procedure, the IOP decreased, and visual acuity remained stable. In glaucoma cases that involve a prior increase in IOP, IOP can continue to increase during the disease course even if temporary control of IOP has been achieved. If LASIK is performed in such cases, the treatment of glaucoma becomes insufficient because of underestimation of the typical IOP. In fact, the measurement of IOP can become difficult because of high-IOP levels. Therefore, LASIK should not be performed on patients with glaucoma who are at high risk of elevated IOP. PMID:26426645

  10. Interface Fluid Syndrome Induced by Uncontrolled Intraocular Pressure Without Triggering Factors After LASIK in a Glaucoma Patient: A Case Report.

    PubMed

    Shoji, Nobuyuki; Ishida, Akira; Haruki, Takahiro; Matsumura, Kazuhiro; Kasahara, Masayuki; Shimizu, Kimiya

    2015-09-01

    This study sought to describe a glaucoma patient with interface fluid syndrome (IFS) induced by uncontrolled intraocular pressure (IOP) without triggering factors after laser in situ keratomileusis (LASIK). Case report and review of the literature. A 23-year-old man with open-angle glaucoma underwent bilateral LASIK for myopia in 2009. Two years later, the patient reported sudden vision loss. The IOP in the right eye was not measurable using Goldmann applanation tonometry (GAT), but was determined to be 33.7 mm Hg using a noncontact tonometer. IFS was diagnosed based on the presence of space-occupying interface fluid on anterior segment optical coherence tomography images. After a trabeculectomy was performed, the IOP decreased to 10 mm Hg, and GAT measurement became possible. However, the corneal fold remained visible in the flap interface. Six months later, the IOP in the left eye increased, and a trabeculectomy was performed during the early stages of this increase in IOP. Following this procedure, the IOP decreased, and visual acuity remained stable. In glaucoma cases that involve a prior increase in IOP, IOP can continue to increase during the disease course even if temporary control of IOP has been achieved. If LASIK is performed in such cases, the treatment of glaucoma becomes insufficient because of underestimation of the typical IOP. In fact, the measurement of IOP can become difficult because of high-IOP levels. Therefore, LASIK should not be performed on patients with glaucoma who are at high risk of elevated IOP. PMID:26426645

  11. Associations with Intraocular Pressure in a Large Cohort

    PubMed Central

    Chan, Michelle P.Y.; Grossi, Carlota M.; Khawaja, Anthony P.; Yip, Jennifer L.Y.; Khaw, Kay-Tee; Patel, Praveen J.; Khaw, Peng T.; Morgan, James E.; Vernon, Stephen A.; Foster, Paul J.

    2016-01-01

    Purpose To describe the associations of physical and demographic factors with Goldmann-correlated intraocular pressure (IOPg) and corneal-compensated intraocular pressure (IOPcc) in a British cohort. Design Cross-sectional study within the UK Biobank, a large-scale multisite cohort study in the United Kingdom. Participants We included 110 573 participants from the UK Biobank with intraocular pressure (IOP) measurements available. Their mean age was 57 years (range, 40–69 years); 54% were women, and 90% were white. Methods Participants had 1 IOP measurement made on each eye using the Ocular Response Analyzer noncontact tonometer. Linear regression models were used to assess the associations of IOP with physical and demographic factors. Main Outcome Measures The IOPg and IOPcc. Results The mean IOPg was 15.72 mmHg (95% confidence interval [CI], 15.70–15.74 mmHg), and the mean IOPcc was 15.95 mmHg (15.92–15.97 mmHg). After adjusting for covariates, IOPg and IOPcc were both significantly associated with older age, male sex, higher systolic blood pressure (SBP), faster heart rate, greater myopia, self-reported glaucoma, and colder season (all P < 0.001). The strongest determinants of both IOPg and IOPcc were SBP (partial R2: IOPg 2.30%, IOPcc 2.26%), followed by refractive error (IOPg 0.60%, IOPcc 1.04%). The following variables had different directions of association with IOPg and IOPcc: height (−0.77 mmHg/m IOPg; 1.03 mmHg/m IOPcc), smoking (0.19 mmHg IOPg, −0.35 mmHg IOPcc), self-reported diabetes (0.41 mmHg IOPg, −0.05 mmHg IOPcc), and black ethnicity (−0.80 mmHg IOPg, 0.77 mmHg IOPcc). This suggests that height, smoking, diabetes, and ethnicity are related to corneal biomechanical properties. The increase in both IOPg and IOPcc with age was greatest among those of mixed ethnicities, followed by blacks and whites. The same set of covariates explained 7.4% of the variability of IOPcc but only 5.3% of the variability of IOPg. Conclusions This analysis

  12. A1-, A2A- and A3-subtype adenosine receptors modulate intraocular pressure in the mouse

    PubMed Central

    Avila, Marcel Y; Stone, Richard A; Civan, Mortimer M

    2001-01-01

    Despite the potential importance of the mouse in studying the pharmacology of aqueous dynamics, measurement of intraocular pressure (IOP) in its very small eye has been problematic. Utilizing a novel servo-null electrophysiologic approach recently applied to the mouse, we have identified a diversity of adenosine-receptor mechanisms in modulating IOP in this species. We report the first evidence that A3 receptors increase IOP in any species, and verify in the mouse reports with larger mammals that A1 receptors lower and A2A receptors increase IOP. PMID:11564641

  13. Preventive Dorzolamide-Timolol for Rising Intraocular Pressure During Steep Trendelenburg Position Surgery.

    PubMed

    Molloy, Bonnie Lee; Cong, Xiamei; Watson, Charles

    2016-06-01

    The study purpose was to evaluate preventive use of dorzolamide-timolol ophthalmic solution (Cosopt) during laparoscopic surgery with the patient in steep Trendelenburg (ST) position. Periorbital swelling, venous congestion, and elevated intraocular pressure (IOP) may produce low ocular perfusion. Prompt IOP reduction is important because 30- to 40-minute episodes of acute IOP elevations can result in retinal ganglion cell dysfunction. Dorzolamide-timolol ophthalmic drops reduce IOP and may ameliorate this effect. A double-blind randomized experimental study was conducted to test the effect of dorzolamide-timolol on IOP elevation during laparoscopic surgeries in ST position. Patients were randomly assigned to receive dorzolamide-timolol treatment or balanced salt solution following anesthesia induction. The IOP levels were measured at baseline and 30-minutes intervals throughout surgery. The generalized estimating equations model was used to analyze treatment and time effects and treatment by time interactions. Ninety patients were recruited, with 46 receiving dorzolamide-timolol treatment and 44 receiving balanced salt solution. Statistical analysis revealed significant treatment and time effects and treatment-time interactions on IOP. Patients' IOP was significantly lower in the treatment group than controls (P < .05 to P < .001). Treatment effects were medium to strong. Prophylactic therapy with dorzolamide-timolol significantly reduced IOP of surgical patients during ST positioning. PMID:27501654

  14. Perioperative dorzolamide-timolol intervention for rising intraocular pressure during steep Trendelenburg positioned surgery.

    PubMed

    Molloy, Bonnie; Cong, Xiaomei

    2014-06-01

    Elevated intraocular pressure (IOP) and venous congestion may produce a low ocular perfusion state that can lead to postoperative visual loss (POVL). The literature cites the importance of early IOP reduction to prevent optic nerve damage and visual loss. This study examined dorzolamide hydrochloride and timolol maleate (Cosopt) eyedrops on reducing elevated IOP during laparoscopic surgery with the patient in steep Trendelenburg position. A quasi-experimental study design was used. Subjects involving robotic urologic and gynecologic procedures at 3 separate medical centers were included. The medication was administered topically to both eyes at time points when IOP approached 40 mm Hg. The IOP was measured at 30-minute intervals compared with a supine, anesthetized baseline and final postprocedure supine measurements. A total of 194 patients were recruited, and 63 patients received dorzolamide-timolol treatment when IOP levels reached 38 to 40 mm Hg. Repeated-measures analysis of variance showed that IOP values dropped significantly after drug intervention at 60, 90, and 120 minutes (P < .001). Effect sizes of pharmacologic intervention on IOP reduction were strong (partial eta2 of 0.60 to 0.66). Treatment with dorzolamide-timolol eyedrops significantly reduces elevated IOP of patients who undergo lengthy laparoscopic surgery in the steep Trendelenburg position. PMID:25109158

  15. Pharmacotherapy of intraocular pressure: part I. Parasympathomimetic, sympathomimetic and sympatholytics.

    PubMed

    Costagliola, Ciro; dell'Omo, Roberto; Romano, Mario R; Rinaldi, Michele; Zeppa, Lucia; Parmeggiani, Francesco

    2009-11-01

    Elevated intraocular pressure (IOP) has been recognized as the major risk factor for the development of glaucoma and a wide range of options are now available to reduce it: medical treatment, laser, filtering, or cyclodestructive surgery (alone or in combination). All these modalities act by decreasing eye pressure and, thereby, protecting the optic nerve head from a mechanic direct and/or vascular indirect insult. Topical medical therapy represents the first-choice treatment and, in most cases, it effectively controls IOP, avoiding the occurrence of further optic nerve damage. All medications lower IOP in two main ways: decreasing the production of aqueous humour or by increasing its outflow from the eye. Consequently, antiglaucoma drugs either suppress aqueous humour formation (beta-adrenergic antagonists, carbonic anhydrase inhibitors, and alpha-2-adrenergic agonists) or raise aqueous humour outflow throughout the conventional (e.g., pilocarpine) or uveoscleral (prostaglandin FP receptor agonists, and prostamides) route. In addition, fixed and unfixed combinations of antiglaucoma compounds have also been available for patients requiring more than one type of medication. This review, which is part one of two (please see Expert Opinion on Pharmacotherapy 10 (17)) briefly considers the characteristics of sympathomimetic, sympatholytics and parasympathomimetic commonly employed in the medical treatment of glaucoma, mainly the primary open-angle form, focusing the discussion on the clinical evidence supporting the use of these three classes of compound. PMID:19874249

  16. Central corneal thickness and intraocular pressure in premature infants.

    PubMed

    Sekeroglu, Mehmet Ali; Hekimoglu, Emre; Petricli, İkbal Seza; Karakaya, Jale; Ozcan, Beyza; Yucel, Husniye; Kavurt, Aysen Sumru; Bas, Ahmet Yagmur

    2015-12-01

    To evaluate the central corneal thickness (CCT) and intraocular pressure (IOP) of premature infants and to document correlation of them with gestational age, chronological age, and birth weight of infants. Using a hand-held applanation tonometer and a portable pachymeter, IOP and CCT of 170 premature infants were measured just before initial retinopathy of prematurity screening examination and re-measured 4 weeks after the first visit. The CCT and IOP were positively correlated during the first (r = 0.616, p < 0.001) and second (r = 0.564, p < 0.001) visits. The mean CCT at first and second visits were 568.1 ± 22.1 (527-628) and 561.6 ± 21.4 (520-619) µm, consecutively (p < 0.001). Gestational age, chronological age and birth weight of infants were found to be negatively correlated with CCT at first (r = -0.751, p < 0.001; r = -0.745, p < 0.001; r = -0.581, p < 0.001, consecutively) and second (r = -0.729, p < 0.001; r = -0.729, p < 0.001; r = -0.555, p < 0.001, consecutively) visits. The mean IOP at first and second visits were 14.1 ± 1.9 (11-19) and 13.7 ± 1.7 (11-18) mmHg, consecutively (p < 0.001). Gestational age, chronological age, and birth weight of infants were found to be negatively correlated with IOP at first (r = -0.724, p < 0.001; r = -0.715, p < 0.001; r = -0.558, p < 0.001, consecutively) and second (r = -0.704, p < 0.001; r = -0.703, p < 0.001; r = -0.518, p < 0.001, consecutively) visits. CCT and IOP of the premature infants with a smaller gestational age were found to be higher (p < 0.001 for both). Premature infants with smaller gestational age have higher CCT and IOP values when compared to older infants. These values tend to become lower 4 weeks after the first examination as infants become older. The CCT and IOP were positively correlated with each other and both were negatively correlated with gestational age, chronological age, and birth weight during first and second visits. PMID:26286757

  17. The effects of intravenous alfaxalone with and without premedication on intraocular pressure in healthy dogs.

    PubMed

    Bauer, Bianca S; Ambros, Barbara

    2016-04-01

    The objective of this study was to investigate the effects of intravenous alfaxalone with and without premedication on intraocular pressure (IOP) in healthy dogs. Thirty-three dogs were randomized to receive 1 of 3 treatments: acepromazine [0.03 mg/kg body weight (BW)] with butorphanol (0.2 mg/kg BW) intramuscularly (IM), followed by intravenous (IV) alfaxalone (1.5 mg/kg BW); dexmedetomidine (0.002 mg/kg BW) with hydromorphone (0.1 mg/kg BW) IM, followed by alfaxalone (1 mg/kg BW) IV; and saline 0.9% (0.02 mL/kg BW) IM, followed by alfaxalone (3 mg/kg BW) IV. Intraocular pressure (IOP) was measured at baseline, 15 min, and 30 min after premedication, after pre-oxygenation, after administration of alfaxalone, and after intubation. After induction and after intubation, the IOP was significantly increased in all groups compared to baseline. While premedication with acepromazine/butorphanol or dexmedetomidine/hydromorphone did not cause a significant increase in IOP, the risk of vomiting and the associated peak in IOP after dexmedetomidine/hydromorphone should be considered when selecting an anesthetic protocol for dogs with poor tolerance for transient increases in IOP. PMID:27127343

  18. Seasonal changes of 24-hour intraocular pressure rhythm in healthy Shanghai population.

    PubMed

    Cheng, Jingyi; Xiao, Ming; Xu, Huan; Fang, Shaobin; Chen, Xu; Kong, Xiangmei; Sun, Xinghuai

    2016-08-01

    The aim of the present study was to investigate and compare the 24-hour intraocular pressure (IOP) rhythms in winter and summer in the healthy population of Shanghai, China.This is a cross-sectional study in which 24-hour IOP measurements were taken for all eligible healthy volunteers in winter and summer, respectively, and the temperature, hours of sunlight (sunlight time), and circulatory parameters, including heart rate, systolic blood pressure, and diastolic blood pressure, were also recorded. The 24-hour IOP curves and IOP parameters (mean, peak, trough, and fluctuation of IOP together with the diurnal-to-nocturnal IOP change) in winter and summer were obtained and compared. The magnitude of IOP changes from summer to winter was also calculated.A total of 29 participants (58 eyes), 14 (48.28%) male and 15 (51.72%) female, aged 43.66 ± 12.20 (19-61) years, were considered eligible for this study. Generally, IOP decreased progressively before noon, increased notably in the nocturnal period, and peaked at 12:00 AM in winter and at 2:00 AM in summer. The pattern of 24-hour IOP in winter and summer was significantly different (P = 0.002). The average IOPs from 4:00 PM to 8:00 AM, except for 6:00 AM, were significantly higher in winter (P < 0.05). However, no significant differences were shown after adjusting for temperature and/or sunlight time. From summer to winter, the extent of IOP increase was mostly around 0 to 3 mm Hg, and the IOPs increased more significantly in the nocturnal period than in the diurnal period (P = 0.05).The 24-hour IOP rhythms were different in winter and summer, with higher IOP level in winter. Temperature and sunlight time, which are independent of heart rate and blood pressure, affected the 24-hour IOP rhythms in healthy people in Shanghai, China. Further investigations are expected for the rhythm of some endogenous substance secretion and the inner mechanism of regulation of IOP. PMID:27495076

  19. Seasonal changes of 24-hour intraocular pressure rhythm in healthy Shanghai population

    PubMed Central

    Cheng, Jingyi; Xiao, Ming; Xu, Huan; Fang, Shaobin; Chen, Xu; Kong, Xiangmei; Sun, Xinghuai

    2016-01-01

    Abstract The aim of the present study was to investigate and compare the 24-hour intraocular pressure (IOP) rhythms in winter and summer in the healthy population of Shanghai, China. This is a cross-sectional study in which 24-hour IOP measurements were taken for all eligible healthy volunteers in winter and summer, respectively, and the temperature, hours of sunlight (sunlight time), and circulatory parameters, including heart rate, systolic blood pressure, and diastolic blood pressure, were also recorded. The 24-hour IOP curves and IOP parameters (mean, peak, trough, and fluctuation of IOP together with the diurnal-to-nocturnal IOP change) in winter and summer were obtained and compared. The magnitude of IOP changes from summer to winter was also calculated. A total of 29 participants (58 eyes), 14 (48.28%) male and 15 (51.72%) female, aged 43.66 ± 12.20 (19–61) years, were considered eligible for this study. Generally, IOP decreased progressively before noon, increased notably in the nocturnal period, and peaked at 12:00 am in winter and at 2:00 am in summer. The pattern of 24-hour IOP in winter and summer was significantly different (P = 0.002). The average IOPs from 4:00 pm to 8:00 am, except for 6:00 am, were significantly higher in winter (P < 0.05). However, no significant differences were shown after adjusting for temperature and/or sunlight time. From summer to winter, the extent of IOP increase was mostly around 0 to 3 mm Hg, and the IOPs increased more significantly in the nocturnal period than in the diurnal period (P = 0.05). The 24-hour IOP rhythms were different in winter and summer, with higher IOP level in winter. Temperature and sunlight time, which are independent of heart rate and blood pressure, affected the 24-hour IOP rhythms in healthy people in Shanghai, China. Further investigations are expected for the rhythm of some endogenous substance secretion and the inner mechanism of regulation of IOP. PMID:27495076

  20. Stem Cells in the Trabecular Meshwork for Regulating Intraocular Pressure.

    PubMed

    Yun, Hongmin; Zhou, Yi; Wills, Andrew; Du, Yiqin

    2016-06-01

    Intraocular pressure (IOP) is still the main treatment target for glaucoma. Outflow resistance mainly exists at the trabecular meshwork (TM) outflow pathway, which is responsible for IOP regulation. Changes of TM cellularity and TM extracellular matrix turnover may play important roles in IOP regulation. In this article, we review basic anatomy and physiology of the outflow pathway and TM stem cell characteristics regarding the location, isolation, identification and function. TM stem cells are localized at the insert region of the TM and are label-retaining in vivo. They can be isolated by side-population cell sorting, cloning culture, or sphere culture. TM stem cells are multipotent with the ability to home to the TM region and differentiate into TM cells in vivo. Other stem cell types, such as adipose-derived stem cells, mesenchymal stem cells and induced pluripotent stem cells have been discovered for TM cell differentiation and TM regeneration. We also review glaucomatous animal models, which are suitable to study stem cell-based therapies for TM regeneration. PMID:27183473

  1. Non-continuous measurement of intraocular pressure in laboratory animals.

    PubMed

    Millar, J Cameron; Pang, Iok-Hou

    2015-12-01

    Glaucoma is a leading cause of blindness, which is treatable but currently incurable. Numerous animal models therefore have both been and continue to be utilized in the study of numerous aspects of this condition. One important facet associated with the use of such models is the ability to accurately and reproducibly measure (by cannulation) or estimate (by tonometry) intraocular pressure (IOP). At this juncture there are several different approaches to IOP measurement in different experimental animal species, and the list continues to grow. We feel therefore that a review of this subject matter is timely and should prove useful to others who wish to perform similar measurements. The general principles underlying various types of tonometric and non-tonometric techniques for non-continuous determination of IOP are considered. There follows discussion of specific details as to how these techniques are applied to experimental animal species involved in the research of this disease. Specific comments regarding anesthesia, circadian rhythm, and animal handling are also included, especially in the case of rodents. Brief consideration is also given to possible future developments. PMID:25933714

  2. Twenty-four-Hour Measurement of Intraocular Pressure in Guinea Pigs (Cavia porcellus).

    PubMed

    Ansari-Mood, Maneli; Mehdi-Rajaei, Seyed; Sadjadi, Reza; Selk-Ghaffari, Masoud; Williams, David L

    2016-01-01

    The objective of this study was to measure intraocular pressure (IOP) in intact, healthy guinea pigs (15 male, 15 female) every 2 h for a 24-h period. First, IOP was measured by using rebound tonometry (RBT). After a 1-min rest period, 0.5% proparacaine ophthalmic solution, a topical anesthetic, was applied to both eyes; 4 min after anesthetic instillation, IOP was measured by using applanation tonometry (APT). The IOP was lower during the light period (0700 to 1900) than during the dark phase (2000 to 0600). The lowest IOP by both RBT and APT (3.68 and 13.37 mm Hg, respectively) occurred at 0700, whereas maximal IOP occurred at 2300 for RBT (8.12 mm Hg) but at 2100 for APT (20.62 mm Hg). No significant differences in IOP between the left and right eyes or between RBT and APT were noted. In addition, daily variations in the IOP of guinea pigs seem to be independent of sex and body weight. The results of this study may be beneficial in the diagnosis and observation of glaucoma in guinea pigs. PMID:26817986

  3. Twenty-four–Hour Measurement of Intraocular Pressure in Guinea Pigs (Cavia porcellus)

    PubMed Central

    Ansari-Mood, Maneli; Mehdi-Rajaei, Seyed; Sadjadi, Reza; Selk-Ghaffari, Masoud; Williams, David L

    2016-01-01

    The objective of this study was to measure intraocular pressure (IOP) in intact, healthy guinea pigs (15 male, 15 female) every 2 h for a 24-h period. First, IOP was measured by using rebound tonometry (RBT). After a 1-min rest period, 0.5% proparacaine ophthalmic solution, a topical anesthetic, was applied to both eyes; 4 min after anesthetic instillation, IOP was measured by using applanation tonometry (APT). The IOP was lower during the light period (0700 to 1900) than during the dark phase (2000 to 0600). The lowest IOP by both RBT and APT (3.68 and 13.37 mm Hg, respectively) occurred at 0700, whereas maximal IOP occurred at 2300 for RBT (8.12 mm Hg) but at 2100 for APT (20.62 mm Hg). No significant differences in IOP between the left and right eyes or between RBT and APT were noted. In addition, daily variations in the IOP of guinea pigs seem to be independent of sex and body weight. The results of this study may be beneficial in the diagnosis and observation of glaucoma in guinea pigs. PMID:26817986

  4. Association between Glucose Levels and Intraocular Pressure: Pre- and Postprandial Analysis in Diabetic and Nondiabetic Patients

    PubMed Central

    Pimentel, Luis Guilherme Milesi; Gracitelli, Carolina P. B.; da Silva, Leticia Sant'Ana Cardoso; Souza, Aline Katia Siqueira; Prata, Tiago Santos

    2015-01-01

    The aim of this study was to evaluate the relationship between glucose levels and intraocular pressure (IOP) fluctuation in diabetic and nondiabetic patients. Seventeen nondiabetic and 20 diabetic subjects underwent a complete ophthalmic examination, capillary glucose testing, and applanation tonometry in two distinct situations: first, fasting for at least 8 hours and, second, postprandial measurements. Baseline glucose levels were higher in diabetic patients (P < 0.001). Postprandial IOP was significantly higher than baseline IOP in diabetic (P < 0.001) and nondiabetic patients (P = 0.006). Postprandial glucose levels were significantly higher than baseline measurements in both diabetic (P = 0.005) and nondiabetic patients (P = 0.015). There was a significant association between glucose levels variation and IOP change in both diabetic patients (R2 = 0.540; P < 0.001) and nondiabetic individuals (R2 = 0.291; P = 0.025). There is also a significant association between the baseline glucose levels and IOP change in diabetic group (R2 = 0.445; P = 0.001). In a multivariable model, the magnitude of glucose level change remained significantly associated with IOP variation even including age, baseline IOP, ancestry, and gender as a confounding factor (P < 0.001). We concluded that there is a significant association between blood glucose levels and IOP variation, especially in diabetic patients. PMID:25642344

  5. The Effect of ND:YAG Laser Posterior Capsulotomy Size on Refraction, Intraocular Pressure, and Macular Thickness

    PubMed Central

    Karahan, Eyyup; Tuncer, Ibrahim; Zengin, Mehmet Ozgur

    2014-01-01

    Purpose. The aim of this study is to examine the influence of capsulotomy size on, spherical equivalent (SE), intraocular pressure (IOP), and macular thickness. Materials and Methods. Sixty-eight patients were examined preoperatively and 1, 4, and 12 weeks after Nd:YAG capsulotomy. Patients were divided into two groups based on the postoperative capsulotomy size. Changes in SE, IOP, and macular thickness were compared between two groups. Results. We found a higher hyperopic shift in large capsulotomy group. In both groups 1 and 2, IOP increased 1 week postoperatively. Intraocular pressure rise in group 2 was higher than in group 1. Both groups had increased macular thickness at 1 week postoperatively. The degree of macular thickening was similar in group 1 and group 2. Comment. Patients who underwent a larger capsulotomy have a higher hyperopic shift and IOP elevation. Rise in macular thickness was similar in large and small capsulotomy groups. PMID:24724016

  6. The Effect of ND:YAG Laser Posterior Capsulotomy Size on Refraction, Intraocular Pressure, and Macular Thickness.

    PubMed

    Karahan, Eyyup; Tuncer, Ibrahim; Zengin, Mehmet Ozgur

    2014-01-01

    Purpose. The aim of this study is to examine the influence of capsulotomy size on, spherical equivalent (SE), intraocular pressure (IOP), and macular thickness. Materials and Methods. Sixty-eight patients were examined preoperatively and 1, 4, and 12 weeks after Nd:YAG capsulotomy. Patients were divided into two groups based on the postoperative capsulotomy size. Changes in SE, IOP, and macular thickness were compared between two groups. Results. We found a higher hyperopic shift in large capsulotomy group. In both groups 1 and 2, IOP increased 1 week postoperatively. Intraocular pressure rise in group 2 was higher than in group 1. Both groups had increased macular thickness at 1 week postoperatively. The degree of macular thickening was similar in group 1 and group 2. Comment. Patients who underwent a larger capsulotomy have a higher hyperopic shift and IOP elevation. Rise in macular thickness was similar in large and small capsulotomy groups. PMID:24724016

  7. Oxygen saturation changes in the optic nerve head during acute intraocular pressure elevation in monkeys

    NASA Astrophysics Data System (ADS)

    Khoobehi, Bahram; Kawano, Hiroyuki; Ning, Jinfeng; Burgoyne, Claude F.; Rice, David A.; Khan, Fareeha; Thompson, Hilary W.; Beach, James M.

    2009-02-01

    Background and Objective: To evaluate the effect of an acute elevated intraocular pressure (IOP) on oxygen saturation of structures of the optic nerve head. Study Design/Materials and Methods: In the cynomolgus monkey eye, IOP was set to 10 mm Hg, and then raised to 30, 45, and 55 mm Hg. The ONH and overlying vessels were imaged using a fundus camera attached to a hyperspectral imaging system (HSI) at 10 and 30 minutes after IOP elevation. Results: Raising IOP from 10 to 30 mm Hg did not significantly (P < 0.0001) change saturation in vessels or ONH tissue structures but at 55 mm Hg, all structures showed significant reduction. Conclusions: Quantitative assay of the blood oxygen saturation in structures on the surface and overlying the optic nerve head is possible using hyperspectral imaging techniques.

  8. Importance of intraocular pressure in glaucoma

    NASA Astrophysics Data System (ADS)

    Joos, Karen M.

    1999-06-01

    Glaucoma results in permanent vision loss and affects the peripheral vision initially. It is presented in 22.5 million people worldwide and is the 3rd cause of blindness. Present tonometers are not ideal for intraocular pressure measurements in all eyes. Of concern, PRK and LASIK may result in lower intraocular pressure readings. A challenges now exists for the development of a tonometer which can easily compensate for corneas with many parameters to avoid a future increase in normal-tension glaucoma or glaucoma which is advanced.

  9. Insulin resistance is associated with intraocular pressure elevation in a non-obese Korean population.

    PubMed

    Chun, Yoon Hong; Han, Kyungdo; Park, Shin Hae; Park, Kyung-Min; Yim, Hyeon Woo; Lee, Won-Chul; Park, Yong Gyu; Park, Yong-Moon

    2015-01-01

    Based on reports of an association between elevated intraocular pressure (IOP) and metabolic syndrome (MetS), and the major role of insulin resistance (IR) in MetS pathogenesis, a positive association between IOP and IR has been hypothesized. Although Asian populations tend to have lower body mass indices (BMIs) than Western populations, they tend to have a higher risk of developing MetS. This study examined the hypothesis that the association between IOP and IR differs by obesity status in an Asian population, by examining a nationally representative sample of South Korean adults. Data collected from 4,621 South Korean adults regarding demographic, lifestyle, and laboratory parameters by the 2010 Korea National Health and Nutrition Examination Survey were subjected to linear regression analysis to evaluate the relationship between IOP and metabolic profiles. After adjusting for confounding factors, the data were subjected to multiple linear regression analysis to examine the association between IR, as measured by the homeostasis model assessment of insulin resistance (HOMA-IR), and IOP. Obesity was defined as BMI≥27.5 kg/m2, and the subjects were divided into obese vs. non-obese groups for investigation of the association between IR and IOP according to obesity status. IOP was found to correlate with fasting blood sugar, total cholesterol, insulin, and HOMA-IR values in non-obese men; and with BMI, waist circumference, triglycerides, total cholesterol, HOMA-IR, and low-density lipoprotein cholesterol values in non-obese women, whereas no association between IOP and IR was found in obese men or women. IOP was significantly associated with IR in non-obese men and women after adjusting for age, and in non-obese men after adjusting for age, BMI, and lifestyle and demographic factors. These findings indicate that a positive and independent relationship exists between IOP and IR in non-obese individuals only, suggesting that other factors likely contribute to IOP

  10. Comparative evaluation of intraocular pressure with an air-puff tonometer versus a Goldmann applanation tonometer

    PubMed Central

    Farhood, Qasim K

    2013-01-01

    Purpose Tonometry, or measurement of intraocular pressure (IOP), is one of the most important examination procedures in ophthalmic clinics, and IOP is an important parameter in the diagnosis of glaucoma. Because there are numerous types of tonometer available, it is important to evaluate the differences in readings between different tonometers. Goldmann applanation tonometers (GATs) and noncontact air-puff tonometers (APTs) are largely available in ophthalmic clinics. The purpose of this study was to evaluate the role of AP tonometer by comparing the measurements of IOP made using this device with those made using a GAT. Patients and methods This study involved 196 eyes from 98 study participants, all of whom were patients attending an ophthalmic outpatient clinic. Each patient’s IOP was measured using both Goldmann applanation tonometry and AP tonometry, and the difference in readings between the two methods was calculated. Results The mean IOP as measured by GAT was 13.06 ± 4.774 mmHg, while that as measured by AP tonometer was 15.91 ± 6.955 mmHg. The mean difference between the two methods of measurement was 2.72 ± 2.34 mmHg. The readings obtained by AP tonometer were higher than those obtained by GAT in 74% of patients, and this difference was most obvious when the GAT measurement of IOP exceeded 24 mmHg. No statistically significant variation in IOP was noted between the devices when the patients’ age, sex, and laterality (right and left eyes) were considered. Conclusion There is a significant difference in the measurement of IOP between GATs and AP tonometers. Goldmann applanation tonometry remains the most suitable and reliable method for measuring IOP. Because measurements of IOP by AP tonometer are usually higher than those obtained by GAT regardless of the patient’s age, sex, or laterality of eyes, AP tonometry is a suitable method for community or mass screenings of IOP. PMID:23293511

  11. Does Rebound Tonometry Probe Misalignment Modify Intraocular Pressure Measurements in Human Eyes?

    PubMed Central

    Beasley, Ian G.; Laughton, Deborah S.; Coldrick, Benjamin J.; Drew, Thomas E.; Sallah, Marium; Davies, Leon N.

    2013-01-01

    Purpose. To examine the influence of positional misalignments on intraocular pressure (IOP) measurement with a rebound tonometer. Methods. Using the iCare rebound tonometer, IOP readings were taken from the right eye of 36 healthy subjects at the central corneal apex (CC) and compared to IOP measures using the Goldmann applanation tonometer (GAT). Using a bespoke rig, iCare IOP readings were also taken 2 mm laterally from CC, both nasally and temporally, along with angular deviations of 5 and 10 degrees, both nasally and temporally to the visual axis. Results. Mean IOP ± SD, as measured by GAT, was 14.7 ± 2.5 mmHg versus iCare tonometer readings of 17.4 ± 3.6 mmHg at CC, representing an iCare IOP overestimation of 2.7 ± 2.8 mmHg (P < 0.001), which increased at higher average IOPs. IOP at CC using the iCare tonometer was not significantly different to values at lateral displacements. IOP was marginally underestimated with angular deviation of the probe but only reaching significance at 10 degrees nasally. Conclusions. As shown previously, the iCare tonometer overestimates IOP compared to GAT. However, IOP measurement in normal, healthy subjects using the iCare rebound tonometer appears insensitive to misalignments. An IOP underestimation of <1 mmHg with the probe deviated 10 degrees nasally reached statistical but not clinical significance levels. PMID:24073330

  12. The effect of dorzolamide 2% on circadian intraocular pressure in cats with primary congenital glaucoma

    PubMed Central

    Sigle, Kelly J; Camaño-Garcia, Gabriel; Carriquiry, Alicia L; Betts, Daniel M; Kuehn, Markus H; McLellan, Gillian J

    2012-01-01

    Objective To determine the extent of fluctuation in circadian intraocular pressure (IOP) and the efficacy of topical dorzolamide 2% q 8h in lowering IOP and blunting circadian fluctuation in IOP in glaucomatous cats. Animals Studied 7 adult cats with primary congenital glaucoma (PCG). Procedures Measurements of IOP and pupil diameter were obtained for both eyes (OU) of each cat q 4h for 12 days. Cats were housed in a laboratory animal facility with a 12 hour light:dark cycle. Baseline values were established for 2 days. For the next 5 days, placebo (1.4% polyvinyl alcohol) was administered OU q 8h. Dorzolamide 2% (Trusopt, Merck and Co., Inc., West Point, PA) was then administered OU q 8h for a further 5 days. A multivariate mixed linear model was fitted to the data, with parameters estimated from a Bayesian perspective. The 4am time point was selected as the reference for the purposes of comparisons. Results Estimated mean IOP for the reference time point pre-treatment was symmetric (about 33mmHg OU). In all cats, IOP was significantly lower during the diurnal phase, relative to the 4 am measurements, with highest IOP observed 2-6h after the onset of the dark-phase. Circadian fluctuations in IOP were dampened during the treatment period. There was a significant decrease in IOP in all cats during the dorzolamide treatment period (estimated mean for the treatment period reference =17.9 mmHg OU). Conclusion Topical dorzolamide 2% q 8 h is effective in reducing IOP and IOP fluctuation in cats with PCG. PMID:21923823

  13. Intraocular pressure changes related to intravitreal injections of ranibizumab: analysis of pseudophakia and glaucoma subgroup.

    PubMed

    Demirel, Sibel; Yanik, Ozge; Batioglu, Figen; Ozmert, Emin

    2015-08-01

    The purpose of this study was to determine intraocular pressure (IOP) changes following intravitreal ranibizumab injections and to investigate the effect of pre-existing glaucoma and pseudophakia. Two hundred and two eyes of 175 patients who received repeated intravitreal ranibizumab injections were included in this study. IOP measurements were obtained at both 30 min and 24 h after each injection. IOP changes after the first, third, sixth, ninth, and twelfth injections were analyzed. Data gotten from subgroups with pre-existing glaucoma and pseudophakia were also analyzed. The mean number of injections was 4.81 ± 2.7 (range: 3-18), while the mean IOP prior to the first intravitreal ranibizumab injection was 15.11 ± 2.8 (9-25) mmHg. At the last visit, IOP was 14.66 ± 2.8 (9-22) mmHg. There was no cumulative increase in IOP at either 30 min or 24 h values throughout repeated injections. Pseudophakic patients had significantly lower mean IOP values at 30 min after all injections except for twelfth. The number of eyes with an IOP higher than 21 mm Hg and the mean IOP values were significantly higher in patients with pre-existing glaucoma at 30 min after the first and third injections. Pseudophakic eyes are less prone to immediate IOP spikes than phakic eyes. Pre-existing glaucoma may be a potential risk factor for uncontrolled IOP spikes immediately after intravitreal injection; nonetheless, this effect is usually transient and does not cause long-term problems. Also, ranibizumab injections can be administered safely under close monitoring. PMID:25079762

  14. Short-term intraocular pressure changes after intravitreal injection of bevacizumab in diabetic retinopathy patients

    PubMed Central

    Farhood, Qasim Kadhim; Twfeeq, Sinan Mohammad

    2014-01-01

    Background This study examined the changes in short-term intraocular pressure (IOP) in a prospective series of patients undergoing intravitreal bevacizumab injection. The aim was to evaluate the frequency and predictive factors related to intraocular pressure (IOP) elevation in patients receiving intravitreal bevacizumab. Patients and methods This study included 52 patients with diabetic retinopathy between 28 to 75 years of age with a mean age of 51 years; 30 (58%) were females, and 22 (42%) were males. All patients received bevacizumab (1.25 mg/0.05 mL) injected intravitreally in a standard fashion between May 2012 to February 2013 in the AL-Jumhoury teaching hospital. IOP was measured at baseline, 5, 10, and 30 minutes after injection using Goldman applanation tonometry. Statistics Data were analyzed using the SPSS v.12.0 for windows. Basic, demographic, and clinical data were analyzed using means, proportions, and appropriate 95% confidence intervals (CIs). Results Most patients (85%) were diagnosed with proliferative diabetic retinopathy, while 15% presented with diabetic macular edema. The mean IOP values at baseline, 5, 10, and 30 minutes after injection were 14.0 mmHg (95% CI 13.4–14.7), 36.1 mmHg (95% CI 33.5–38.6), 25.7 mmHg (95% CI 23.8–27.5), and 15.5 mmHg (95% CI 12.4–16.51), respectively. Regression analysis showed a trend toward phakic patients having higher IOP at 30 minutes. Conclusion Intravitreal injection of bevacizumab is safe with respect to short-term IOP changes, as almost all IOP returned to a safe range (<25 mmHg) within 30 minutes. Elevated IOP 30 minutes after injection only occurs rarely, so routine prophylactic use of anti-glaucoma medication is not indicated. PMID:24707164

  15. Short-Term Reproducibility of Twenty-Four-Hour Intraocular Pressure Curves in Untreated Patients with Primary Open-Angle Glaucoma and Ocular Hypertension

    PubMed Central

    Xu, Shuo; Jiao, Qin; Cheng, Yu; Sun, Jie; Lu, Qiong; Zhong, Yisheng

    2015-01-01

    Purpose To assess the short-term day-to-day reproducibility of 24-hour intraocular pressure (IOP) curves in various respects in untreated primary open-angle glaucoma (POAG) and ocular hypertension (OHT) patients. Methods 47 subjects with POAG and 34 subjects with OHT underwent IOP measurements every 2 hours in both eyes for consecutive 48 hours by a non-contact tonometer (NCT). IOP values at each time point were recorded. Mean IOP, peak IOP, time difference of peak IOP between two days and IOP fluctuation were also calculated. Intraclass correlation coefficients (ICCs) and Bland-Altman plots were used to evaluate reproducibility. Results ICCs of the entire IOP values for a complete 24-hour curve were 0.577 and 0.561 in POAG and OHT patients, respectively. ICCs of IOP values at different time points ranged from 0.384 (10am) to 0.686 (4am) in POAG patients and from 0.347 (6am) to 0.760 (4am) in OHT patients. ICCs of mean IOP, peak IOP and IOP fluctuation were respectively 0.832, 0.704, 0.367 in POAG patients and 0.867, 0.816 0.633 in OHT patients. Only 37.23% and 35.29% of the peak IOP time points appeared within the time difference of 2 hours in POAG and OHT patients, respectively, while 53.19% and 48.53% appeared within 4 hours in POAG and OHT patients, respectively. Conclusion A 24-hour IOP curve in a single day is not highly reproducible in short-term and has limited use for evaluating individual IOP condition. Mean IOP and peak IOP for a 24-hour IOP curve are useful parameters in clinical follow-up, while IOP value at a certain time point, IOP fluctuation and peak IOP time point should be interpreted with caution. PMID:26466325

  16. Real-time intraocular pressure measurement during phacoemulsification in dogs ex vivo

    PubMed Central

    KANG, Seonmi; PARK, Sangwan; NOH, Hyunwoo; KWAK, Jiyoon; SEO, Kangmoon

    2015-01-01

    This study was performed to evaluate changes in intraocular pressure (IOP) during standard coaxial phacoemulsification using 4 different bottle heights (BHs) and 2 different incision sizes. Coaxial phacoemulsification was performed with a venturi-based machine in 8 enucleated canine eyes through 3.0 and 3.2 mm clear corneal incisions (CCIs). A pressure transducer inserted in the peripheral cornea monitored the IOP in real-time. The surgery was subdivided into 4 stages: sculpt-segment removal, irrigation/aspiration, capsular polishing and viscoelastic removal. The mean IOP and the difference between the maximum and minimum IOPs were calculated at each stage and compared. The ultrasound time and volume of irrigation fluid used were recorded. The mean IOP increased with an elevation in the BH. The mean IOP in the irrigation/aspiration stage was significantly higher than that in the sculpt-segment removal stage at the same BH. The difference between the maximum and minimum IOP at each stage was greater in the 3.2 mm than the 3.0 mm CCIs, although the mean IOP was lower with the 3.2 mm than the 3.0 mm CCIs. The ultrasound time and irrigation fluid volume were greater with the 3.2 mm than the 3.0 mm CCIs. Therefore, fluidic parameters during each stage could be reassessed and adjusted to reduce complications arising from an elevated IOP. Phacoemulsification with 3.0 mm CCIs at a lower BH might lead to less stress on the eye from IOP fluctuations, ultrasound energy and irrigation fluid. PMID:25716691

  17. Lens Position Parameters as Predictors of Intraocular Pressure Reduction After Cataract Surgery in Nonglaucomatous Patients With Open Angles

    PubMed Central

    Hsu, Chi-Hsin; Kakigi, Caitlin L.; Lin, Shuai-Chun; Wang, Yuan-Hung; Porco, Travis; Lin, Shan C.

    2015-01-01

    Purpose To evaluate the relationship between lens position parameters and intraocular pressure (IOP) reduction after cataract surgery in nonglaucomatous eyes with open angles. Methods The main outcome of the prospective study was percentage of IOP change, which was calculated using the preoperative IOP and the IOP 4 months after cataract surgery in nonglaucomatous eyes with open angles. Lens position (LP), defined as anterior chamber depth (ACD) + 1/2 lens thickness (LT), was assessed preoperatively using parameters from optical biometry. Preoperative IOP, central corneal thickness, ACD, LT, axial length (AXL), and the ratio of preoperative IOP to ACD (PD ratio) were also evaluated as potential predictors of percentage of IOP change. The predictive values of the parameters we found to be associated with the primary outcome were compared. Results Four months after cataract surgery, the average IOP reduction was 2.03 ± 2.42 mm Hg, a 12.74% reduction from the preoperative mean of 14.5 ± 3.05 mm Hg. Lens position was correlated with IOP reduction percentage after adjusting for confounders (P = 0.002). Higher preoperative IOP, shallower ACD, shorter AXL, and thicker LT were significantly associated with percentage of IOP decrease. Although not statistically significant, LP was a better predictor of percentage of IOP change compared to PD ratio, preoperative IOP, and ACD. Conclusions The percentage of IOP reduction after cataract surgery in nonglaucomatous eyes with open angles is greater in more anteriorly positioned lenses. Lens position, which is convenient to compute by basic ocular biometric data, is an accessible predictor with considerable predictive value for postoperative IOP change. PMID:26650901

  18. Infant Botulism and Raised Intraocular Pressure.

    PubMed

    Eberly, Matthew D; Uber, Ian; Kieling, Christopher R; Birdsong, Richard H

    2009-11-01

    Infant botulism is an exceedingly rare disease. Because confirmatory laboratory testing is not available for several days after time of presentation, infant botulism remains a clinical diagnosis. The authors demonstrate how raised intraocular pressure may provide an additional clinical clue to making the diagnosis. PMID:19873952

  19. 21 CFR 886.4280 - Intraocular pressure measuring device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Intraocular pressure measuring device. 886.4280... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4280 Intraocular pressure measuring device. (a) Identification. An intraocular pressure measuring device is a manual or AC-powered...

  20. 21 CFR 886.4280 - Intraocular pressure measuring device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Intraocular pressure measuring device. 886.4280... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4280 Intraocular pressure measuring device. (a) Identification. An intraocular pressure measuring device is a manual or AC-powered...

  1. 21 CFR 886.4280 - Intraocular pressure measuring device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Intraocular pressure measuring device. 886.4280... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4280 Intraocular pressure measuring device. (a) Identification. An intraocular pressure measuring device is a manual or AC-powered...

  2. 21 CFR 886.4280 - Intraocular pressure measuring device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Intraocular pressure measuring device. 886.4280... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4280 Intraocular pressure measuring device. (a) Identification. An intraocular pressure measuring device is a manual or AC-powered...

  3. Lowered intraocular pressure in a glaucoma patient after intravitreal injection of ocriplasmin

    PubMed Central

    McClintock, Michael; MacCumber, Mathew W

    2015-01-01

    We report the case of a glaucoma patient who received a single intravitreal injection of 125 µg ocriplasmin for vitreomacular traction in the right eye. The patient had bilateral advanced glaucoma and had previously undergone an implantation of an Ahmed glaucoma valve in the right eye and trabeculectomy in both eyes. The patient was using three topical ophthalmic intraocular pressure (IOP)-lowering medications on the day of injection. Baseline uncorrected Snellen visual acuity was 20/80-1 and IOP was 19 mmHg. Resolution of vitreomacular traction was achieved 1 week after injection. IOP was transiently decreased, reaching a maximum reduction of 12 mmHg below baseline at 1 month after injection, when serous choroidal effusion was also present. IOP returned to baseline levels and choroidal effusion resolved at 2 months after injection of IOP-lowering medication. Vitrectomy with epiretinal membrane and internal limiting membrane peeling, endolaser photocoagulation, and fluid–gas exchange were performed in the right eye ~3.5 months after injection to treat persistent epiretinal membrane, and presumed tractional retinal detachment. Final visual acuity was 20/50+ and IOP was 18 mmHg at 16 weeks after surgery. To our knowledge, this is the first report of IOP reduction and serous choroidal effusion after ocriplasmin injection. PMID:26604668

  4. Nucleoside-derived antagonists to A3 adenosine receptors lower mouse intraocular pressure and act across species.

    PubMed

    Wang, Zhao; Do, Chi Wai; Avila, Marcel Y; Peterson-Yantorno, Kim; Stone, Richard A; Gao, Zhan-Guo; Joshi, Bhalchandra; Besada, Pedro; Jeong, Lak Shin; Jacobson, Kenneth A; Civan, Mortimer M

    2010-01-01

    The purpose of the study was to determine whether novel, selective antagonists of human A3 adenosine receptors (ARs) derived from the A3-selective agonist Cl-IB-MECA lower intraocular pressure (IOP) and act across species. IOP was measured invasively with a micropipette by the Servo-Null Micropipette System (SNMS) and by non-invasive pneumotonometry during topical drug application. Antagonist efficacy was also assayed by measuring inhibition of adenosine-triggered shrinkage of native bovine nonpigmented ciliary epithelial (NPE) cells. Five agonist-based A3AR antagonists lowered mouse IOP measured with SNMS tonometry by 3-5 mm Hg within minutes of topical application. Of the five agonist derivatives, LJ 1251 was the only antagonist to lower IOP measured by pneumotonometry. No effect was detected pneumotonometrically over 30 min following application of the other four compounds, consonant with slower, smaller responses previously measured non-invasively following topical application of A3AR agonists and the dihydropyridine A3AR antagonist MRS 1191. Latanoprost similarly lowered SNMS-measured IOP, but not IOP measured non-invasively over 30 min. Like MRS 1191, agonist-based A3AR antagonists applied to native bovine NPE cells inhibited adenosine-triggered shrinkage. In summary, the results indicate that antagonists of human A3ARs derived from the potent, selective A3 agonist Cl-IB-MECA display efficacy in mouse and bovine cells, as well. When intraocular delivery was enhanced by measuring mouse IOP invasively, five derivatives of the A3AR agonist Cl-IB-MECA lowered IOP but only one rapidly reduced IOP measured non-invasively after topical application. We conclude that derivatives of the highly-selective A3AR agonist Cl-IB-MECA can reduce IOP upon reaching their intraocular target, and that nucleoside-based derivatives are promising A3 antagonists for study in multiple animal models. PMID:19878673

  5. Nucleoside-Derived Antagonists to A3 Adenosine Receptors Lower Mouse Intraocular Pressure and Act across Species

    PubMed Central

    Wang, Zhao; Do, Chi Wai; Avila, Marcel Y.; Peterson-Yantorno, Kim; Stone, Richard A.; Gao, Zhan-Guo; Joshi, Bhalchandra; Besada, Pedro; Jeong, Lak Shin; Jacobson, Kenneth A.; Civan, Mortimer M.

    2009-01-01

    The purpose of the study was to determine whether novel, selective antagonists of human A3 adenosine receptors (ARs) derived from the A3-selective agonist Cl-IB-MECA lower intraocular pressure (IOP) and act across species. IOP was measured invasively with a micropipette by the Servo-Null Micropipette System (SNMS) and by non-invasive pneumotonometry during topical drug application. Antagonist efficacy was also assayed by measuring inhibition of adenosine-triggered shrinkage of native bovine nonpigmented ciliary epithelial (NPE) cells. Five agonist-based A3AR antagonists lowered mouse IOP measured with SNMS tonometry by 3–5 mm Hg within minutes of topical application. Of the five agonist derivatives, LJ 1251 was the only antagonist to lower IOP measured by pneumotonometry. No effect was detected pneumotonometrically over 30 min following application of the other four compounds, consonant with slower, smaller responses previously measured non-invasively following topical application of A3AR agonists and the dihydropyridine A3AR antagonist MRS 1191. Latanoprost similarly lowered SNMS-measured IOP, but not IOP measured non-invasively over 30 minutes. Like MRS 1191, agonist-based A3AR antagonists applied to native bovine NPE cells inhibited adenosine-triggered shrinkage. In summary, the results indicate that antagonists of human A3ARs derived from the potent, selective A3 agonist Cl-IB-MECA display efficacy in mouse and bovine cells, as well. When intraocular delivery was enhanced by measuring mouse IOP invasively, five derivatives of the A3AR agonist Cl-IB-MECA lowered IOP but only one rapidly reduced IOP measured non-invasively after topical application. We conclude that derivatives of the highly selective A3AR agonist Cl-IB-MECA can reduce IOP upon reaching their intraocular target, and that nucleoside-based derivatives are promising A3 antagonists for study in multiple animal models. PMID:19878673

  6. Intraocular pressure dynamics with prostaglandin analogs: a clinical application of the water-drinking test

    PubMed Central

    Özyol, Pelin; Özyol, Erhan; Baldemir, Ercan

    2016-01-01

    Aim To evaluate the clinical applicability of the water-drinking test in treatment-naive primary open-angle glaucoma patients. Methods Twenty newly diagnosed primary open-angle glaucoma patients and 20 healthy controls were enrolled in this prospective study. The water-drinking test was performed at baseline and 6 weeks and 3 months after prostaglandin analog treatment. Peak and fluctuation of intraocular pressure (IOP) measurements obtained with the water-drinking test during follow-up were analyzed. Analysis of variance for repeated measures and paired and unpaired t-tests were used for statistical analysis. Results The mean baseline IOP values in patients with primary open-angle glaucoma were 25.1±4.6 mmHg before prostaglandin analog treatment, 19.8±3.7 mmHg at week 6, and 17.9±2.2 mmHg at month 3 after treatment. The difference in mean baseline IOP of the water-drinking tests was statistically significant (P<0.001). At 6 weeks of prostaglandin analog treatment, two patients had high peak and fluctuation of IOP measurements despite a reduction in baseline IOP. After modifying treatment, patients had lower peak and fluctuation of IOP values at month 3 of the study. Conclusion Peak and fluctuation of IOP in response to the water-drinking test were lower with prostaglandin analogs compared with before medication. The water-drinking test can represent an additional benefit in the management of glaucoma patients, especially by detecting higher peak and fluctuation of IOP values despite a reduced mean IOP. Therefore, it could be helpful as a supplementary method in monitoring IOP in the clinical practice. PMID:27555742

  7. A Longitudinal Study of Association between Adiposity Markers and Intraocular Pressure: The Kangbuk Samsung Health Study

    PubMed Central

    Zhao, Di; Kim, Myung Hun; Pastor-Barriuso, Roberto; Chang, Yoosoo; Ryu, Seungho; Zhang, Yiyi; Rampal, Sanjay; Shin, Hocheol; Kim, Joon Mo; Friedman, David S.; Guallar, Eliseo; Cho, Juhee

    2016-01-01

    Importance Intraocular pressure (IOP) reduction or stabilization is the only proven method for glaucoma management. Identifying risk factors for IOP is crucial to understand the pathophysiology of glaucoma. Objective To examine the associations of change in body mass index (BMI), waist circumference, and percent fat mass with change in intraocular pressure (IOP) in a large sample of Korean adults. Design, setting and participants Cohort study of 274,064 young and middle age Korean adults with normal fundoscopic findings who attended annual or biennial health exams from January 1, 2002 to Feb 28, 2010 (577,981 screening visits). Exposures BMI, waist circumference, and percent fat mass. Main Outcome Measure(s) At each visit, IOP was measured in both eyes with automated noncontact tonometers. Results In multivariable-adjusted models, the average increase in IOP (95% confidence intervals) over time per interquartile increase in BMI (1.26 kg/m2), waist circumference (6.20 cm), and percent fat mass (3.40%) were 0.18 mmHg (0.17 to 0.19), 0.27 mmHg (0.26 to 0.29), and 0.10 mmHg (0.09 to 0.11), respectively (all P < 0.001). The association was stronger in men compared to women (P < 0.001) and it was only slightly attenuated after including diabetes and hypertension as potential mediators in the model. Conclusions and Relevance Increases in adiposity were significantly associated with an increase in IOP in a large cohort of Korean adults attending health screening visits, an association that was stronger for central obesity. Further research is needed to understand better the underlying mechanisms of this association, and to establish the role of weight gain in increasing IOP and the risk of glaucoma and its complications. PMID:26731527

  8. Detecting IOP Fluctuations in Glaucoma Patients

    PubMed Central

    Nuyen, Brenda; Mansouri, Kaweh

    2016-01-01

    Lowering intraocular pressure (IOP) remains the guiding principle of glaucoma management. Although IOP is the only treatable risk factor, its 24-hour behavior is poorly understood. Current glaucoma management usually relies on single IOP measurements during clinic hours, even though IOP is a dynamic parameter with rhythms dependent on individual patients. It has further been shown that most glaucoma patients have their highest IOP measurements outside clinic hours. The fact that these IOP peaks go largely undetected may explain why certain patients progress in their disease despite treatment. Nevertheless, single IOP measurements have determined all major clinical guidelines regarding glaucoma treatment. Other potentially informative parameters, such as fluctuations in IOP and peak IOP, have been neglected, and effects of IOP-lowering interventions on such measures are largely unknown. Continuous 24-hour IOP monitoring has been an interest for more than 50 years, but only recent technological advances have provided clinicians with a device for such an endeavor. This review discusses current uses and shortcomings of current measurement techniques, and provides an overview on current and future methods for 24-hour IOP assessment. It may be possible to incorporate continuous IOP monitoring into clinical practice, potentially to reduce glaucoma-related vision loss. PMID:27014387

  9. Detecting IOP Fluctuations in Glaucoma Patients.

    PubMed

    Nuyen, Brenda; Mansouri, Kaweh

    2016-01-01

    Lowering intraocular pressure (IOP) remains the guiding principle of glaucoma management. Although IOP is the only treatable risk factor, its 24-hour behavior is poorly understood. Current glaucoma management usually relies on single IOP measurements during clinic hours, even though IOP is a dynamic parameter with rhythms dependent on individual patients. It has further been shown that most glaucoma patients have their highest IOP measurements outside clinic hours. The fact that these IOP peaks go largely undetected may explain why certain patients progress in their disease despite treatment. Nevertheless, single IOP measurements have determined all major clinical guidelines regarding glaucoma treatment. Other potentially informative parameters, such as fluctuations in IOP and peak IOP, have been neglected, and effects of IOP-lowering interventions on such measures are largely unknown. Continuous 24-hour IOP monitoring has been an interest for more than 50 years, but only recent technological advances have provided clinicians with a device for such an endeavor. This review discusses current uses and shortcomings of current measurement techniques, and provides an overview on current and future methods for 24-hour IOP assessment. It may be possible to incorporate continuous IOP monitoring into clinical practice, potentially to reduce glaucoma-related vision loss. PMID:27014387

  10. The influence of intraocular pressure and air jet pressure on corneal contactless tonometry tests.

    PubMed

    Simonini, Irene; Pandolfi, Anna

    2016-05-01

    The air puff is a dynamic contactless tonometer test used in ophthalmology clinical practice to assess the biomechanical properties of the human cornea and the intraocular pressure due to the filling fluids of the eye. The test is controversial, since the dynamic response of the cornea is governed by the interaction of several factors which cannot be discerned within a single measurement. In this study we describe a numerical model of the air puff tests, and perform a parametric analysis on the major action parameters (jet pressure and intraocular pressure) to assess their relevance on the mechanical response of a patient-specific cornea. The particular cornea considered here has been treated with laser reprofiling to correct myopia, and the parametric study has been conducted on both the preoperative and postoperative geometries. The material properties of the cornea have been obtained by means of an identification procedure that compares the static biomechanical response of preoperative and postoperative corneas under the physiological IOP. The parametric study on the intraocular pressure suggests that the displacement of the cornea׳s apex can be a reliable indicator for tonometry, and the one on the air jet pressure predicts the outcomes of two or more distinct measurements on the same cornea, which can be used in inverse procedures to estimate the material properties of the tissue. PMID:26282384

  11. Driving time modulates accommodative response and intraocular pressure.

    PubMed

    Vera, Jesús; Diaz-Piedra, Carolina; Jiménez, Raimundo; Morales, José M; Catena, Andrés; Cardenas, David; Di Stasi, Leandro L

    2016-10-01

    Driving is a task mainly reliant on the visual system. Most of the time, while driving, our eyes are constantly focusing and refocusing between the road and the dashboard or near and far traffic. Thus, prolonged driving time should produce visual fatigue. Here, for the first time, we investigated the effects of driving time, a common inducer of driver fatigue, on two ocular parameters: the accommodative response (AR) and the intraocular pressure (IOP). A pre/post-test design has been used to assess the impact of driving time on both indices. Twelve participants (out of 17 recruited) completed the study (5 women, 24.42±2.84years old). The participants were healthy and active drivers with no visual impairment or pathology. They drove for 2h in a virtual driving environment. We assessed AR and IOP before and after the driving session, and also collected subjective measures of arousal and fatigue. We found that IOP and AR decreased (i.e., the accommodative lag increased) after the driving session (p=0.03 and p<0.001, respectively). Moreover, the nearest distances tested (20cm, 25cm, and 33cm) induced the highest decreases in AR (corrected p-values<0.05). Consistent with these findings, the subjective levels of arousal decreased and levels of fatigue increased after the driving session (all p-values<0.001). These results represent an innovative step towards an objective, valid, and reliable assessment of fatigue-impaired driving based on visual fatigue signs. PMID:27235337

  12. The Effect of Swimming Goggles on Intraocular Pressure and Blood Flow within the Optic Nerve Head

    PubMed Central

    Ma, Kyoung Tak; Chung, Woo Suk; Seo, Kyoung Yul; Seong, Gong Je

    2007-01-01

    Purpose Goggles are frequently worn in the sport of swimming and are designed to form a seal around the periorbital tissue orbit. The resultant pressure on the eye may have the potential to affect intraocular pressure and blood flow of the optic nerve head. This study evaluates the influence of wearing swimming goggles on intraocular pressure (IOP) and blood flow of the ocular nerve head (ONH) in normal subjects. Materials and Methods Thirty healthy participants took part in this study. The IOP of each participant was measured using a Goldmann tonometer. Measurements were taken immediately before putting on swimming goggles, at 5, 10, 30, and 60 minutes after putting on swimming goggles, and then immediately after taking off the goggles. Blood flow of the ONH was measured using the Heidelberg retinal flowmeter. Results The average IOP before, during and after wearing the swimming goggles were 11.88 ± 2.82 mmHg, 14.20 ± 2.81mmHg and 11.78 ± 2.89 mmHg, respectively. The IOP increased immediately after putting on the goggles (p < 0.05) and then returned to normal values immediately after removal (p > 0.05). Blood flow of the ONH was 336.60 ± 89.07 Arbitrary Units (AU) before and 319.18 ± 96.02 AU after the goggles were worn (p < 0.05). Conclusion A small but significant IOP elevation was observed immediately after the swimming goggles were put on. This elevated IOP was maintained while the goggles were kept on, and then returned to normal levels as soon as they were taken off. Blood flow of the ONH did not change significantly throughout the experiment. These facts should be considered for safety concerns, especially in advanced glaucoma patients. PMID:17963338

  13. Intraocular Pressure, Blood Pressure, and Retinal Blood Flow Autoregulation: A Mathematical Model to Clarify Their Relationship and Clinical Relevance

    PubMed Central

    Guidoboni, Giovanna; Harris, Alon; Cassani, Simone; Arciero, Julia; Siesky, Brent; Amireskandari, Annahita; Tobe, Leslie; Egan, Patrick; Januleviciene, Ingrida; Park, Joshua

    2014-01-01

    Purpose. This study investigates the relationship between intraocular pressure (IOP) and retinal hemodynamics and predicts how arterial blood pressure (BP) and blood flow autoregulation (AR) influence this relationship. Methods. A mathematical model is developed to simulate blood flow in the central retinal vessels and retinal microvasculature as current flowing through a network of resistances and capacitances. Variable resistances describe active and passive diameter changes due to AR and IOP. The model is validated by using clinically measured values of retinal blood flow and velocity. The model simulations for six theoretical patients with high, normal, and low BP (HBP-, NBP-, LBP-) and functional or absent AR (-wAR, -woAR) are compared with clinical data. Results. The model predicts that NBPwAR and HBPwAR patients can regulate retinal blood flow (RBF) as IOP varies between 15 and 23 mm Hg and between 23 and 29 mm Hg, respectively, whereas LBPwAR patients do not adequately regulate blood flow if IOP is 15 mm Hg or higher. Hemodynamic alterations would be noticeable only if IOP changes occur outside of the regulating range, which, most importantly, depend on BP. The model predictions are consistent with clinical data for IOP reduction via surgery and medications and for cases of induced IOP elevation. Conclusions. The theoretical model results suggest that the ability of IOP to induce noticeable changes in retinal hemodynamics depends on the levels of BP and AR of the individual. These predictions might help to explain the inconsistencies found in the clinical literature concerning the relationship between IOP and retinal hemodynamics. PMID:24876284

  14. ATP-Sensitive Potassium (KATP) Channel Openers Diazoxide and Nicorandil Lower Intraocular Pressure In Vivo

    PubMed Central

    Chowdhury, Uttio Roy; Holman, Bradley H.; Fautsch, Michael P.

    2013-01-01

    Purpose. To evaluate the expression of ATP-sensitive potassium (KATP) channel subunits and study the effect of KATP channel openers diazoxide and nicorandil on intraocular pressure (IOP) in an in vivo mouse model. Methods. Expression of KATP channel subunits in normal C57BL/6 mouse eyes was studied by immunohistochemistry and confocal microscopy. Wild-type C57BL/6 mice were treated with KATP channel openers diazoxide (n = 10) and nicorandil (n = 10) for 14 days. Similar treatments with diazoxide were performed on Kir6.2(−/−) mice (n = 10). IOP was recorded with a handheld tonometer 1 hour, 4 hours, and 23 hours following daily treatment. Posttreatment histology was examined by light and transmission electron microscopy. Results. The KATP channel subunits SUR2B, Kir6.1, and Kir6.2 were identified in all tissues within mouse eyes. Treatment with diazoxide in wild-type mice decreased IOP by 21.5 ± 3.2% with an absolute IOP reduction of 3.9 ± 0.6 mm Hg (P = 0.002). Nicorandil also decreased IOP (18.9 ± 1.8%) with an absolute IOP reduction of 3.4 ± 0.4 mm Hg (P = 0.002). Treatment with diazoxide in Kir6.2(−/−) mice had no effect on IOP. No morphological abnormalities were observed in diazoxide- or nicorandil-treated eyes. Conclusions. KATP channel openers diazoxide and nicorandil are effective regulators of IOP in mouse eyes. Kir6.2 appears to be a major KATP channel subunit through which IOP is lowered following treatment with diazoxide. PMID:23778875

  15. Diclofenac prevents temporal increase of intraocular pressure after uneventful cataract surgery with longer operation time

    PubMed Central

    Shimura, Masahiko; Nakazawa, Toru; Yasuda, Kanako; Shiono, Takashi; Nishida, Kohji

    2009-01-01

    Purpose: This study compares the effect of topical diclofenac with that of betamethasone against postoperative increase of intraocular pressure (IOP) after cataract surgery in normal patients, and also investigated the risk factors for postoperative increase of IOP in each group. Methods: Fifty consecutive patients without systemic disease who have bilateral and symmetrical cataracts underwent uncomplicated cataract surgery in both eyes (100 eyes in total). Postoperatively, topical diclofenac was applied 4 times daily to one eye, and topical betamethasone to the other eye in each patient. IOP and best corrected logMAR visual acuity (BCVA) in each eye were measured up to 8 weeks. Total surgery time and effective phacoemulsification time (EPT) for each case was recorded. Results: BCVA in both diclofenac- and betamethasone-treated eyes significantly improved after the cataract surgery; however, no statistical difference in VA was noted between the diclofenac- and betamethasone-treated eyes throughout the observation period. IOP in the diclofenac-treated eyes decreased with time, in contrast to the IOP in the betamethasone-treated eyes, which showed a slight increase. At 4 and 8 weeks postoperatively, there was significant difference between these two eye groups. Multiple regression analysis revealed that postoperative increase in IOP at 8 weeks in the betamethasone-treated eyes was closely correlated with total surgery time and EPT, but the IOP in the diclofenac-treated eyes showed no correlation with any surgical or clinical parameters. Conclusions: Postoperative increase in IOP after cataract surgery was affected by total surgery time and EPT in the betamethasone-treated eye. The time for surgery and EPT is longer in complicated cases including patients with a hard nucleus or small pupils, and also longer for beginning surgeons and in older patients. In these cases, diclofenac in place of betamethasone as a postoperative topical antiinflammatory drug is recommended

  16. Elevated Intraocular Pressure after Descemet Stripping Automated Endothelial Keratoplasty in Patients with a Trabeculectomy: A Case Series

    PubMed Central

    Chan, Elsie; Ang, Ghee Soon; George Kong, Yu Xiang

    2015-01-01

    ABSTRACT We report a case series of three patients with previous trabeculectomies who developed elevated intraocular pressure (IOP) in the immediate postoperative period after routine Descemet stripping automated endothelial keratoplasty (DSAEK). All patients had functioning trabeculectomies preoperatively, and developed elevated IOP between 41 and 69 mm Hg within 24 hours following DSAEK surgery. The IOP was successfully controlled in all patients with topical IOP-lowering medications and oral acetazolamide, with the addition of ocular massage and release of aqueous for two patients. Thereafter, all patients maintained well-controlled IOPs. Patients with trabeculectomies should be followed-up closely immediately after DSAEK to monitor for raised IOP. The mechanism for this pressure rise is uncertain, but may involve air in the trabeculectomy sclerostomy or bleb resulting in blockage of aqueous flow. How to cite this article: Sheales MPH, Chan E, Ang GS, Kong YXG. Elevated Intraocular Pressure after Descemet Stripping Automated Endothelial Keratoplasty in Patients with a Trabeculectomy: A Case Series. J Curr Glaucoma Pract 2015;9(3):100-103. PMID:26997845

  17. The Relationship between Corvis ST Tonometry Measured Corneal Parameters and Intraocular Pressure, Corneal Thickness and Corneal Curvature

    PubMed Central

    Asaoka, Ryo; Nakakura, Shunsuke; Tabuchi, Hitoshi; Murata, Hiroshi; Nakao, Yoshitaka; Ihara, Noriko; Rimayanti, Ulfah; Aihara, Makoto; Kiuchi, Yoshiaki

    2015-01-01

    The purpose of the study was to investigate the correlation between Corneal Visualization Scheimpflug Technology (Corvis ST tonometry: CST) parameters and various other ocular parameters, including intraocular pressure (IOP) with Goldmann applanation tonometry. IOP with Goldmann applanation tonometry (IOP-G), central corneal thickness (CCT), axial length (AL), corneal curvature, and CST parameters were measured in 94 eyes of 94 normal subjects. The relationship between ten CST parameters against age, gender, IOP-G, AL, CST-determined CCT and average corneal curvature was investigated using linear modeling. In addition, the relationship between IOP-G versus CST-determined CCT, AL, and other CST parameters was also investigated using linear modeling. Linear modeling showed that the CST measurement ‘A time-1’ is dependent on IOP-G, age, AL, and average corneal curvature; ‘A length-1’ depends on age and average corneal curvature; ‘A velocity-1’ depends on IOP-G and AL; ‘A time-2’ depends on IOP-G, age, and AL; ‘A length-2’ depends on CCT; ‘A velocity-2’ depends on IOP-G, age, AL, CCT, and average corneal curvature; ‘peak distance’ depends on gender; ‘maximum deformation amplitude’ depends on IOP-G, age, and AL. In the optimal model for IOP-G, A time-1, A velocity-1, and highest concavity curvature, but not CCT, were selected as the most important explanatory variables. In conclusion, many CST parameters were not significantly related to CCT, but IOP usually was a significant predictor, suggesting that an adjustment should be made to improve their usefulness for clinical investigations. It was also suggested CST parameters were more influential for IOP-G than CCT and average corneal curvature. PMID:26485129

  18. Association between Urinary Albumin Excretion and Intraocular Pressure in Type 2 Diabetic Patients without Renal Impairment

    PubMed Central

    Choi, Jin A.; Han, Kyungdo; Kwon, Hyuk-Sang

    2014-01-01

    Background To assess the relationship between urinary albumin excretion and intraocular pressure (IOP) in type 2 diabetes patients without renal impairment. Methods We explored the effects of albuminuria on high IOP in 402 non-glaucomatous type 2 diabetes without renal impairment who participated in the 2011 Korean National Health and Nutrition Examination Survey (KNHANES). Multiple logistic regression analysis was used to assess the relationship between log-transformed albumin/creatinine ratio (ACR) tertiles and an IOP of ≥18 mmHg after adjusting for age, gender, hypertension, body mass index, triglycerides, area of residence, and education level. Results Subjects with a high IOP ≥18 mmHg were more likely to be current smokers (P = 0.038), heavy drinkers (P = 0.006), and to have high systolic blood pressure (P = 0.016), triglycerides (P = 0.008), and a higher log-transformed ACR (P = 0.022).In multivariate regression analysis, ACR tertile was associated with the prevalence of high IOP significantly (P = 0.022). The associations between ACR tertiles and high IOP were significant in overweight patients and those with abdominal obesity (P = 0.003 and 0.003, respectively). In contrast, there were no associations in the subgroup of patients who were not overweight and those without abdominal obesity (P = 0.291 and 0.561, respectively). Conclusions Urinary albumin excretion is associated with high IOP in the type 2 diabetes population without renal insufficiency. The effect of the albuminuria on IOP was evident in a subgroup of patients with components of metabolic syndrome. PMID:24788677

  19. System for Rapid, Precise Modulation of Intraocular Pressure, toward Minimally-Invasive In Vivo Measurement of Intracranial Pressure

    PubMed Central

    Stockslager, Max A.; Samuels, Brian C.; Allingham, R. Rand; Klesmith, Zoe A.; Schwaner, Stephen A.; Forest, Craig R.; Ethier, C. Ross

    2016-01-01

    Pathologic changes in intracranial pressure (ICP) are commonly observed in a variety of medical conditions, including traumatic brain injury, stroke, brain tumors, and glaucoma. However, current ICP measurement techniques are invasive, requiring a lumbar puncture or surgical insertion of a cannula into the cerebrospinal fluid (CSF)-filled ventricles of the brain. A potential alternative approach to ICP measurement leverages the unique anatomy of the central retinal vein, which is exposed to both intraocular pressure (IOP) and ICP as it travels inside the eye and through the optic nerve; manipulating IOP while observing changes in the natural pulsations of the central retinal vein could potentially provide an accurate, indirect measure of ICP. As a step toward implementing this technique, we describe the design, fabrication, and characterization of a system that is capable of manipulating IOP in vivo with <0.1 mmHg resolution and settling times less than 2 seconds. In vitro tests were carried out to characterize system performance. Then, as a proof of concept, we used the system to manipulate IOP in tree shrews (Tupaia belangeri) while video of the retinal vessels was recorded and the caliber of a selected vein was quantified. Modulating IOP using our system elicited a rapid change in the appearance of the retinal vein of interest: IOP was lowered from 10 to 3 mmHg, and retinal vein caliber sharply increased as IOP decreased from 7 to 5 mmHg. Another important feature of this technology is its capability to measure ocular compliance and outflow facility in vivo, as demonstrated in tree shrews. Collectively, these proof-of-concept demonstrations support the utility of this system to manipulate IOP for a variety of useful applications in ocular biomechanics, and provide a framework for further study of the mechanisms of retinal venous pulsation. PMID:26771837

  20. System for Rapid, Precise Modulation of Intraocular Pressure, toward Minimally-Invasive In Vivo Measurement of Intracranial Pressure.

    PubMed

    Stockslager, Max A; Samuels, Brian C; Allingham, R Rand; Klesmith, Zoe A; Schwaner, Stephen A; Forest, Craig R; Ethier, C Ross

    2016-01-01

    Pathologic changes in intracranial pressure (ICP) are commonly observed in a variety of medical conditions, including traumatic brain injury, stroke, brain tumors, and glaucoma. However, current ICP measurement techniques are invasive, requiring a lumbar puncture or surgical insertion of a cannula into the cerebrospinal fluid (CSF)-filled ventricles of the brain. A potential alternative approach to ICP measurement leverages the unique anatomy of the central retinal vein, which is exposed to both intraocular pressure (IOP) and ICP as it travels inside the eye and through the optic nerve; manipulating IOP while observing changes in the natural pulsations of the central retinal vein could potentially provide an accurate, indirect measure of ICP. As a step toward implementing this technique, we describe the design, fabrication, and characterization of a system that is capable of manipulating IOP in vivo with <0.1 mmHg resolution and settling times less than 2 seconds. In vitro tests were carried out to characterize system performance. Then, as a proof of concept, we used the system to manipulate IOP in tree shrews (Tupaia belangeri) while video of the retinal vessels was recorded and the caliber of a selected vein was quantified. Modulating IOP using our system elicited a rapid change in the appearance of the retinal vein of interest: IOP was lowered from 10 to 3 mmHg, and retinal vein caliber sharply increased as IOP decreased from 7 to 5 mmHg. Another important feature of this technology is its capability to measure ocular compliance and outflow facility in vivo, as demonstrated in tree shrews. Collectively, these proof-of-concept demonstrations support the utility of this system to manipulate IOP for a variety of useful applications in ocular biomechanics, and provide a framework for further study of the mechanisms of retinal venous pulsation. PMID:26771837

  1. The effect of adjustable suture (Khaw) trabeculectomy on intraocular pressure: a retrospective case series.

    PubMed

    Kaplan, Ahmet; Kocatürk, Tolga; Dayanır, Volkan

    2016-02-01

    The aim of the study is to investigate long-term intraocular pressure (IOP) outcome as well as complications associated with adjustable suture trabeculectomy in glaucoma patients who were uncontrolled under maximum medical therapy. In this retrospective case series, 35 eyes of 30 patients are included in the study. Adjustable suture trabeculectomy with 0.2 mg/cc mitomycin-C for 3 min was performed by the same surgeon. Subconjunctival 5-fluorouracil injection, transconjunctival suture adjustment, digital massage, and/or argon suturolysis were utilized postoperatively as needed. Complete success, qualified success, and failure were defined as IOP ≤ 18 mmHg without medication, IOP ≤ 18 mmHg with one or more medications, and IOP >18 mmHg with medication or need for additional glaucoma surgery, respectively. Of the 35 eyes, 13 had primary open angle, 18 had psuedoexfoliative, 1 had juvenile, 1 had pigmentary, 1 had uveitic, and 1 had chronic angle-closure glaucoma. Mean preoperative IOP of 30.1 ± 10.5 mmHg dropped to 10.8 ± 4.7 mmHg (p < 0.001) after a mean follow-up of 595 ± 435 days. Nine eyes had the desired IOP on first postoperative day where no transconjunctival suture adjustment was performed. Remaining 26 eyes required a mean of two adjustments (range 1-7) during the first postoperative 24 days in order to achieve a desirable IOP. Complete success, qualified success, and failure were observed in 28 (80 %), 5 (14 %), and 2 (6 %) eyes, respectively. There were no serious complications related to adjustable suture trabeculectomy. We believe adjustable suture trabeculectomy to be a safe and effective alternative to standard trabeculectomy where a desirable low IOP can be achieved. PMID:26002838

  2. Distribution of intraocular pressure and its determinants in an Iranian adult population

    PubMed Central

    Hashemi, Hassan; Khabazkhoob, Mehdi; Emamian, Mohammad Hassan; Shariati, Mohammad; Yekta, Abbasali; Fotouhi, Akbar

    2016-01-01

    AIM To determine the distribution of intraocular pressure (IOP) and its determinants in an Iranian population. METHODS In a cross-sectional survey, random cluster sampling was conducted from the 40-64 years old population of Shahroud, in the north of Iran. All participants had optometry and ophthalmic exams. IOP was determined using the Goldmann tonometry method and biometric components were measured. RESULTS Of the 6311 people selected for the study, 5190 (82.2%) participated. The mean age of the participants was 50.9±6.2y and 58.7% of them were female. Mean IOP was 12.87±2.27 mm Hg. In this study 0.3% of the participants had an IOP higher than 21 mm Hg. The multiple linear regression model revealed that sex (Coef=-0.30; 95% CI: -0.43 to -0.17), diabetes (Coef=0.43; 95% CI: 0.19 to 0.67), high systolic blood pressure (Coef=0.02; 95% CI: 0.01 to 0.02), high body mass index (BMI) (Coef=0.03; 95% CI: 0.01 to 0.04), higher education (Coef=0.02, 95% CI: 0.01 to 0.04), thicker central corneal thickness (Coef=0.01; 95% CI: 0.01 to 0.02), and myopic shift in spherical equivalent (Coef=-0.14; 95% CI: -0.18 to -0.10) significantly correlated with high IOP. CONCLUSION The IOP in this 40-64 years old population is low overall. In the north of Iran, average IOP is statistically significantly correlated with female sex, diabetes, higher BMI, systolic blood pressure, higher education, thicker cornea, and myopic refractive error. PMID:27588277

  3. Comparison of the Thickness of the Lamina Cribrosa and Vascular Factors in Early Normal-tension Glaucoma with Low and High Intraocular Pressures

    PubMed Central

    Kim, Jee Hyun; Lee, Jong Wook; Lee, Kyoo Won

    2014-01-01

    Purpose To compare the thickness of the lamina cribrosa (LC) and vascular factors of early normal-tension glaucoma (NTG) patients with high and low intraocular pressure (IOP) that are expected to be associated with the development of glaucoma. Methods Seventy-one Korean NTG patients with low IOP (the highest IOP <15 mmHg, 40 patients) and high IOP (the lowest IOP >15 mmHg, 31 patients) were included in this study. The thickness of LC and vascular factors were compared. The thickness of the LC was measured using the enhanced depth imaging method with spectral domain optical coherence tomography (Heidelberg Spectralis). Results The mean thickness of the central LC was 190.0 ± 19.2 µm in the low IOP group and 197.8 ± 23.6 µm in the high IOP group, but there was no statistical significant difference between the two groups (p > 0.05). The prevalence of self-reported Raynaud phenomenon was significantly higher in the low IOP group (33.0%) than the high IOP group (10.3%, p = 0.04). Conclusions The laminar thickness did not significantly differ between the high and low IOP groups. However, the prevalence of Raynaud phenomenon was higher in the low IOP groups. These results suggest that the development of glaucoma with low IOP patients may be more influenced by peripheral vasospasm, such as Raynaud phenomenon, rather than laminar thickness in NTG. PMID:25435750

  4. Efficacy of combined cataract extraction and endoscopic cyclophotocoagulation for the reduction of intraocular pressure and medication burden

    PubMed Central

    Roberts, Sammie J.; Mulvahill, Matthew; SooHoo, Jeffrey R.; Pantcheva, Mina B.; Kahook, Malik Y.; Seibold, Leonard K.

    2016-01-01

    AIM To report on the efficacy of combined endoscopic cyclophotocoagulation (ECP) and phacoemulsification cataract extraction (PCE) with intraocular lens placement for reduction of intraocular pressure (IOP) and medication burden in glaucoma. METHODS A retrospective case review of 91 eyes (73 patients) with glaucoma and cataract that underwent combined PCE/ECP surgery was performed. Baseline demographic and ocular characteristics were recorded, as well as intraocular pressure, number of glaucoma medications, and visual acuity postoperatively with 12-month follow-up. Treatment failure was defined as less than 20% reduction in IOP from baseline on two consecutive visits (at 1, 3, 6, or 12mo postoperatively), IOP ≥21 mm Hg or ≤5 mm Hg on two consecutive visits, or additional glaucoma surgery performed within 12mo after PCE/ECP. RESULTS Overall, mean medicated IOP was reduced from 16.65 mm Hg at baseline to 13.38 mm Hg at 12mo (P<0.0001). Mean number of glaucoma medications was reduced from 1.88 medications at baseline to 1.48 medications at 12mo (P=0.0003). At 3mo postoperatively, the success rate was 73.6% (95%CI: 63.3, 81.5), 57.1% at 6mo (95% CI: 46.3, 66.6), and 49.7% at 12mo (95%CI: 38.9, 59.6). Patient demographic characteristics were not associated with treatment success. The only ocular characteristic associated with treatment success was a higher baseline IOP. CONCLUSION Combined PCE/ECP surgery is an effective surgical option for the reduction of IOP and medication burden in glaucoma patients. Patients with higher baseline IOP levels are most likely to benefit from this procedure. PMID:27275423

  5. Factors Influencing Intraocular Pressure Changes after Laser In Situ Keratomileusis with Flaps Created by Femtosecond Laser or Mechanical Microkeratome

    PubMed Central

    Lin, Meng-Yin; Chang, David C. K.; Shen, Yun-Dun; Lin, Yen-Kuang; Lin, Chang-Ping; Wang, I-Jong

    2016-01-01

    The aim of this study is to describe factors that influence the measured intraocular pressure (IOP) change and to develop a predictive model after myopic laser in situ keratomileusis (LASIK) with a femtosecond (FS) laser or a microkeratome (MK). We retrospectively reviewed preoperative, intraoperative, and 12-month postoperative medical records in 2485 eyes of 1309 patients who underwent LASIK with an FS laser or an MK for myopia and myopic astigmatism. Data were extracted, such as preoperative age, sex, IOP, manifest spherical equivalent (MSE), central corneal keratometry (CCK), central corneal thickness (CCT), and intended flap thickness and postoperative IOP (postIOP) at 1, 6 and 12 months. Linear mixed model (LMM) and multivariate linear regression (MLR) method were used for data analysis. In both models, the preoperative CCT and ablation depth had significant effects on predicting IOP changes in the FS and MK groups. The intended flap thickness was a significant predictor only in the FS laser group (P < .0001 in both models). In the FS group, LMM and MLR could respectively explain 47.00% and 18.91% of the variation of postoperative IOP underestimation (R2 = 0.47 and R2 = 0.1891). In the MK group, LMM and MLR could explain 37.79% and 19.13% of the variation of IOP underestimation (R2 = 0.3779 and 0.1913 respectively). The best-fit model for prediction of IOP changes was the LMM in LASIK with an FS laser. PMID:26824754

  6. Factors Influencing Intraocular Pressure Changes after Laser In Situ Keratomileusis with Flaps Created by Femtosecond Laser or Mechanical Microkeratome.

    PubMed

    Lin, Meng-Yin; Chang, David C K; Shen, Yun-Dun; Lin, Yen-Kuang; Lin, Chang-Ping; Wang, I-Jong

    2016-01-01

    The aim of this study is to describe factors that influence the measured intraocular pressure (IOP) change and to develop a predictive model after myopic laser in situ keratomileusis (LASIK) with a femtosecond (FS) laser or a microkeratome (MK). We retrospectively reviewed preoperative, intraoperative, and 12-month postoperative medical records in 2485 eyes of 1309 patients who underwent LASIK with an FS laser or an MK for myopia and myopic astigmatism. Data were extracted, such as preoperative age, sex, IOP, manifest spherical equivalent (MSE), central corneal keratometry (CCK), central corneal thickness (CCT), and intended flap thickness and postoperative IOP (postIOP) at 1, 6 and 12 months. Linear mixed model (LMM) and multivariate linear regression (MLR) method were used for data analysis. In both models, the preoperative CCT and ablation depth had significant effects on predicting IOP changes in the FS and MK groups. The intended flap thickness was a significant predictor only in the FS laser group (P < .0001 in both models). In the FS group, LMM and MLR could respectively explain 47.00% and 18.91% of the variation of postoperative IOP underestimation (R2 = 0.47 and R(2) = 0.1891). In the MK group, LMM and MLR could explain 37.79% and 19.13% of the variation of IOP underestimation (R(2) = 0.3779 and 0.1913 respectively). The best-fit model for prediction of IOP changes was the LMM in LASIK with an FS laser. PMID:26824754

  7. Allometry and Scaling of the Intraocular Pressure and Aqueous Humour Flow Rate in Vertebrate Eyes.

    PubMed

    Zouache, Moussa A; Eames, Ian; Samsudin, Amir

    2016-01-01

    In vertebrates, intraocular pressure (IOP) is required to maintain the eye into a shape allowing it to function as an optical instrument. It is sustained by the balance between the production of aqueous humour by the ciliary body and the resistance to its outflow from the eye. Dysregulation of the IOP is often pathological to vision. High IOP may lead to glaucoma, which is in man the second most prevalent cause of blindness. Here, we examine the importance of the IOP and rate of formation of aqueous humour in the development of vertebrate eyes by performing allometric and scaling analyses of the forces acting on the eye during head movement and the energy demands of the cornea, and testing the predictions of the models against a list of measurements in vertebrates collated through a systematic review. We show that the IOP has a weak dependence on body mass, and that in order to maintain the focal length of the eye, it needs to be an order of magnitude greater than the pressure drop across the eye resulting from gravity or head movement. This constitutes an evolutionary constraint that is common to all vertebrates. In animals with cornea-based optics, this constraint also represents a condition to maintain visual acuity. Estimated IOPs were found to increase with the evolution of terrestrial animals. The rate of formation of aqueous humour was found to be adjusted to the metabolic requirements of the cornea, scaling as [Formula: see text], where Vac is the volume of the anterior chamber. The present work highlights an interdependence between IOP and aqueous flow rate crucial to ocular function that must be considered to understand the evolution of the dioptric apparatus. It should also be taken into consideration in the prevention and treatment of glaucoma. PMID:26990431

  8. Allometry and Scaling of the Intraocular Pressure and Aqueous Humour Flow Rate in Vertebrate Eyes

    PubMed Central

    Zouache, Moussa A.; Eames, Ian; Samsudin, Amir

    2016-01-01

    In vertebrates, intraocular pressure (IOP) is required to maintain the eye into a shape allowing it to function as an optical instrument. It is sustained by the balance between the production of aqueous humour by the ciliary body and the resistance to its outflow from the eye. Dysregulation of the IOP is often pathological to vision. High IOP may lead to glaucoma, which is in man the second most prevalent cause of blindness. Here, we examine the importance of the IOP and rate of formation of aqueous humour in the development of vertebrate eyes by performing allometric and scaling analyses of the forces acting on the eye during head movement and the energy demands of the cornea, and testing the predictions of the models against a list of measurements in vertebrates collated through a systematic review. We show that the IOP has a weak dependence on body mass, and that in order to maintain the focal length of the eye, it needs to be an order of magnitude greater than the pressure drop across the eye resulting from gravity or head movement. This constitutes an evolutionary constraint that is common to all vertebrates. In animals with cornea-based optics, this constraint also represents a condition to maintain visual acuity. Estimated IOPs were found to increase with the evolution of terrestrial animals. The rate of formation of aqueous humour was found to be adjusted to the metabolic requirements of the cornea, scaling as Vac0.67, where Vac is the volume of the anterior chamber. The present work highlights an interdependence between IOP and aqueous flow rate crucial to ocular function that must be considered to understand the evolution of the dioptric apparatus. It should also be taken into consideration in the prevention and treatment of glaucoma. PMID:26990431

  9. Dynamic response of intraocular pressure and biomechanical effects of the eye considering fluid-structure interaction.

    PubMed

    Salimi, S; Park, S Simon; Freiheit, T

    2011-09-01

    The vibration characteristics of shell structures such as eyes have been shown to vary with intraocular pressure (IOP). Therefore, vibration characteristics of the eye have the potential to provide improved correlation to IOP over traditional IOP measurements. As background to examine an improved IOP correlation, this paper develops a finite element model of an eye subject to vibration. The eye is modeled as a shell structure filled with inviscid pressurized fluid in which there is no mean flow. This model solves a problem of a fluid with coupled structural interactions of a generally spherically shaped shell system. The model is verified by comparing its vibrational characteristics with an experimental modal analysis of an elastic spherical shell filled with water. The structural dynamic effects due to change in pressure of the fluid are examined. It is shown that the frequency response of this fluid-solid coupled system has a clear increase in natural frequency as the fluid pressure rises. The fluid and structure interaction is important for accurate prediction of system dynamics. This model is then extended to improve its accuracy in modeling the eye by including the effect of the lens to study corneal vibration. The effect of biomechanical parameters such as the thicknesses of different parts of the eye and eye dimensions in altering measured natural frequencies is investigated and compared to the influence of biomechanical parameters in Goldmann applanation tonometry models. The dynamic response of the eye is found to be less sensitive to biomechanical parameters than the applanation tonometry model. PMID:22010744

  10. [The influence of electro-stimulation anaesthesia on the intraocular pressure (author's transl)].

    PubMed

    Abdulla, W; Oggel, K; Schwab, R

    1981-04-01

    The effect of electrostimulation anaesthesia was studied in 23 patients undergoing ophthalmic surgery. Intraocular pressure (IOP) was measured 30 minutes after premedication (I), immediately after intubation (II), after the start of stimulation and relaxation (III) and after the establishment of full relaxation and achievement of full stimulation (IV). After intubation IOP increased from 16.4 +/- 3.3 mm Hg to 19.4 +/- 5.6 mm Hg (p less than 0.05), but decreased at reading IV statistically significantly compared with reading I to 12.7 +/- 2.8 mm Hg. To investigate the effect of electrostimulation alone on IOP, we performed tonometry on 10 control persons, in whom we observed a rise in IOP which can be attributed to current induced contractions of the extraocular muscles. The results demonstrate that there is a direct relation between electrostimulation and extraocular muscles, and we find it essential to relax the patients sufficiently to avoid hazards of IOP elevation. PMID:7247003

  11. Revealing anisotropic properties of cornea at different intraocular pressures using optical coherence elastography

    NASA Astrophysics Data System (ADS)

    Li, Jiasong; Singh, Manmohan; Han, Zhaolong; Wu, Chen; Nair, Achuth; Aglyamov, Salavat R.; Twa, Michael D.; Larin, Kirill V.

    2016-03-01

    In this study we have evaluated the elastic anisotropy of porcine corneas with increasing intraocular pressures (IOPs) using a noncontact optical coherence elastography (OCE) technique. A focused air-pulse induced low amplitude (<=10 μm) elastic waves in fresh porcine corneas (n=9) in situ in the whole eye-globe configuration. A phase-stabilized swept source optical coherence elastography (PhS-SSOCE) system imaged the propagation of the elastic wave in different stepped radial directions. A closed-loop feedback system was utilized to artificially manipulate the IOP, and OCE measurements were repeated while the IOP was increased in 5 mmHg increments from 15 to 30 mmHg. The OCE measurements demonstrated that the elastic anisotropy of the cornea became more pronounced at higher IOPs, and that there were distinct radial angles of higher and lower stiffness. The presented noncontact OCE method was capable of detecting and assessing the corneal elastic anisotropy as a function of IOP. Due to the noninvasive nature and small amplitude of the elastic wave, this method may be able to provide additional information about corneal health and integrity in vivo.

  12. Intraocular Pressure, Tear Production, and Ocular Echobiometry in Guinea Pigs (Cavia porcellus).

    PubMed

    Rajaei, Seyed Mehdi; Mood, Maneli Ansari; Sadjadi, Reza; Azizi, Farzaneh

    2016-01-01

    The purpose of this study was to evaluate intraocular pressure (IOP) by means of rebound tonometry, to assess tear production by using the endodontic absorbent paper point tear test (EAPTT) and phenol red thread test (PRTT), and to determine the effects of time of day on IOP and tear production in guinea pigs. The study population comprised 24 healthy adult guinea pigs (12 male, 12 female; 48 eyes) of different breeds and ranging in age from 12 to 15 mo. IOP and tear production were measured at 3 time points (0700, 1500, and 2300) during a 24-h period. Overall values (mean ± 1 SD) were: IOP, 6.81 ± 1.41 mm Hg (range, 4.83 to 8.50); PRTT, 14.33 ± 1.35 mm (range, 12.50 to 16.83); and EAPTT, 8.54 ± 1.08 mm (range, 7.17 to 10.0 mm). In addition, ultrasound biometry was performed by using a B-mode system with linear 8-MHz transducer. This study reports reference values for IOP and tear production in guinea pigs. PMID:27423156

  13. Brinzolamide nanocrystal formulations for ophthalmic delivery: reduction of elevated intraocular pressure in vivo.

    PubMed

    Tuomela, Annika; Liu, Peng; Puranen, Jooseppi; Rönkkö, Seppo; Laaksonen, Timo; Kalesnykas, Giedrius; Oksala, Olli; Ilkka, Jukka; Laru, Johanna; Järvinen, Kristiina; Hirvonen, Jouni; Peltonen, Leena

    2014-06-01

    Nanocrystal-based drug delivery systems provide important tools for ocular formulation development, especially when considering poorly soluble drugs. The objective of the study was to formulate ophthalmic, intraocular pressure (IOP) reducing, nanocrystal suspensions from a poorly soluble drug, brinzolamide (BRA), using a rapid wet milling technique, and to investigate their IOP reducing effect in vivo. Different stabilizers for the nanocrystals were screened (hydroxypropyl methylcellulose (HPMC), poloxamer F127 and F68, polysorbate 80) and HPMC was found to be the only successful stabilizer. In order to investigate both the effect of an added absorption enhancer (polysorbate 80) and the impact of the free drug in the nanocrystal suspension, formulations in phosphate buffered saline (PBS) at pH 7.4 and pH 4.5 were prepared. Particle size, polydispersity (PI), solid state (DSC), morphology (SEM) as well as dissolution behavior and the uniformity of the formulations were characterized. There was rapid dissolution of BRA (in PBS pH 7.4) from all the nanocrystal formulations; after 1 min 100% of the drug was fully dissolved. The effect was significantly pronounced at pH 4.5, where the dissolved fraction of drug was the highest. The cytotoxicity of nanocrystal formulations to human corneal epithelial cell (HCE-T) viability was tested. The effects of the nanocrystal formulations and the commercial product on the cell viability were comparable. The intraocular pressure (IOP) lowering effect was investigated in vivo using a modern rat ocular hypertensive model and elevated IOP reduction was seen in vivo with all the formulations. Notably, the reduction achieved in experimentally elevated IOP was comparable to that obtained with a marketed product. In conclusion, various BRA nanocrystal formulations, which all showed advantageous dissolution and absorption behavior, were successfully formulated. PMID:24680962

  14. The Effect of a Diving Mask on Intraocular Pressure in a Healthy Population

    PubMed Central

    Goenadi, Catherina Josephine; Law, David Zhiwei; Lee, Jia Wen; Ong, Ee Lin; Chee, Wai Kitt; Cheng, Jason

    2016-01-01

    Purpose Swimming goggles increase the intraocular pressure (IOP) via the periorbital frame pressure and suction effect. In comparison, diving masks have a larger frame rim and incorporate the nose. The exact effect(s) of diving masks on IOP is unknown. This study evaluates the influence of diving masks on IOP in normal, healthy subjects. Methods Tonometry was performed in both eyes of all subjects with an AVIA®Tono-Pen by a single investigator. Measurements were taken at baseline without the diving mask and with the subjects wearing a small-volume, double-window diving mask, but with the mask lenses removed. Two IOP readings in each eye were measured, and an additional reading was measured if the difference between the initial 2 was ≥2 mm Hg. Central corneal thickness (CCT) was also measured in each eye, using a contact pachymeter (OcuScan®Alcon). Results Forty eyes of 20 healthy volunteers (age 29.7 ± 9.3 years; range 21–52) were included. The mean CCT was 544.4 ± 43.5 µm. The mean IOP before the diving mask was worn had been 17.23 ± 2.18 mm Hg (n = 40). The IOP decreased by 0.43 mm Hg (p $1003c; 0.05) to 16.80 ± 2.57 mm Hg after the diving mask had been put on. There was no correlation between IOP change and age (r = 0.143, p = 0.337), gender (r = −0.174, p = 0.283) or CCT (r = −0.123, p = 0.445). Conclusion There was no increase in IOP after the diving mask had been worn. A small but statistically significant decrease in IOP was observed. This study demonstrates that unlike swimming goggles, the strap tension and frame pressure on the periorbital tissue from a diving mask does not increase IOP. Diving masks may be a suitable alternative to swimming goggles for patients with advanced glaucoma or glaucoma filtration surgery. PMID:27462262

  15. Comparison of Tono-Pen and Goldmann applanation tonometers for measurement of intraocular pressure in healthy children

    PubMed Central

    Bradfield, Yasmin S.; Kaminski, Brett M.; Repka, Michael X.; Melia, Michele

    2012-01-01

    Purpose To assess the agreement of intraocular pressure (IOP) measured with the Tono-Pen and the Goldmann applanation tonometer (GAT) in normal children and adolescents. Methods A total of 439 subjects from birth to <18 years of age without anterior segment anomalies or glaucoma had their IOP measured with the two instruments by separate, masked examiners in the office or under general anesthesia. Results On average, the Tono-Pen measured values slightly lower than the GAT for IOP <11 mm Hg and slightly higher than the GAT for IOP >11 mm Hg in the office setting. Using the average of GAT and Tono-Pen IOPs to estimate the true IOP, the average difference (GAT–Tono-Pen) was 0.4 mm Hg at IOP of 10 mm Hg and −3.0 mm Hg at IOP of 20 mm Hg. The 95% limits of agreement on the average difference between instruments were ±6.4 mm Hg in the office setting and ±6.8 mm Hg under general anesthesia. Larger differences between instruments were found with younger age. Standard error of measurement with the Tono-Pen was 1.44 mm Hg and 1.82 mm Hg for the office and anesthesia settings, respectively. Thicker corneas were associated with higher IOP with both the GAT and the Tono-Pen. Conclusions In normal children, average differences between IOP measured by Tono-Pen and GAT were small, although there was substantial test–retest variability. Younger age was associated with larger average differences, as was higher IOP in the office setting. PMID:22459105

  16. A capacitor-based sensor and a contact lens sensing system for intraocular pressure monitoring

    NASA Astrophysics Data System (ADS)

    Chiou, Jin-Chern; Huang, Yu-Chieh; Yeh, Guan-Ting

    2016-01-01

    This study proposes a capacitor-based sensor on a soft contact lens for the measurement of intraocular pressure (IOP). The sensor was designed and fabricated via microelectromechanical system fabrication technologies. The soft contact lens is designed to be worn on a cornea such that the curvature of the contact lens corresponds substantially to that of the cornea. In addition, the contact lens was fabricated via a cast-molding method using poly-2-hydroxyethyl methacrylate to achieve a lens with high oxygen permeability, which can be worn comfortably for a long time. An IOP sensor prototype was implemented, which exhibited 1.2239 pF mmHg-1 (13,171 ppm mmHg-1) sensitivity during measurements of an artificial anterior chamber at pressures between 18 and 30 mmHg. The results indicate that the developed capacitor-based IOP sensor exhibited high stability and reproducibility in a series of measurements performed under various pressures. The capacitance of the proposed IOP sensor can successfully be converted into a digital value via a capacitor-to-digital converter and be transmitted via a commercial wireless telemetry system in this study.

  17. ARHGEF12 influences the risk of glaucoma by increasing intraocular pressure.

    PubMed

    Springelkamp, Henriët; Iglesias, Adriana I; Cuellar-Partida, Gabriel; Amin, Najaf; Burdon, Kathryn P; van Leeuwen, Elisabeth M; Gharahkhani, Puya; Mishra, Aniket; van der Lee, Sven J; Hewitt, Alex W; Rivadeneira, Fernando; Viswanathan, Ananth C; Wolfs, Roger C W; Martin, Nicholas G; Ramdas, Wishal D; van Koolwijk, Leonieke M; Pennell, Craig E; Vingerling, Johannes R; Mountain, Jenny E; Uitterlinden, André G; Hofman, Albert; Mitchell, Paul; Lemij, Hans G; Wang, Jie Jin; Klaver, Caroline C W; Mackey, David A; Craig, Jamie E; van Duijn, Cornelia M; MacGregor, Stuart

    2015-05-01

    Primary open-angle glaucoma (POAG) is a blinding disease. Two important risk factors for this disease are a positive family history and elevated intraocular pressure (IOP), which is also highly heritable. Genes found to date associated with IOP and POAG are ABCA1, CAV1/CAV2, GAS7 and TMCO1. However, these genes explain only a small part of the heritability of IOP and POAG. We performed a genome-wide association study of IOP in the population-based Rotterdam Study I and Rotterdam Study II using single nucleotide polymorphisms (SNPs) imputed to 1000 Genomes. In this discovery cohort (n = 8105), we identified a new locus associated with IOP. The most significantly associated SNP was rs58073046 (β = 0.44, P-value = 1.87 × 10(-8), minor allele frequency = 0.12), within the gene ARHGEF12. Independent replication in five population-based studies (n = 7471) resulted in an effect size in the same direction that was significantly associated (β = 0.16, P-value = 0.04). The SNP was also significantly associated with POAG in two independent case-control studies [n = 1225 cases and n = 4117 controls; odds ratio (OR) = 1.53, P-value = 1.99 × 10(-8)], especially with high-tension glaucoma (OR = 1.66, P-value = 2.81 × 10(-9); for normal-tension glaucoma OR = 1.29, P-value = 4.23 × 10(-2)). ARHGEF12 plays an important role in the RhoA/RhoA kinase pathway, which has been implicated in IOP regulation. Furthermore, it binds to ABCA1 and links the ABCA1, CAV1/CAV2 and GAS7 pathway to Mendelian POAG genes (MYOC, OPTN, WDR36). In conclusion, this study identified a novel association between IOP and ARHGEF12. PMID:25637523

  18. Intraocular Pressure Rise in Subjects with and without Glaucoma during Four Common Yoga Positions

    PubMed Central

    Jasien, Jessica V.; Jonas, Jost B.; de Moraes, C. Gustavo; Ritch, Robert

    2015-01-01

    Purpose To measure changes in intraocular pressure (IOP) in association with yoga exercises with a head-down position. Methods The single Center, prospective, observational study included 10 subjects with primary open-angle glaucoma and 10 normal individuals, who performed the yoga exercises of Adho Mukha Svanasana, Uttanasana, Halasana and Viparita Karani for two minutes each. IOP was measured by pneumatonometry at baseline and during and after the exercises. Results All yoga poses were associated with a significant (P<0.01) rise in IOP within one minute after assuming the yoga position. The highest IOP increase (P<0.01) was measured in the Adho Mukha Svanasana position (IOP increase from 17±3.2 mmHg to 28±3.8 mmHg in glaucoma patients; from 17±2.8 mmHg to 29±3.9 mmHg in normal individuals), followed by the Uttanasana position (17±3.9 mmHg to 27±3.4 mmHg (glaucoma patients) and from 18±2.5 mmHg to 26±3.6 mmHg normal individuals)), the Halasana position (18±2.8 mmHg to 24±3.5 mmHg (glaucoma patients); 18±2.7 mmHg to 22±3.4 mmHg (normal individuals)), and finally the Viparita Kirani position (17±4 mmHg to 21±3.6 mmHg (glaucoma patients); 17±2.8 to 21±2.4 mmHg (normal individuals)). IOP dropped back to baseline values within two minutes after returning to a sitting position. Overall, IOP rise was not significantly different between glaucoma and normal subjects (P = 0.813), all though glaucoma eyes tended to have measurements 2 mm Hg higher on average. Conclusions Yoga exercises with head-down positions were associated with a rapid rise in IOP in glaucoma and healthy eyes. IOP returned to baseline values within 2 minutes. Future studies are warranted addressing whether yoga exercise associated IOP changes are associated with similar changes in cerebrospinal fluid pressure and whether they increase the risk of glaucoma progression. Trial Registration ClinicalTrials.gov #NCT01915680 PMID:26698309

  19. The Diurnal and Nocturnal Effect of Travoprost with SofZia on Intraocular Pressure and Ocular Perfusion Pressure

    PubMed Central

    Seibold, Leonard K.; Kahook, Malik Y.

    2013-01-01

    Purpose To determine the 24-hour effects of travoprost with sofZia on intraocular pressure (IOP) and ocular perfusion pressure as well as the endurance of IOP lowering after last dosing. Design Prospective, open-label study Methods Forty subjects with open angle glaucoma or ocular hypertension were admitted to our sleep laboratory for three 24-hour sessions monitoring IOP, blood pressure (BP), and heart rate. The first baseline session occurred after medication washout or immediately after enrollment for treatment naive patients. A second 24-hour monitoring session was performed after four weeks of once nightly treatment of travoprost with sofZia. The medication was then discontinued and a third 24-hour session was completed 60-84 hours after the last dose taken. IOP measurements were taken using a pneumotonometer every two hours in the sitting position during the 16-hour diurnal period and in the supine position during the 8-hour nocturnal period. Ocular perfusion pressure was defined as 2/3[diastolic BP + 1/3(systolic BP - diastolic BP)] - IOP. Results Treatment with travoprost with sofZia significantly lowered mean diurnal and nocturnal IOP levels from baseline (Diurnal 18.1±3.9 to 15.3±3.3 mm Hg; Nocturnal 20.6±3.6 to 19.4±3.4 mm Hg, p<0.01 for both). Once treatment was discontinued, mean IOP remained at levels significantly less than baseline during both the diurnal (16.6±3.8 mm Hg) and nocturnal periods (19.4±3.5 mm Hg). Mean baseline ocular perfusion pressure was significantly increased during the diurnal but not the nocturnal period (Diurnal 73.7±11.4 to 76.5±10.3 mm Hg, p=0.01; Nocturnal 64.4±12.6 to 64.2±11.1 mm Hg, p=0.67). Conclusion Travoprost with sofZia significantly lowers IOP throughout the diurnal and nocturnal periods, and increases ocular perfusion pressure in the diurnal, but not the nocturnal period in open angle glaucoma and ocular hypertension. The treatment effect on IOP endures for at least 84 hours after the last dose. PMID

  20. The intraocular pressure-lowering properties of intravenous paracetamol

    PubMed Central

    van den Heever, Henning; Meyer, David

    2016-01-01

    Aim The aim of this paper was to investigate the intraocular pressure (IOP)-changing properties of a single standard dose of intravenous (IV) paracetamol and compare it to that of topical timolol, oral acetazolamide, and no treatment. Methods A prospective, randomized, investigator-blind, parallel-group study was conducted in 73 eyes of 52 subjects. Subjects received a single dose of IV paracetamol (1 g), oral acetazolamide (250 mg), topical timolol (0.5%, one drop), or no treatment. Baseline IOP was measured, and the measurement was repeated at 1, 2, 4, and 6 hours after treatment. Results Paracetamol reduced IOP from baseline by −10.8% (95% confidence interval [CI]: −4.9% to −16.8%, P=0.146) at 1 hour, −13.3% (95% CI: −8.3% to −18.4%, P=0.045) at 2 hours, −11.8% (95% CI: −5.5% to −18.4%, P=1.000) at 4 hours, and −23.9% (95% CI: −17.8% to −30.1%, P=0.006) at 6 hours after treatment. In the no-treatment group, the change was −2.9% (95% CI: +1.0% to −6.7%, P= referent) at 1 hour, −2.1% (95% CI: +2.9% to −7.2%, P= referent) at 2 hours, −7.6% (95% CI: −3.9% to −11.2%, P= referent) at 4 hours, and −6.9% (95% CI: −3.6% to −10.2%, P= referent) at 6 hours. Acetazolamide reduced IOP by −18.8% (95% CI: −12.7% to −24.8%, P=0.000) at 1 hour, −26.2% (95% CI: −18.2% to −34.2%, P=0.001) at 2 hours, −24.6% (95% CI: −16.9% to −32.3%, P=0.000) after 4 hours, and −26.9% (95% CI: −19.6% to −34.3%, P=0.000) 6 hours after treatment. Timolol reduced IOP by −31.2% (95% CI: −26.7% to −35.7%, P=0.000) at 1 hour, −27.7% (95% CI: −20.7% to −34.8%, P=0.000) at 2 hours, −28.7% (95% CI: −21.1% to −36.2%, P=0.000) at 4 hours, and −21.3% (95% CI: −13.4% to −30.0%, P=0.030) at 6 hours after treatment. The average change in IOP for the no-treatment group was −4.8% (95% CI: −2.6% to −6.9%, P= referent). It was −15.7% (95% CI: −9.3% to −22.1%, P=0.021) for paracetamol, −23.1% (95% CI: −16.4% to

  1. Point-of-care monitoring of perioperative intraocular pressure using portable tonometry in a patient with Posner-Schlossman syndrome: a case report

    PubMed Central

    Rhim, Jin-Ho; Moon, Young-Jin; Yu, Jihion; Park, Jong-Yeon; Bangaari, Ashish

    2014-01-01

    A 56-year-old man with a rotator cuff injury, scheduled for arthroscopic reconstruction surgery, had a history of recurrent symptoms of eyeball pain and blurred vision for several years. After close examination, he was diagnosed with Posner-Schlossman syndrome. Three weeks before the scheduled surgery, his intraocular pressure (IOP) increased (> 30 mmHg) and he became extremely anxious about the surgery. We monitored his IOP intraoperatively and successfully completed general anesthesia without any sequelae. As Posner-Schlossman syndrome can present with severe complications that may lead to postoperative visual loss, intraoperative monitoring of intraocular monitoring and careful anesthetic management are crucial to protect vision. PMID:24729850

  2. Intraocular pressure elevation after intravitreal triamcinolone acetonide injection: a Meta-analysis

    PubMed Central

    Yuksel-Elgin, Cansu; Elgin, Ceyhun

    2016-01-01

    AIM To report on intraocular pressure (IOP) after intravitreal injections of triamcinolone acetonide. METHODS Systematic literature review of studies that investigated the effects of an injection of triamcinolone intravitreal triamcinolone acetonide on IOP was conducted according to the Cochrane Collaboration methodology and the reported effects have been analyzed with Meta-analysis. RESULTS We found that the IOP follows an inverted-U shape pattern over time starting with an average value of 14.81±1.22 mm Hg before the injection, rising to a maximum of 19.48±2.15 mm Hg after one month of injection and falling down to 16.16±1.92 mm Hg after 6mo. Moreover, country of study, age, previous history of glaucoma and gender compositions matter for cross-study were different in reported IOP changes. CONCLUSION Our findings may be helpful in determining pressure elevation risk of intravitreal triamcinolone acetonide therapy as well as comparing it with those of more recent therapies such as the anti-vascular endothelial growth factor agents. PMID:26949624

  3. Comparison of brimonidine-timolol and dorzolamide-timolol in the management of intraocular pressure increase after phacoemulsification

    PubMed Central

    Turk, Adem; Ceylan, Osman Melih; Gokce, Gokcen; Borazan, Mehmet; Kola, Mehmet

    2015-01-01

    AIM To compare the effectiveness of brimonidine/timolol fixed combination (BTFC) and dorzolamide/timolol fixed combination (DTFC) in the management of short-term intraocular pressure (IOP) increase after phacoemulsification surgery. METHODS Eighty eyes of 80 patients undergoing phacoemulsification and intraocular lens (IOL) implantation were randomly assigned into three groups. Group 1 consisted of 28 eyes and represented the control group. Group 2 consisted of 25 eyes undergoing phacoemulsification surgery and BTFC was instilled at the end of surgery. Group 3 consisted of 27 eyes undergoing phacoemulsification surgery and DTFC was instilled at the end of surgery. IOP was measured preoperatively and 6, 24h and 1wk postoperatively. RESULTS There was no statistically significant difference in preoperative baseline IOP among the three groups (P=0.84). However, IOP was significantly lower in groups 2 and 3 compared to the control group (P<0.05 for all comparisons) at all postoperative visits. There was no significant difference between groups 2 and 3 at any visit. Eight eyes (28.6%) in the control group, two (8%) in Group 2 and one (3.7%) in Group 3 had IOP >25 mm Hg at 6h after surgery (P=0.008). However, IOP decreased and was >25 mm Hg in only one eye in each group at 24h after surgery. CONCLUSION BTFC and DTFC have similar effects in reducing increases in IOP after phacoemulsification surgery and can both be recommended for preventing IOP spikes after such surgery. PMID:26558206

  4. The effects of intravenous dexmedetomidine premedication on intraocular pressure and pressor response to laryngoscopy and intubation

    PubMed Central

    Chandra, Alka; Ranjan, Reena; Kumar, Jay; Vohra, Ashima; Thakur, Vijay Kumar

    2016-01-01

    Background and Aims: Penetrating eye injuries are a challenge for the anesthesiologists in emergency due to increase in intraocular pressure (IOP). The aim of this study was to evaluate the effects of intravenous dexmedetomidine premedication on changes in IOP and hemodynamic response following laryngoscopy and tracheal intubation. Material and Methods: Hundred patients aged 18-60 years undergoing elective nonophthalmic surgery were divided into two groups of 50 each. Group D received a bolus dose of dexmedetomidine (0.4 μg/kg) diluted to 20 ml normal saline and Group C received normal saline (0.4 ml/kg) over 10 min as premedication. Heart rate (HR), systolic blood pressure (SBP) and IOP were measured and recorded before premedication (T1), 5 and 10 m after premedication (T2, T3), immediately after induction, intubation and then 1, 3, 5 min after intubation (T4, 5, 6, 7, 8). Results: HR was comparable in both groups at preoperative level, but it was significantly low in the drug group when compared with the control group at T4-T8 (P = 0.034, P < 0.001, 0.001, 0.036 and 0.001, respectively). The SBP was comparable in both the groups at baseline and till before induction. At T4-T8 there was a fall in SBP in Group D compared to the Group C (P = 0.045, P = 0.007, 0.001, 0.001 and 0.001, respectively). The baseline IOP was comparable in both the groups (P = NS). There was a significant fall in the IOP in Group D, 5 min after the drug infusion compared to Group C, which was sustained till 5 min after intubation (T8) (P < 0.001 at all intervals). Conclusion: Dexmedetomidine premedication in the dose of 0.4 μg/kg lowers the IOP and attenuates the pressor response to laryngoscopy and intubation. PMID:27275049

  5. Iris transillumination defect and its gene modulators do not correlate with intraocular pressure in the BXD family of mice

    PubMed Central

    Lu, Hong; Lu, Lu; Williams, Robert W.

    2016-01-01

    Purpose Intraocular pressure (IOP) is currently the only treatable phenotype associated with primary open angle glaucoma (POAG). Our group has developed the BXD murine panel for identifying genetic modulators of the various endophenotypes of glaucoma, including pigment dispersion, IOP, and retinal ganglion cell (RGC) death. The BXD family consists of the inbred progeny of crosses between the C57BL/6J (B6) strain and the glaucoma-prone DBA/2J (D2) strain that has mutations in Tyrp1 and Gpnmb. The role of these genes in the iris transillumination defect (TID) has been well documented; however, their possible roles in modulating IOP during glaucoma onset and progression are yet not well understood. Methods We used the IOP data sets and the Eye M430v2 (Sep08) RMA Database available on GeneNetwork to determine whether mutations in Tyrp1 and Gpnmb or TIDs have a direct role in the elevation of IOP in the BXD family. We also determined whether TIDs and IOP are coregulated. Results As expected, Tyrp1 and Gpnmb expression levels showed a high degree of correlation with TIDs. However, there was no correlation between the expression of these genes and IOP. Moreover, unlike TIDs, IOP did not map to either the Tyrp1 or Gpnmb locus. Although the Tyrp1 and Gpnmb mutations in BXD strains are a prerequisite for the development of TID, they are not required for or associated with elevated IOP. Conclusions Genetic modulators of IOP thus may be independently identified using the full array of BXD mice without concern for the presence of TIDs or mutations in Typr1 and/or Gpnmb. PMID:27011731

  6. Intraocular Pressure Changes in Non-Glaucomatous Patients Receiving Intravitreal Anti-Vascular Endothelial Growth Factor Agents

    PubMed Central

    Kiddee, Weerawat; Montriwet, Mayuree

    2015-01-01

    Purpose To study the prevalence of sustained intraocular pressure (IOP) elevation associated with intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) agents. Methods Prospective comparative study. Non-glaucomatous patients scheduled to receive intravitreal injection of anti-VEGF therapy were recruited from an outpatient eye clinic, Songklanagarind Hospital between April 2013 and March 2014. The IOP was measured by Goldmann applanation tonometer before and at 1 hour, 1 week, 1 month, 3 months, and 6 months after injection. The IOP was compared using the repeated measures analysis. Sustained IOP elevation was defined as either an IOP > 21 mmHg or an increase from baseline ≥ 5 mmHg on two consecutive visits. Results Seventy eyes of 54 patients met the inclusion criteria. The most common diagnosis was diabetic macular edema (48%). The mean IOP ± standard deviation (SD) before treatment was 13.7 ± 2.8 mmHg. The means ± SDs after treatment at 1 hour, 1 week, 1 month, 3 months, and 6 months were 11.3 ± 2.6, 13.7 ± 3.6, 14.1 ± 3.3, 14.0 ± 2.3, and 13.7 ± 2.4 mmHg, respectively. A mean of IOP difference at 1 hour postinjection and at baseline was −2.36 ± 2.5 mmHg (P < 0.001). Four of 70 treated eyes (5.7%) developed sustained IOP elevation (IOP ≥ 5 mmHg from baseline on two consecutive visits). The IOP returned to baseline levels after 1 month, in three eyes. One eye had sustained IOP elevation at 3 and 6 months follow-up. Thereafter, IOP returned to baseline level. There was no need of anti-glaucoma medication. Conclusions After receiving intravitreal injection of anti-VEGF agent, a small proportion of non-glaucomatous eyes developed a sustained IOP elevation without requiring IOP-lowering treatment. At 1 hour postinjection, there was a significant reduction of the mean IOP compared with the baseline level. PMID:26360382

  7. The effect of intraocular and intracranial pressure on retinal structure and function in rats

    PubMed Central

    Zhao, Da; He, Zheng; Vingrys, Algis J; Bui, Bang V; Nguyen, Christine T O

    2015-01-01

    An increasing number of studies indicate that the optic nerve head of the eye is sensitive not only to changes in intraocular pressure (IOP), but also to intracranial pressure (ICP). This study examines changes to optic nerve and retinal structure in a rat model in response to a range of IOP and ICP levels using optical coherence tomography. Furthermore, we examine the functional sequelae of these structural changes by quantifying the effect of pressure changes on the electroretinogram. IOP elevation (10–90 mmHg) induces progressive deformation of the optic nerve head and retinal surface (P < 0.05), compression of the retina (P < 0.05) and bipolar cell (b-wave), and retinal ganglion cell (scotopic threshold response) dysfunction (P < 0.05). Simultaneously altering ICP (−5 to 30 mmHg) modifies these IOP-induced responses, with lower ICP (−5 mmHg) exacerbating and higher ICP (15–30 mmHg) ameliorating structural and functional deficits. Thus, the balance between IOP and ICP (optic nerve pressure gradient, ONPG = IOP − ICP) plays an important role in optic nerve integrity. Structural and functional parameters exhibit a two-phase relationship to ONPG, with structural changes being more sensitive to ONPG modification (threshold = −0.6 to 11.3 mmHg) compared with functional changes (threshold = 49.7–54.6 mmHg). These findings have implications for diseases including glaucoma, intracranial hypertension, and long-term exposure to microgravity. PMID:26290528

  8. Ocular health assessment, tear production, and intraocular pressure in the Andros Island iguana (Cyclura cychlura cychlura).

    PubMed

    Wojick, Kimberlee B; Naples, Lisa M; Knapp, Charles R

    2013-03-01

    The purpose of this study was to assess the ocular health of a wild population of Andros Island iguanas (Cyclura cychlura cychlura) and determine reference values for tear production and intraocular pressure (IOP) for this species. Fifty-two iguanas, 20 males and 32 females, ranging in size from 11.1- to 51.0-cm snout-to-vent length (SVL), were included in the sample set, with measurements obtained from each eye. No abnormalities were found on ophthalmic examination, with the exception of mild, focal chemosis in one individual and periocular ticks in 52% of iguanas. Tear production was measured using the phenol red thread test, and IOP was measured using the TonoVet rebound tonometer set on the P (undefined species) setting. No significant difference was found between males and females for either measurement. No significant difference was found between right and left eyes for intraocular pressure; however, a significant difference was found between eyes for tear production values. The mean (+/- SD) of IOP in the left and right eyes were 4.77 +/- 1.88 mm Hg and 5.12 +/- 2.52 mm Hg, respectively, with a range of 1-11 mm Hg. The mean (+/- SD) of tear production in the left and right eyes were 10.63 +/- 6.89 mm/15 sec (range 1-28 mm/15 sec) and 12.44 +/- 7.52 mm/15 sec (range 1-23 mm/15 sec), respectively. A positive correlation was found between SVL and all ocular parameters measured. This study provides an assessment of ocular health, as well as baseline values for IOP and tear production, in the Andros Island iguana. PMID:23505711

  9. Metal chelator combined with permeability enhancer ameliorates oxidative stress-associated neurodegeneration in rat eyes with elevated intraocular pressure

    PubMed Central

    Liu, P.; Zhang, M.; Shoeb, M.; Hogan, D.; Tang, Luosheng; Syed, M. F.; Wang, C. Z.; Campbell, G.A.; Ansari, N.H.

    2014-01-01

    Since as many as half of glaucoma patients on intraocular pressure (IOP)-lowering therapy continue to experience optic nerve toxicity, it is imperative to find other effective therapies. Iron and calcium ions play key roles in oxidative stress, a hallmark of glaucoma. Therefore, we tested metal chelation by means of ethylenediaminetetraacetic acid (EDTA) combined with the permeability enhancer methyl sulfonyl methane (MSM) applied topically on the eye to determine if this non-invasive treatment is neuroprotective in rat optic nerve and retinal ganglion cells exposed to oxidative stress induced by elevated IOP. Hyaluronic acid (HA) was injected in the anterior chamber of the rat eye to elevate the IOP. EDTA-MSM was applied topically to the eye for 3 months. Eyeballs and optic nerves were processed for histological assessment of cytoarchitecture. Protein-lipid aldehyde adducts, and cyclooxygnease-2 (COX-2) were detected immunohistochemically. HA administration increased IOP and associated oxidative stress and inflammation. Elevated IOP was not affected by EDTA-MSM treatment. However oxidative damage and inflammation were ameliorated as reflected by decrease in formation of protein-lipid aldehyde adducts and COX-2 expression, respectively. Furthermore, EDTA-MSM treatment increased retinal ganglion cell survival and decreased demyelinization of optic nerve compared with untreated eyes. Chelation treatment with EDTA-MSM ameliorates sequelae of IOP-induced toxicity without affecting IOP. Since most current therapies aim at reducing IOP and damage occurs even in the absence of elevated IOP, EDTA-MSM has the potential to work in conjunction with pressure-reducing therapies to alleviate damage to the optic nerve and retinal ganglion cells. PMID:24509160

  10. Metal chelator combined with permeability enhancer ameliorates oxidative stress-associated neurodegeneration in rat eyes with elevated intraocular pressure.

    PubMed

    Liu, P; Zhang, M; Shoeb, M; Hogan, D; Tang, Luosheng; Syed, M F; Wang, C Z; Campbell, G A; Ansari, N H

    2014-04-01

    Because as many as half of glaucoma patients on intraocular pressure (IOP)-lowering therapy continue to experience optic nerve toxicity, it is imperative to find other effective therapies. Iron and calcium ions play key roles in oxidative stress, a hallmark of glaucoma. Therefore, we tested metal chelation by means of ethylenediaminetetraacetic acid (EDTA) combined with the permeability enhancer methylsulfonylmethane (MSM) applied topically on the eye to determine if this noninvasive treatment is neuroprotective in rat optic nerve and retinal ganglion cells exposed to oxidative stress induced by elevated IOP. Hyaluronic acid (HA) was injected into the anterior chamber of the rat eye to elevate the IOP. EDTA-MSM was applied topically to the eye for 3 months. Eyeballs and optic nerves were processed for histological assessment of cytoarchitecture. Protein-lipid aldehyde adducts and cyclooxygenase-2 (COX-2) were detected immunohistochemically. HA administration increased IOP and associated oxidative stress and inflammation. Elevated IOP was not affected by EDTA-MSM treatment. However, oxidative damage and inflammation were ameliorated as reflected by a decrease in formation of protein-lipid aldehyde adducts and COX-2 expression, respectively. Furthermore, EDTA-MSM treatment increased retinal ganglion cell survival and decreased demyelination of optic nerve compared with untreated eyes. Chelation treatment with EDTA-MSM ameliorates sequelae of IOP-induced toxicity without affecting IOP. Because most current therapies aim at reducing IOP and damage occurs even in the absence of elevated IOP, EDTA-MSM has the potential to work in conjunction with pressure-reducing therapies to alleviate damage to the optic nerve and retinal ganglion cells. PMID:24509160

  11. Modeling glaucoma in rats by sclerosing aqueous outflow pathways to elevate intraocular pressure.

    PubMed

    Morrison, John C; Cepurna, William O; Johnson, Elaine C

    2015-12-01

    Injection of hypertonic saline via episcleral veins toward the limbus in laboratory rats can produce elevated intraocular pressure (IOP) by sclerosis of aqueous humor outflow pathways. This article describes important anatomic characteristics of the rat optic nerve head (ONH) that make it an attractive animal model for human glaucoma, along with the anatomy of rat aqueous humor outflow on which this technique is based. The injection technique itself is also described, with the aid of a supplemental movie, including necessary equipment and specific tips to acquire this skill. Outcomes of a successful injection are presented, including IOP elevation and patterns of optic nerve injury. These concepts are then specifically considered in light of the use of this model to assess potential neuroprotective therapies. Advantages of the hypertonic saline model include a delayed and relatively gradual IOP elevation, likely reproduction of scleral and ONH stresses and strains that may be important in producing axonal injury, and its ability to be applied to any rat (and potentially mouse) strain, leaving the unmanipulated fellow eye as an internal control. Challenges include the demanding surgical skill required by the technique itself, a wide range of IOP response, and mild corneal clouding in some animals. However, meticulous application of the principles detailed in this article and practice will allow most researchers to attain this useful skill for studying cellular events of glaucomatous optic nerve damage. PMID:26003399

  12. Safety and efficacy of travoprost solution for the treatment of elevated intraocular pressure

    PubMed Central

    Quaranta, Luciano; Riva, Ivano; Katsanos, Andreas; Floriani, Irene; Centofanti, Marco; Konstas, Anastasios G P

    2015-01-01

    Travoprost is a prostaglandin analogue widely used for reducing intraocular pressure (IOP) in patients affected with glaucoma and ocular hypertension. It exerts its ocular hypotensive effect through the prostaglandin FP receptors, located in the ciliary muscle and the trabecular meshwork. Several studies have shown that topical administration of travoprost induces a mean IOP reduction ranging from 25% to 32%, and sustained throughout the 24-hour cycle. When compared with timolol, travoprost is more effective at reducing IOP, while generally no difference has been found in the head-to-head comparison with other prostaglandin analogues. The fixed combination of travoprost and timolol has demonstrated a hypotensive efficacy comparable to the concomitant administration of the two drugs. Recently, a new preservative-free formulation of travoprost 0.004% has been marketed for reducing tolerability-related problems in subjects affected with ocular surface disease. Low rates of topical and systemic adverse reactions, strong ocular hypotensive efficacy, and once-a-day dosing make travoprost a first-line treatment for patients affected with elevated IOP. PMID:25914522

  13. Regulation of intraocular pressure by soluble and membrane guanylate cyclases and their role in glaucoma

    PubMed Central

    Buys, Emmanuel S.; Potter, Lincoln R.; Pasquale, Louis R.; Ksander, Bruce R.

    2014-01-01

    Glaucoma is a progressive optic neuropathy characterized by visual field defects that ultimately lead to irreversible blindness (Alward, 2000; Anderson et al., 2006). By the year 2020, an estimated 80 million people will have glaucoma, 11 million of which will be bilaterally blind. Primary open-angle glaucoma (POAG) is the most common type of glaucoma. Elevated intraocular pressure (IOP) is currently the only risk factor amenable to treatment. How IOP is regulated and can be modulated remains a topic of active investigation. Available therapies, mostly geared toward lowering IOP, offer incomplete protection, and POAG often goes undetected until irreparable damage has been done, highlighting the need for novel therapeutic approaches, drug targets, and biomarkers (Heijl et al., 2002; Quigley, 2011). In this review, the role of soluble (nitric oxide (NO)-activated) and membrane-bound, natriuretic peptide (NP)-activated guanylate cyclases that generate the secondary signaling molecule cyclic guanosine monophosphate (cGMP) in the regulation of IOP and in the pathophysiology of POAG will be discussed. PMID:24904270

  14. Application of Cornelian Cherry Iridoid-Polyphenolic Fraction and Loganic Acid to Reduce Intraocular Pressure

    PubMed Central

    Szumny, Dorota; Sozański, Tomasz; Kucharska, Alicja Z.; Dziewiszek, Wojciech; Piórecki, Narcyz; Magdalan, Jan; Chlebda-Sieragowska, Ewa; Kupczynski, Robert; Szeląg, Adam; Szumny, Antoni

    2015-01-01

    One of the most common diseases of old age in modern societies is glaucoma. It is strongly connected with increased intraocular pressure (IOP) and could permanently damage vision in the affected eye. As there are only a limited number of chemical compounds that can decrease IOP as well as blood flow in eye vessels, the up-to-date investigation of new molecules is important. The chemical composition of the dried Cornelian cherry (Cornus mas L.) polar, iridoid-polyphenol-rich fraction was investigated. Loganic acid (50%) and pelargonidin-3-galactoside (7%) were found as the main components. Among the other constituents, iridoid compound cornuside and the anthocyans cyanidin 3-O-galactoside, cyanidin 3-O-robinobioside, and pelargonidin 3-O-robinobioside were quantified in the fraction. In an animal model (New Zealand rabbits), the influence of loganic acid and the polyphenolic fraction isolated from Cornelian cherry fruit was investigated. We found a strong IOP-hypotensive effect for a 0.7% solution of loganic acid, which could be compared with the widely ophthalmologically used timolol. About a 25% decrease in IOP was observed within the first 3 hours of use. PMID:26124854

  15. Manifestations of type 2 diabetes in corneal endothelial cell density, corneal thickness and intraocular pressure

    PubMed Central

    Briggs, Stella; Osuagwu, Uchechukwu L; AlHarthi, Essam M

    2016-01-01

    Abstract We sought to evaluate central corneal thickness (CCT), corneal endothelial cell density (ECD) and intraocular pressure (IOP) in patients with type 2 diabetes mellitus (DM) and to associate potential differences with diabetes duration and treatment modality in a prospective, randomized study. We measured ECD, CCT and IOP of 125 patients with type 2 DM (mean age 57.1±11.5 years) and compared them with 90 age-matched controls. Measured parameters were analyzed for association with diabetes duration and glucose control modalities (insulin injection or oral medication) while controlling for age. In the diabetic group, the mean ECD (2511±252 cells/mm2), mean CCT (539.7±33.6 µm) and mean IOP (18.3±2.5 mmHg) varied significantly from those the control group [ECD: 2713±132 cells/mm2 (P<0.0001), CCT: 525.0±45.3 µm (P=0.003) and IOP: 16.7±1.8 mmHg (P<0.0001)]. ECD was significantly reduced by about 32 cell/mm2 for diabetics with duration of >10 years when compared with those with duration of <10 years (P<0.05). CCT was thicker and IOP was higher for diabetics with duration of >10 years than those with duration of <10 years (P>0.05). None of the measured parameters was significantly associated with diabetes duration and treatment modality (P>0.05). In conclusion, subjects with type 2 DM exhibit significant changes in ECD, IOP and CCT, which, however, are not correlated with disease duration or if the patients receive on insulin injection or oral medications.

  16. Effects of Topical Bimatoprost 0.01% and Timolol 0.5% on Circadian IOP, Blood Pressure and Perfusion Pressure in Patients with Glaucoma or Ocular Hypertension: A Randomized, Double Masked, Placebo-Controlled Clinical Trial

    PubMed Central

    Tanga, Lucia; Berardo, Francesca; Ferrazza, Manuela; Michelessi, Manuele; Roberti, Gloria

    2015-01-01

    Purpose To compare the 24-hour (24h) effects on intraocular pressure (IOP) and cardiovascular parameters of timolol 0.5% and bimatoprost 0.01% in open angle glaucoma and ocular hypertensive subjects. Methods In this prospective, randomized, double masked, crossover, clinical trial, after washout from previous medications enrolled subjects underwent 24h IOP, blood pressure (BP) and heart rate (HR) measurements and were randomized to either topical bimatoprost 0.01% at night plus placebo in the morning or to timolol 0.5% bid. After 8 weeks of treatment a second 24h assessment of IOP, BP and HR was performed and then subjects switched to the opposite treatment for additional 8 weeks when a third 24h assessment was performed. The primary endpoint was the comparison of the mean 24h IOP after each treatment. Secondary endpoints included the comparisons of IOP at each timepoint of the 24h curve and the comparison of BP, HR, ocular perfusion pressure and tolerability. Results Mean untreated 24h IOP was 20.3 mmHg (95%CI 19.0 to 21.6). Mean 24h IOP was significantly lower after 8 weeks of treatment with bimatoprost 0.01% than after 8 weeks of treatment with timolol 0.5% bid (15.7 vs 16.8 mmHg, p = 0.0003). Mean IOP during the day hours was significantly reduced from baseline by both drugs while mean IOP during the night hours was reduced by -2.3 mmHg (p = 0.0002) by bimatoprost 0.01% plus placebo and by -1.1 mmHg by timolol 0.5% bid (p = 0.06). Timolol 0.5% significantly reduced the mean 24h systolic BP from baseline, the diastolic BP during the day hours, the HR during the night hours, and the mean 24h systolic ocular perfusion pressure. Conclusion Both Bimatoprost 0.01% and Timolol 0.5% are effective in reducing the mean 24h IOP from an untreated baseline but Bimatoprost 0.01% is more effective than timolol 0.5% throughout the 24h. Timolol 0.5% effect on IOP is reduced during the night hours and is associated with reduced BP, HR and ocular perfusion pressure. Trial

  17. Effects of Systemic Administration of Dexmedetomidine on Intraocular Pressure and Ocular Perfusion Pressure during Laparoscopic Surgery in a Steep Trendelenburg Position: Prospective, Randomized, Double-Blinded Study

    PubMed Central

    2016-01-01

    Increased intraocular pressure (IOP) during surgery is a risk factor for postoperative ophthalmological complications. We assessed the efficacy of systemically infused dexmedetomidine in preventing the increase in IOP caused by a steep Trendelenburg position, and evaluated the influence of underlying hypertension on IOP during surgery. Sixty patients undergoing laparoscopic surgery in a steep Trendelenburg position were included. Patients in the dexmedetomidine group received a 1.0 µg/kg IV loading dose of dexmedetomidine before anesthesia, followed by an infusion of 0.5 µg/kg/hr throughout the operation. Patients in the saline group were infused with the same volume of normal saline. IOP and ocular perfusion pressure (OPP) were measured 16 times pre- and intraoperatively. In the saline group, IOP increased in the steep Trendelenburg position, and was 11.3 mmHg higher at the end of the time at the position compared with the baseline value (before anesthetic induction). This increase in IOP was attenuated in the dexmedetomidine group, for which IOP was only 4.2 mmHg higher (P < 0.001 vs. the saline group). The steep Trendelenburg position was associated with a decrease in OPP; the degree of decrease was comparable for both groups. In intragroup comparisons between patients with underlying hypertension and normotensive patients, the values of IOP at every time point were comparable. Dexmedetomidine infusion attenuated the increase in IOP during laparoscopic surgery in a steep Trendelenburg position, without further decreasing the OPP. Systemic hypertension did not seem to be associated with any additional increase in IOP during surgery. (Registration at the Clinical Research Information Service of Korea National Institute of Health ID: KCT0001482) PMID:27247511

  18. Impact of the Topical Ophthalmic Corticosteroid Loteprednol Etabonate on Intraocular Pressure.

    PubMed

    Sheppard, John D; Comstock, Timothy L; Cavet, Megan E

    2016-04-01

    Corticosteroids are a mainstay therapeutic option for the treatment of ocular inflammation. However, safety remains a concern for clinicians, particularly with long-term use. Though highly effective at suppressing inflammatory and allergic responses, topical ophthalmic corticosteroids carry an inherent risk of side effects, including elevated intraocular pressure (IOP), a risk factor for the development of glaucoma. The corticosteroid loteprednol etabonate (LE) contains an ester rather than a ketone at the C-20 position, minimizing the potential for side effects, including IOP elevation. In early pivotal clinical trials of LE ophthalmic suspension for conjunctivitis (allergic, giant papillary), anterior uveitis, and post-operative inflammation, LE had minimal impact on IOP over short-term (<28 days) and long-term (≥28 days) use. Since then, new LE formulations-including a gel, an ointment, and a suspension of LE in combination with tobramycin-have become commercially available. Multiple studies evaluating the safety and efficacy of LE for inflammatory conditions have been reported, including those requiring longer-term treatment such as photorefractive keratectomy, corneal transplantation, and dry eye disease. We review the available published data on the effect of LE on IOP and report on the cumulative incidence of clinically significant IOP elevations (≥10 mm Hg from baseline) with short-term and long-term LE use. In all studies, LE consistently demonstrated a low propensity to elevate IOP, regardless of formulation, dosage regimen, or treatment duration, including in known steroid responders. The cumulative proportion of patients exhibiting clinically significant IOP increases was 0.8% (14/1725 subjects) in studies evaluating short-term LE treatment and 1.5% (21/1386 subjects) in long-term studies. Furthermore, use of LE was associated with significantly lower rates of IOP elevation ≥10 mm Hg as compared to prednisolone acetate or dexamethasone (when

  19. Effects of Central Corneal Stromal Thickness and Epithelial Thickness on Intraocular Pressure Using Goldmann Applanation and Non-Contact Tonometers

    PubMed Central

    Lee, Marvin; Ahn, Jaehong

    2016-01-01

    Purpose To investigate whether corneal thickness parameters measured by optical coherence tomography (OCT), such as central corneal thickness (CCT), central corneal stromal thickness (CCST), and central corneal epithelial thickness (CCET), influence the intraocular pressure (IOP) difference measured by Goldmann applanation tonometry (GAT) and non-contact tonometry (NCT). Methods In total, 50 eyes from 50 subjects without glaucomatous defects were included in this retrospective, cross-sectional study. We measured IOP using GAT and NCT and calculated the difference between the two methods. CCT was measured by a Cirrus HD-OCT device using anterior segment imaging. The basement membrane of the epithelium, which was seen as a high-reflection line in the OCT image, was taken as a reference line to measure CCST and CCET. Results The mean IOP measured by GAT and NCT was 16.7 ± 3.0 and 18.1 ± 3.8 mmHg, respectively. The mean IOP difference was 1.5 ± 1.7 mmHg, and the IOP measured by NCT was 8.4% ± 11.3% higher than that measured by GAT. The CCET and CCST were 57.9 ± 5.6 and 501.7 ± 33.8 μm, respectively. CCT showed a positive correlation with both GAT IOP (r = 0.648, P < 0.001) and NCT IOP (r = 0.676, P < 0.001). Although CCST showed a significant correlation with GAT IOP and NCT IOP, CCET did not. The difference between GAT IOP and NCT IOP increased with CCT (r = 0.333, P = 0.018), and CCET was positively correlated with the IOP difference between GAT and NCT (r = 0.435, P = 0.002). Conclusions IOP increased with greater CCT, and CCST seemed to have a more important role than CCET. CCET also increased with greater CCT, and this may be a possible explanation for the increasing difference in IOP between GAT and NCT with increasing CCT. PMID:26998838

  20. Effects of Different Intensities of Exercise on Intraocular Pressure

    ERIC Educational Resources Information Center

    Rowe, Deryl; And Others

    1976-01-01

    The decrease in intraocular pressure during exercise and the first few minutes of recovery is related to a decrease in blood pH and an increase in blood lactate concentration, not to the intensity of the exercise. (MB)

  1. Investigation of postoperative intraocular pressure in cases of silicone oil removal using 25-gauge transconjunctival sutureless vitrectomy with oblique incisions

    PubMed Central

    Takashina, Hirotsugu; Watanabe, Akira; Tsuneoka, Hiroshi

    2015-01-01

    Background The purpose of this study was to investigate postoperative intraocular pressure (IOP) in cases of silicone oil (SO) removal when using 25-gauge transconjunctival sutureless vitrectomy (TSV) with oblique incisions. Methods We enrolled ten consecutive eyes with SO removal (SO group) and eleven consecutive eyes with idiopathic epiretinal membrane (ERM) as the initial vitrectomy (ERM group) in cases using 25-gauge TSV with oblique incisions. Postoperative IOPs were compared between the two groups at each of the four examination periods. Results No significant differences were identified in any of the periods examined. Conclusion The use of 25-gauge TSV with oblique incisions resulted in almost equivalent postoperative IOPs between cases with SO removal and idiopathic ERM as the initial operation. Self-sealing sclerotomy in 25-gauge TSV with oblique incisions may primarily involve the valve architecture, and be complemented by vitreous incarceration. PMID:26508831

  2. Argon laser peripheral iridoplasty versus systemic intraocular pressure-lowering medications as immediate management for acute phacomorphic angle closure

    PubMed Central

    Lee, Jacky WY; Lai, Jimmy SM; Yick, Doris WF; Yuen, Can YF

    2013-01-01

    Background The purpose of this study was to compare the efficacy and safety of argon laser peripheral iridoplasty (ALPI) and systemic intraocular pressure (IOP)-lowering medications in the immediate management of acute phacomorphic angle closure. Methods Consecutive cases of acute phacomorphic angle closure were randomized to receive ALPI and an intravenous or oral carbonic anhydrase inhibitor as initial treatment. Intravenous mannitol was administered for presenting IOP > 60 mmHg or IOP > 40 mmHg 2 hours posttreatment in both arms. Results Of 10 consecutive cases, six received medical therapy and four received ALPI. Fifty percent in the medical group and none in the ALPI group required intravenous mannitol. The ALPI group took less time to achieve IOP < 25 mmHg (18.8 ± 7.5 minutes versus 115.0 ± 97.0 minutes, P = 0.001, F test); had a greater IOP reduction within 30 minutes (69.8% ± 7.7% versus 40.9 ± 23.9%, P = 0.03, t-test); and had a consistently smaller post-attack cup to disc ratio (0.50 ± 0.02 versus 0.60 ± 0.20, P = 0.002, F test). Conclusion ALPI offers greater safety, consistency, and efficacy than systemic IOP-lowering medications as initial treatment for phacomorphic angle closure. PMID:23326185

  3. Genome-wide analysis of multi-ancestry cohorts identifies new loci influencing intraocular pressure and susceptibility to glaucoma.

    PubMed

    Hysi, Pirro G; Cheng, Ching-Yu; Springelkamp, Henriët; Macgregor, Stuart; Bailey, Jessica N Cooke; Wojciechowski, Robert; Vitart, Veronique; Nag, Abhishek; Hewitt, Alex W; Höhn, René; Venturini, Cristina; Mirshahi, Alireza; Ramdas, Wishal D; Thorleifsson, Gudmar; Vithana, Eranga; Khor, Chiea-Chuen; Stefansson, Arni B; Liao, Jiemin; Haines, Jonathan L; Amin, Najaf; Wang, Ya Xing; Wild, Philipp S; Ozel, Ayse B; Li, Jun Z; Fleck, Brian W; Zeller, Tanja; Staffieri, Sandra E; Teo, Yik-Ying; Cuellar-Partida, Gabriel; Luo, Xiaoyan; Allingham, R Rand; Richards, Julia E; Senft, Andrea; Karssen, Lennart C; Zheng, Yingfeng; Bellenguez, Céline; Xu, Liang; Iglesias, Adriana I; Wilson, James F; Kang, Jae H; van Leeuwen, Elisabeth M; Jonsson, Vesteinn; Thorsteinsdottir, Unnur; Despriet, Dominiek D G; Ennis, Sarah; Moroi, Sayoko E; Martin, Nicholas G; Jansonius, Nomdo M; Yazar, Seyhan; Tai, E-Shyong; Amouyel, Philippe; Kirwan, James; van Koolwijk, Leonieke M E; Hauser, Michael A; Jonasson, Fridbert; Leo, Paul; Loomis, Stephanie J; Fogarty, Rhys; Rivadeneira, Fernando; Kearns, Lisa; Lackner, Karl J; de Jong, Paulus T V M; Simpson, Claire L; Pennell, Craig E; Oostra, Ben A; Uitterlinden, André G; Saw, Seang-Mei; Lotery, Andrew J; Bailey-Wilson, Joan E; Hofman, Albert; Vingerling, Johannes R; Maubaret, Cécilia; Pfeiffer, Norbert; Wolfs, Roger C W; Lemij, Hans G; Young, Terri L; Pasquale, Louis R; Delcourt, Cécile; Spector, Timothy D; Klaver, Caroline C W; Small, Kerrin S; Burdon, Kathryn P; Stefansson, Kari; Wong, Tien-Yin; Viswanathan, Ananth; Mackey, David A; Craig, Jamie E; Wiggs, Janey L; van Duijn, Cornelia M; Hammond, Christopher J; Aung, Tin

    2014-10-01

    Elevated intraocular pressure (IOP) is an important risk factor in developing glaucoma, and variability in IOP might herald glaucomatous development or progression. We report the results of a genome-wide association study meta-analysis of 18 population cohorts from the International Glaucoma Genetics Consortium (IGGC), comprising 35,296 multi-ancestry participants for IOP. We confirm genetic association of known loci for IOP and primary open-angle glaucoma (POAG) and identify four new IOP-associated loci located on chromosome 3q25.31 within the FNDC3B gene (P = 4.19 × 10(-8) for rs6445055), two on chromosome 9 (P = 2.80 × 10(-11) for rs2472493 near ABCA1 and P = 6.39 × 10(-11) for rs8176693 within ABO) and one on chromosome 11p11.2 (best P = 1.04 × 10(-11) for rs747782). Separate meta-analyses of 4 independent POAG cohorts, totaling 4,284 cases and 95,560 controls, showed that 3 of these loci for IOP were also associated with POAG. PMID:25173106

  4. Genome-wide analysis of multiethnic cohorts identifies new loci influencing intraocular pressure and susceptibility to glaucoma

    PubMed Central

    Vitart, Veronique; Nag, Abhishek; Hewitt, Alex W; Höhn, René; Venturini, Cristina; Mirshahi, Alireza; Ramdas, Wishal D.; Thorleifsson, Gudmar; Vithana, Eranga; Khor, Chiea-Chuen; Stefansson, Arni B; Liao, Jiemin; Haines, Jonathan L; Amin, Najaf; Wang, Ya Xing; Wild, Philipp S; Ozel, Ayse B; Li, Jun Z; Fleck, Brian W; Zeller, Tanja; Staffieri, Sandra E; Teo, Yik-Ying; Cuellar-Partida, Gabriel; Luo, Xiaoyan; Allingham, R Rand; Richards, Julia E; Senft, Andrea; Karssen, Lennart C; Zheng, Yingfeng; Bellenguez, Céline; Xu, Liang; Iglesias, Adriana I; Wilson, James F; Kang, Jae H; van Leeuwen, Elisabeth M; Jonsson, Vesteinn; Thorsteinsdottir, Unnur; Despriet, Dominiek D.G.; Ennis, Sarah; Moroi, Sayoko E; Martin, Nicholas G; Jansonius, Nomdo M; Yazar, Seyhan; Tai, E-Shyong; Amouyel, Philippe; Kirwan, James; van Koolwijk, Leonieke M.E.; Hauser, Michael A; Jonasson, Fridbert; Leo, Paul; Loomis, Stephanie J; Fogarty, Rhys; Rivadeneira, Fernando; Kearns, Lisa; Lackner, Karl J; de Jong, Paulus T.V.M.; Simpson, Claire L; Pennell, Craig E; Oostra, Ben A; Uitterlinden, André G; Saw, Seang-Mei; Lotery, Andrew J; Bailey-Wilson, Joan E; Hofman, Albert; Vingerling, Johannes R; Maubaret, Cécilia; Pfeiffer, Norbert; Wolfs, Roger C.W.; Lemij, Hans G; Young, Terri L; Pasquale, Louis R; Delcourt, Cécile; Spector, Timothy D; Klaver, Caroline C.W.; Small, Kerrin S; Burdon, Kathryn P; Stefansson, Kari; Wong, Tien-Yin; Viswanathan, Ananth; Mackey, David A; Craig, Jamie E; Wiggs, Janey L; van Duijn, Cornelia M; Hammond, Christopher J; Aung, Tin

    2014-01-01

    Elevated intraocular pressure (IOP) is an important risk factor in developing glaucoma and IOP variability may herald glaucomatous development or progression. We report the results of a genome-wide association study meta-analysis of 18 population cohorts from the International Glaucoma Genetics Consortium (IGGC), comprising 35,296 multiethnic participants for IOP. We confirm genetic association of known loci for IOP and primary open angle glaucoma (POAG) and identify four new IOP loci located on chromosome 3q25.31 within the FNDC3B gene (p=4.19×10−08 for rs6445055), two on chromosome 9 (p=2.80×10−11 for rs2472493 near ABCA1 and p=6.39×10−11 for rs8176693 within ABO) and one on chromosome 11p11.2 (best p=1.04×10−11 for rs747782). Separate meta-analyses of four independent POAG cohorts, totaling 4,284 cases and 95,560 controls, show that three of these IOP loci are also associated with POAG. PMID:25173106

  5. A novel method to predict visual field progression more accurately, using intraocular pressure measurements in glaucoma patients.

    PubMed

    2016-01-01

    Visual field (VF) data were retrospectively obtained from 491 eyes in 317 patients with open angle glaucoma who had undergone ten VF tests (Humphrey Field Analyzer, 24-2, SITA standard). First, mean of total deviation values (mTD) in the tenth VF was predicted using standard linear regression of the first five VFs (VF1-5) through to using all nine preceding VFs (VF1-9). Then an 'intraocular pressure (IOP)-integrated VF trend analysis' was carried out by simply using time multiplied by IOP as the independent term in the linear regression model. Prediction errors (absolute prediction error or root mean squared error: RMSE) for predicting mTD and also point wise TD values of the tenth VF were obtained from both approaches. The mTD absolute prediction errors associated with the IOP-integrated VF trend analysis were significantly smaller than those from the standard trend analysis when VF1-6 through to VF1-8 were used (p < 0.05). The point wise RMSEs from the IOP-integrated trend analysis were significantly smaller than those from the standard trend analysis when VF1-5 through to VF1-9 were used (p < 0.05). This was especially the case when IOP was measured more frequently. Thus a significantly more accurate prediction of VF progression is possible using a simple trend analysis that incorporates IOP measurements. PMID:27562553

  6. A novel method to predict visual field progression more accurately, using intraocular pressure measurements in glaucoma patients

    PubMed Central

    Asaoka, Ryo; Fujino, Yuri; Murata, Hiroshi; Miki, Atsuya; Tanito, Masaki; Mizoue, Shiro; Mori, Kazuhiko; Suzuki, Katsuyoshi; Yamashita, Takehiro; Kashiwagi, Kenji; Shoji, Nobuyuki

    2016-01-01

    Visual field (VF) data were retrospectively obtained from 491 eyes in 317 patients with open angle glaucoma who had undergone ten VF tests (Humphrey Field Analyzer, 24-2, SITA standard). First, mean of total deviation values (mTD) in the tenth VF was predicted using standard linear regression of the first five VFs (VF1-5) through to using all nine preceding VFs (VF1-9). Then an ‘intraocular pressure (IOP)-integrated VF trend analysis’ was carried out by simply using time multiplied by IOP as the independent term in the linear regression model. Prediction errors (absolute prediction error or root mean squared error: RMSE) for predicting mTD and also point wise TD values of the tenth VF were obtained from both approaches. The mTD absolute prediction errors associated with the IOP-integrated VF trend analysis were significantly smaller than those from the standard trend analysis when VF1-6 through to VF1-8 were used (p < 0.05). The point wise RMSEs from the IOP-integrated trend analysis were significantly smaller than those from the standard trend analysis when VF1-5 through to VF1-9 were used (p < 0.05). This was especially the case when IOP was measured more frequently. Thus a significantly more accurate prediction of VF progression is possible using a simple trend analysis that incorporates IOP measurements. PMID:27562553

  7. Repeatability and Reproducibility of Measurements Using a NT-530P Noncontact Tono/Pachymeter and Correlation of Central Corneal Thickness with Intraocular Pressure

    PubMed Central

    Kamiya, Kazutaka; Fujiwara, Kazuko; Shimizu, Kimiya

    2013-01-01

    Purpose. To investigate the repeatability and reproducibility of intraocular pressure (IOP) and central corneal thickness (CCT) measurements using a noncontact tono/pachymeter (NT-530P) and to assess the correlation of CCT with IOP. Methods. Forty-six eyes of healthy volunteers were measured by two examiners. Three consecutive measurements per eye were performed. Repeatability was assessed using the coefficient of variation, and reproducibility was assessed using Bland-Altman plots. Linear correlations were used to determine agreement between CCT and noncorrected IOP and CCT and corrected IOP, which was calculated using a formula built into the NT-530P. Results. The coefficient of variation for IOP was 6.4% and for CCT was 0.4%. The 95% limits of agreement between examiners were −0.17 ± 1.42 mmHg (range: −2.95 to 2.61 mmHg) for IOP, −0.93 ± 4.37 μm (range: −9.50 to 7.64 μm) for CCT. The corrected IOP was significantly higher than the noncorrected IOP (P = 0.010.3). The noncorrected IOP significantly correlated with CCT (r = −0.4883, P = 0.0006). The corrected IOP showed no significant correlation with CCT (r = −0.0285, P = 0.8509). Conclusions. NT-530P offered repeatability and reproducibility in both IOP and CCT measurements. The corrected IOP calculated using the NT-530P was independent of the CCT, suggesting that this IOP may be less influenced by the central corneal thickness. PMID:24222904

  8. Elevated Intraocular Pressure Induces Rho GTPase Mediated Contractile Signaling in the Trabecular Meshwork

    PubMed Central

    Pattabiraman, Padmanabhan P; Inoue, Toshihiro; Rao, P. Vasantha

    2015-01-01

    Rho GTPase regulated contractile signaling in the trabecular meshwork (TM) has been shown to modulate aqueous humor (AH) outflow and intraocular pressure (IOP). To explore whether elevated IOP, a major risk factor for primary open angle glaucoma (POAG) influences Rho GTPase signaling in the TM, we recorded AH outflow in enucleated contralateral porcine eyes perfused for 4–5 hours at either 15 mm or 50 mm Hg pressure. After perfusion, TM tissue extracted from perfused eyes was evaluated for the activation status of Rho GTPase, myosin light chain (MLC), myosin phosphatase target substrate 1 (MYPT1), myristoylated alanine-rich C-kinase substrate (MARCKS) and paxillin. Eyes perfused at 50 mm Hg exhibited a significant decrease in AH outflow facility compared with those perfused at 15 mm Hg. Additionally, TM tissue from eyes perfused at 50 mm Hg revealed significantly increased levels of activated RhoA and phosphorylated MLC, MYPT1, MARCKS and paxillin compared to TM tissue derived from eyes perfused at 15 mm Hg. Taken together, these observations indicate that elevated IOP-induced activation of Rho GTPase-dependent contractile signaling in the TM is associated with increased resistance to AH outflow through the trabecular pathway, and demonstrate the sensitivity of Rho GTPase signaling to mechanical force in the AH outflow pathway. PMID:25956210

  9. Effect of dorzolamide-timolol fixed combination prophylaxis on intraocular pressure spikes after intravitreal bevacizumab injection

    PubMed Central

    Ozcaliskan, Sehnaz; Ozturk, Faruk; Yilmazbas, Pelin; Beyazyildiz, Ozlem

    2015-01-01

    AIM To evaluate the effect of topical dorzolamide-timolol fixed combination prophylaxis on short term intraocular pressure (IOP) changes in patients who had intravitreal bevacizumab injection. METHODS One hundred and fifty one eyes of 151 patients which were followed up in retina clinic in Ulucanlar Eye Training and Research Hospital were evaluated in this study. Patients were divided into two groups. Group 1 consists of 75 patients who had topical dorzolamid-timolol medication two hours before injection; while Group 2 consists of 76 patients without prophylaxis. Demographic data, IOP measurements prior to the injection and one, thirty and sixty minutes and twenty-four hours after the injection were recorded. The data were analyzed using SPSS software version 15.0 (SPSS Inc., Chicago, IL, USA). RESULTS There were no significant difference between two groups in age, gender distrubition and indications for injections. The mean IOPs in Groups 1 and 2 prior to the injection (T0) were 17.84±0.43 and 18.15±0.43 mm Hg, one minute after the injection (T1) were 29.75±1.6 and 34.44±1.59 mm Hg, 30min after the injection (T30) were 20.06±0.6 and 21.71±0.59 mm Hg respectively. The mean IOPs were 18.26±0.56 mm Hg in Group 1 and 19.78±0.56 mm Hg in Group 2 sixty minutes after the injection (T60). All IOP values after the injection were compared between two groups, there was a significant difference between two groups only on T1; one minute after the injection (P=0.04). There were a statiscially significant difference between the baseline values and other recorded values; except on T60, in Groups 1 and 2 (P<0.05). CONCLUSION After intravitreal bevacizumab injection; we observe a transient IOP elevation which normalizes about one hour after intravitreal injection. In patients who had topical dorzolamid-timolol combination prophylaxis before injections, a significant decrease is seen in IOP spikes due to this injection. The appropiate approach will monitor IOP after

  10. Central corneal thickness and intraocular pressure in the Cameroonian nonglaucomatous population

    PubMed Central

    Eballe, André Omgbwa; Koki, Godefroy; Ellong, Augustin; Owono, Didier; Epée, Emilienne; Bella, Lucienne Assumpta; Mvogo, Côme Ebana; Kouam, Jeanne Mayouego

    2010-01-01

    Aim: We performed a prospective, analytical study from 01 January to 31 March 2009 in the Ophthalmology Unit of the Gyneco-Obstetric and Pediatric Hospital of Yaounde, aiming to determine the profile of central corneal thickness (CCT) in the Cameroonian nonglaucomatous black population and its relationship with intraocular pressure (IOP). Results and discussion: Four hundred and eighty-five patients (970 eyes) meeting our inclusion criteria were selected for this study. The average CCT was 529.29 ± 35.9 μm in the right eye (95% confidence interval [CI]: 526.09–532.49), 528.19 ± 35.9 μm in the left eye (95% CI: 524.99–531.40) and 528.74 ± 35.89 μm in both eyes (95% CI: 526.48–531.00), range 440 to 670 μm. The average IOP was 13.01 ± 2.97 mmHg in both eyes (95% CI: 12.82–13.19). A rise in CCT by 100 μm was followed by an increase in IOP of about 2.8 mmHg (95% CI: 2.3–3.6) for both eyes taken together. Linear regression analysis showed that corneal thickness was negatively correlated with age and IOP was positively related with age. Conclusion: CCT in the Cameroonian nonglaucomatous black population was found to be lower compared with CCT values in Caucasian and Asian populations. On the basis of reference values ranging between 527 and 560 μm, an adjustment of IOP values by a correction factor is required for many Cameroonian patients. This will improve the diagnosis and follow-up of glaucoma by helping to detect true ocular hypertension. PMID:20689788

  11. Relationship between Corneal Temperature and Intraocular Pressure in Healthy Individuals: A Clinical Thermographic Analysis

    PubMed Central

    Fabiani, Claudia; Li Voti, Roberto; Rusciano, Dario; Mutolo, Maria Giulia; Pescosolido, Nicola

    2016-01-01

    Purpose. To study the geographical distribution of corneal temperature (CT) and its influence on the intraocular pressure (IOP) of healthy human volunteers. Materials and Methods. Fifteen subjects (7 M, 8 F), 33.8 ± 17.4 years old, were enrolled in this pilot, cross-sectional study. Measurements of CT were taken after one hour with closed eyelids (CET) or closed eyelids with a cooling mask (cm-CET) and compared to baseline. Results. If compared to baseline, after CET, average CT significantly increased by 0.56°C in the RE and by 0.48°C in the LE (p < 0.001) and IOP concomitantly significantly increased by 1.13 mmHg and 1.46 mmHg, respectively, in each eye (p < 0.001). After cm-CET, average CT significantly decreased by 0.11°C and 0.20°C, respectively, in the RE and LE (RE p = 0.04; LE p = 0.024), followed by a significant IOP decrease of 2.19 mmHg and 1.54 mmHg, respectively, in each eye (RE p < 0.001; LE p = 0.0019). Conclusion. Significant variations of CT occurred after CET and cm-CET and were directly correlated with significant differences of IOP. It can be speculated that both oxidative stress and sympathetic nerve fiber stimulation by temperature oscillations may affect the regulation of AH vortex flow and turnover, thus influencing IOP values. PMID:26904273

  12. A nanoparticle formulation of disulfiram prolongs corneal residence time of the drug and reduces intraocular pressure.

    PubMed

    Nagai, Noriaki; Yoshioka, Chiaki; Mano, Yu; Tnabe, Wataru; Ito, Yoshimasa; Okamoto, Norio; Shimomura, Yoshikazu

    2015-03-01

    The goal in the search for successful therapies for glaucoma is the reduction of intraocular pressure (IOP), and the search for effective eye drops that reduce IOP is a high priority. We previously reported the potential of a 2-hydroxypropyl-β-cyclodextrin (HPβCD) solution containing 0.5% DSF (DSF solution) to provide effective anti-glaucoma treatment in eye drop form. In this study, we designed new ophthalmic formulations containing 0.5% DSF nanoparticles prepared by a bead mill method (DSFnano dispersion; particle size 183 ± 92 nm, mean ± S.D.), and compared the IOP-reducing effects of a DSFnano dispersion with those of a DSF solution. The high stability of the DSFnano dispersion was observed until 7 days after preparation, and the DSFnano dispersion showed high antimicrobial activity against Escherichia coli (ATCC 8739). In transcorneal penetration experiments using rabbit corneas, only diethyldithiocarbamate (DDC) was detected in the aqueous humor, while no DSF was detected. The DDC penetration level (area under the curve, AUC) and corneal residence time (mean residence time, MRT) of the DSFnano dispersion were approximately 1.45- and 1.44-fold higher than those of the DSF, respectively. Moreover, the IOP-reducing effects of the DSFnano dispersion were significantly greater than those of the DSF solution in rabbits (the IOP was enhanced by placing the rabbits in a dark room for 5 h). In addition, DSFnano dispersion are tolerated better by a corneal epithelial cell than DSF solution and commercially available timolol maleate eye drops. It is possible that dispersions containing DSF nanoparticles will provide new possibilities for the effective treatment of glaucoma, and that an ocular drug delivery system using drug nanoparticles may expand their usage as therapy in the ophthalmologic field. These findings provide significant information that can be used to design further studies aimed at developing anti-glaucoma drugs. PMID:25633346

  13. Intraocular pressure after phacoemulsification in patients with uncontrolled primary open angle glaucoma

    PubMed Central

    Iancu, R; Corbu, C

    2014-01-01

    Abstract Rationale (hypothesis). Although cataract and glaucoma represent an increasingly common situation encountered concomitantly, the management of this association is still debatable. Objective (aim). We aimed to assess intraocular pressure dynamics after phacoemulsification in patients with uncontrolled primary open angle glaucoma (POAG). Methods and Results. The present study was designed as a prospective, non-randomized, cohort study. The study population comprised of 38 patients with medically uncontrolled POAG who underwent cataract surgery by phacoemulsification between 2011 and 2012. Most of the patients (32/38, 84.2%) needed glaucoma surgery after a variable time (mean time between surgeries was 11.6 +/- 4.18 months). Mean preoperative IOP decreased with 2,1 +/- 3,7 mmHg at 6 months (CI 95% 1.96 to 3.56) and with 1,9 +/- 3,9 mmHg at 12 months compared with the baseline IOP. Postoperative IOP was statistically significant lower compared with its preoperative value at 6 months (p=9.11 x 10⁻⁸) and at one year (p=9.2 x 10⁻⁵). The difference between mean IOP at 6 months and 1 year after cataract surgery was not statistically significant (p>0.05). Preoperatively, all the patients received topical antiglaucoma therapy. After phacoemulsification, their number did not change statistically significant, but it showed a slight increase. Average number of topical glaucoma medications used preoperatively was 2.66 + / -0.66, while at 6 months after surgery it was 2.71 + / - 0,75 and at 12 months postoperatively, 2.9 +/- 0.53. Discussion. IOP decreased statistically significant after phacoemulsification in patients with uncontrolled POAG, but the decrease was not sufficient for optimal glaucoma management; therefore, many patients needed subsequent glaucoma surgery. PMID:24653751

  14. Age-Related Changes of Intraocular Pressure in Elderly People in Southern China: Lingtou Eye Cohort Study

    PubMed Central

    Han, Xiaotong; Niu, Yong; Guo, Xinxing; Hu, Yin; Yan, William; He, Mingguang

    2016-01-01

    Purpose To study age-related changes of intraocular pressure (IOP) and assess the cohort effect in both cross-sectional and longitudinal settings among elderly Chinese adults. Methods Participants were enrolled from the Lingtou Eye Cohort Study with Chinese government officials aged 40 years and older at baseline and received physical check-up and ocular examinations from 2010 to 2012. IOP was measured using a non-contact tonometer according to standardized protocols, as well as systolic blood pressure (SBP), diastolic blood pressure (DBP) and body mass index (BMI). Participants who had attended IOP measurements in both 2010 and 2012 were included in this study. Cross-sectional association of IOP with age was assessed using multivariate liner regression analyses and based on the data of 2010. Longitudinal changes in IOP were assessed by paired t-test. Results A total of 3372 subjects were enrolled in the current analysis (2010 mean [SD] age, 61.9 [7.1] years; 60.2% men). The mean IOP in 2010 was 15.4±2.3 mmHg for women and 15.2±2.3 mmHg for men with an intersex difference (P = 0.029). Cross-sectional analysis showed that IOP was negatively associated with age (P = 0.003, β = -0.033 for women and P<0.001, β = -0.061 for men) adjusted for baseline SBP, DBP and BMI. Paired t-test suggested that IOP was higher in the year 2012 than 2010 in women (P = 0.006) but did not change significantly in men within 2 years (P = 0.345). In addition, the 2-year changes of IOP were not associated with age adjusted for baseline IOP in 2010 (P = 0.249). Conclusion Cross-sectional data suggests that IOP is lower in people with older age. Longitudinal data does not support such findings and thus the identified decreasing pattern with age in cross-sectional analysis is likely caused by cohort effects. PMID:26986222

  15. Intraocular pressure efficacy of glaucoma medications versus placebo in phase II compared to later phase trials.

    PubMed

    Sharpe, R Allan; Nelson, Lindsay A; Stewart, Jeanette A; Stewart, William C

    2013-02-01

    This review aimed to compare the predictive value between the untreated reduction in intraocular pressure (IOP) from baseline or placebo measured in early phase clinical trials to phase III and IV results for glaucoma medicines. Published, placebo-controlled, randomised, parallel, single-masked or double-masked clinical trials with at least one phase II, III and IV study available were reviewed. This study included 50 articles evaluating 9 medicines from 59 active arms and 18 placebo arms. For all studies the phase II IOP reduction from placebo showed less decrease compared to the decrease from baseline (p<0.04). For all medicines, reductions from morning baseline in phase II did not predict better than the decrease from placebo for phase III (p=0.15) or IV (p=0.08) reductions in IOP. In contrast, diurnal IOP reduction from baseline in phase II predicted decreases better than placebo in phase III (p=0.007) and IV (p=0.02). Generally, for prostaglandins, β blockers and carbonic anhydrase inhibitors for the morning trough and diurnal curve there was no difference in pressure reduction from baseline for phase II compared to phase III or IV (p≥0.23). In contrast, where comparisons were available for the decrease in pressure from placebo there were differences for phase II compared to phase III and phase IV (p≤0.02). This study suggests that in early phase glaucoma trials, using the reduction from untreated baseline in general better approximates the results of later regulatory and post-commercialisation trials than the decrease from placebo. PMID:23060621

  16. Reduction of intraocular pressure and improvement of vision after cataract surgeries in angle closure glaucoma with concomitant cataract patients

    PubMed Central

    Zhang, Zong-Mei; Niu, Qing; Nie, Yan; Zhang, Jin

    2015-01-01

    Objective: This study is to compare the efficacy of three different cataract surgeries in eyes with angle closure glaucoma (ACG) with concomitant cataract. Methods: A retrospective comparative analysis of 106 ACG patients (112 eyes) with concomitant cataract was conducted between February, 2012 and February, 2014. Clinical outcomes of ACG patients with concomitant cataract underwent phacoemulsification and intraocular lens implantation (group A, n = 34, 36 eyes, angle closure < 180°); combined phacoemulsification, intraocular lens implantation, and goniosynechialysis (group B, n = 43, 45 eyes, angle closure, 180°~270°); and combined phacoemulsification, intraocular lens implantation, and trabeculectomy (group C, n = 29, 31 eyes, angle closure > 270°) were compared during a 6-month follow-up. Results: There were no statistical differences among the 3 groups in pre-operative or post-operative average visual acuity (VA), intraocular pressure (IOP), anterior chamber depth (ACD), and angle opening distance (AOD) (all P > 0.05). Post-operative VA, IOP, ACD, AOD and the degree of angle opening in the 3 groups were all improved as compared with pre-operative levels (all P < 0.05). No statistical difference was detected among the 3 groups in the incidence of complications (χ2 = 0.376, P = 0.829). Conclusion: Phacoemulsification alone, combined phacoemulsification/goniosynechialysis, and combined phacoemulsification/trabeculectomy provide safe, effective, predictable, and stable options of cataract surgery for treatment of ACG with concomitant cataract. PMID:26629184

  17. Alterations of the synapse of the inner retinal layers after chronic intraocular pressure elevation in glaucoma animal model

    PubMed Central

    2014-01-01

    Background Dendrites of retinal ganglion cells (RGCs) synapse with axon terminals of bipolar cells in the inner plexiform layer (IPL). Changes in RGC dendrites and synapses between bipolar cells in the inner retinal layer may critically alter the function of RGCs in glaucoma. Recently, synaptic plasticity has been observed in the adult central nervous system, including the outer retinal layers. However, few studies have focused on changes in the synapses between RGCs and bipolar cells in glaucoma. In the present study, we used a rat model of ocular hypertension induced by episcleral vein cauterization to investigate changes in synaptic structure and protein expression in the inner retinal layer at various time points after moderate intraocular pressure (IOP) elevation. Results Synaptophysin, a presynaptic vesicle protein, increased throughout the IPL, outer plexiform layer, and outer nuclear layer after IOP elevation. Increased synaptophysin after IOP elevation was expressed in bipolar cells in the innermost IPL. The RGC marker, SMI-32, co-localized with synaptophysin in RGC dendrites and were significantly increased at 1 week and 4 weeks after IOP elevation. Both synaptophysin and postsynaptic vesicle protein, PSD-95, were increased after IOP elevation by western blot analysis. Ribbon synapses in the IPL were quantified and structurally evaluated in retinal sections by transmission electron microscopy. After IOP elevation the total number of ribbon synapses decreased. There were increases in synapse diameter and synaptic vesicle number and decreases in active zone length and the number of docked vesicles after IOP elevation. Conclusions Although the total number of synapses decreased as RGCs were lost after IOP elevation, there are attempts to increase synaptic vesicle proteins and immature synapse formation between RGCs and bipolar cells in the inner retinal layers after glaucoma induction. PMID:25116810

  18. Exercise training prevents increased intraocular pressure and sympathetic vascular modulation in an experimental model of metabolic syndrome

    PubMed Central

    Castro, E.F.S.; Mostarda, C.T.; Rodrigues, B.; Moraes-Silva, I.C.; Feriani, D.J.; De Angelis, K.; Irigoyen, M.C.

    2015-01-01

    The present study aimed to study the effects of exercise training (ET) performed by rats on a 10-week high-fructose diet on metabolic, hemodynamic, and autonomic changes, as well as intraocular pressure (IOP). Male Wistar rats receiving fructose overload in drinking water (100 g/L) were concomitantly trained on a treadmill for 10 weeks (FT group) or kept sedentary (F group), and a control group (C) was kept in normal laboratory conditions. The metabolic evaluation comprised the Lee index, glycemia, and insulin tolerance test (KITT). Arterial pressure (AP) was measured directly, and systolic AP variability was performed to determine peripheral autonomic modulation. ET attenuated impaired metabolic parameters, AP, IOP, and ocular perfusion pressure (OPP) induced by fructose overload (FT vs F). The increase in peripheral sympathetic modulation in F rats, demonstrated by systolic AP variance and low frequency (LF) band (F: 37±2, 6.6±0.3 vs C: 26±3, 3.6±0.5 mmHg2), was prevented by ET (FT: 29±3, 3.4±0.7 mmHg2). Positive correlations were found between the LF band and right IOP (r=0.57, P=0.01) and left IOP (r=0.64, P=0.003). Negative correlations were noted between KITT values and right IOP (r=-0.55, P=0.01) and left IOP (r=-0.62, P=0.005). ET in rats effectively prevented metabolic abnormalities and AP and IOP increases promoted by a high-fructose diet. In addition, ocular benefits triggered by exercise training were associated with peripheral autonomic improvement. PMID:25714884

  19. Exercise training prevents increased intraocular pressure and sympathetic vascular modulation in an experimental model of metabolic syndrome.

    PubMed

    Castro, E F S; Mostarda, C T; Rodrigues, B; Moraes-Silva, I C; Feriani, D J; De Angelis, K; Irigoyen, M C

    2015-04-01

    The present study aimed to study the effects of exercise training (ET) performed by rats on a 10-week high-fructose diet on metabolic, hemodynamic, and autonomic changes, as well as intraocular pressure (IOP). Male Wistar rats receiving fructose overload in drinking water (100 g/L) were concomitantly trained on a treadmill for 10 weeks (FT group) or kept sedentary (F group), and a control group (C) was kept in normal laboratory conditions. The metabolic evaluation comprised the Lee index, glycemia, and insulin tolerance test (KITT). Arterial pressure (AP) was measured directly, and systolic AP variability was performed to determine peripheral autonomic modulation. ET attenuated impaired metabolic parameters, AP, IOP, and ocular perfusion pressure (OPP) induced by fructose overload (FT vs F). The increase in peripheral sympathetic modulation in F rats, demonstrated by systolic AP variance and low frequency (LF) band (F: 37±2, 6.6±0.3 vs C: 26±3, 3.6±0.5 mmHg2), was prevented by ET (FT: 29±3, 3.4±0.7 mmHg2). Positive correlations were found between the LF band and right IOP (r=0.57, P=0.01) and left IOP (r=0.64, P=0.003). Negative correlations were noted between KITT values and right IOP (r=-0.55, P=0.01) and left IOP (r=-0.62, P=0.005). ET in rats effectively prevented metabolic abnormalities and AP and IOP increases promoted by a high-fructose diet. In addition, ocular benefits triggered by exercise training were associated with peripheral autonomic improvement. PMID:25714884

  20. TRPV4 regulates calcium homeostasis, cytoskeletal remodeling, conventional outflow and intraocular pressure in the mammalian eye.

    PubMed

    Ryskamp, Daniel A; Frye, Amber M; Phuong, Tam T T; Yarishkin, Oleg; Jo, Andrew O; Xu, Yong; Lakk, Monika; Iuso, Anthony; Redmon, Sarah N; Ambati, Balamurali; Hageman, Gregory; Prestwich, Glenn D; Torrejon, Karen Y; Križaj, David

    2016-01-01

    An intractable challenge in glaucoma treatment has been to identify druggable targets within the conventional aqueous humor outflow pathway, which is thought to be regulated/dysregulated by elusive mechanosensitive protein(s). Here, biochemical and functional analyses localized the putative mechanosensitive cation channel TRPV4 to the plasma membrane of primary and immortalized human TM (hTM) cells, and to human and mouse TM tissue. Selective TRPV4 agonists and substrate stretch evoked TRPV4-dependent cation/Ca(2+) influx, thickening of F-actin stress fibers and reinforcement of focal adhesion contacts. TRPV4 inhibition enhanced the outflow facility and lowered perfusate pressure in biomimetic TM scaffolds populated with primary hTM cells. Systemic delivery, intraocular injection or topical application of putative TRPV4 antagonist prodrug analogs lowered IOP in glaucomatous mouse eyes and protected retinal neurons from IOP-induced death. Together, these findings indicate that TRPV4 channels function as a critical component of mechanosensitive, Ca(2+)-signaling machinery within the TM, and that TRPV4-dependent cytoskeletal remodeling regulates TM stiffness and outflow. Thus, TRPV4 is a potential IOP sensor within the conventional outflow pathway and a novel target for treating ocular hypertension. PMID:27510430

  1. Effects of betaxolol and flunarizine on visual fields and intraocular pressure in patients with migraine.

    PubMed

    Yarangümeli, Alper; Comoglu, Selçuk; Köz, Ozlem Gürbüz; Elhan, Atilla Halil; Kural, Gülcan

    2003-05-01

    Fifty-one patients with migraine were divided into four groups to investigate the effects of topical betaxolol and systemic calcium channel blocker flunarizine on visual fields (VF) and intraocular pressure (IOP). The first group (Group 0) was followed with no medications, topical betaxolol (bid) was precribed to the second group (Group B), oral flunarizine (10 mg daily) was prescribed to the third group (Group F), and the last group (Group BF) was assigned for combined betaxolol and flunarizine treatment. After a mean follow-up time of 4.2 +/- 1.2 months (3-6 months), IOP measurements and VF tests were repeated. Group B and Group BF were found to be statistically different from the other groups in terms of IOP reduction and VF improvement according to mean deviation and corrected pattern standard deviation indices in the second examinations. On the other hand, Group F and Group BF differed from the other two groups considering the improvement in migrainous complaints. VF findings which are probably influenced by perfusion problems due to vasospastic mechanisms in migraineurs, improved following topical betaxolol treatment. However, systemic use of flunarizine--a calcium channel blocker--did not seem to be effective on visual fields although it had beneficial effects on migraine. PMID:12737504

  2. TRPV4 regulates calcium homeostasis, cytoskeletal remodeling, conventional outflow and intraocular pressure in the mammalian eye

    PubMed Central

    Ryskamp, Daniel A.; Frye, Amber M.; Phuong, Tam T. T.; Yarishkin, Oleg; Jo, Andrew O.; Xu, Yong; Lakk, Monika; Iuso, Anthony; Redmon, Sarah N.; Ambati, Balamurali; Hageman, Gregory; Prestwich, Glenn D.; Torrejon, Karen Y.; Križaj, David

    2016-01-01

    An intractable challenge in glaucoma treatment has been to identify druggable targets within the conventional aqueous humor outflow pathway, which is thought to be regulated/dysregulated by elusive mechanosensitive protein(s). Here, biochemical and functional analyses localized the putative mechanosensitive cation channel TRPV4 to the plasma membrane of primary and immortalized human TM (hTM) cells, and to human and mouse TM tissue. Selective TRPV4 agonists and substrate stretch evoked TRPV4-dependent cation/Ca2+ influx, thickening of F-actin stress fibers and reinforcement of focal adhesion contacts. TRPV4 inhibition enhanced the outflow facility and lowered perfusate pressure in biomimetic TM scaffolds populated with primary hTM cells. Systemic delivery, intraocular injection or topical application of putative TRPV4 antagonist prodrug analogs lowered IOP in glaucomatous mouse eyes and protected retinal neurons from IOP-induced death. Together, these findings indicate that TRPV4 channels function as a critical component of mechanosensitive, Ca2+-signaling machinery within the TM, and that TRPV4-dependent cytoskeletal remodeling regulates TM stiffness and outflow. Thus, TRPV4 is a potential IOP sensor within the conventional outflow pathway and a novel target for treating ocular hypertension. PMID:27510430

  3. Intraocular Pressure Changes: An Important Determinant of the Biocompatibility of Intravitreous Implants

    PubMed Central

    Zou, Ling; Nair, Ashwin; Weng, Hong; Tsai, Yi-Ting; Hu, Zhibing; Tang, Liping

    2011-01-01

    Background In recent years, research efforts exploring the possibility of using biomaterial nanoparticles for intravitreous drug delivery has increased significantly. However, little is known about the effect of material properties on intravitreous tissue responses. Principal Findings To find the answer, nanoparticles made of hyaluronic acid (HA), poly (l-lactic acid) (PLLA), polystyrene (PS), and Poly N-isopropyl acrylamide (PNIPAM) were tested using intravitreous rabbit implantation model. Shortly after implantation, we found that most of the implants accumulated in the trabecular meshwork area followed by clearance from the vitreous. Interestingly, substantial reduction of intraocular pressure (IOP) was observed in eyes implanted with particles made of PS, PNIPAM and PLLA, but not HA nanoparticles and buffered salt solution control. On the other hand, based on histology, we found that the particle implantation had no influence on cornea, iris and even retina. Surprisingly, substantial CD11b+ inflammatory cells were found to accumulate in the trabecular meshwork area in some animals. In addition, there was a good relationship between recruited CD11b+ cells and IOP reduction. Conclusions Overall, the results reveal the potential influence of nanoparticle material properties on IOP reduction and inflammatory responses in trabecular meshwork. Such interactions may be critical for the development of future ocular nanodevices with improved safety and perhaps efficacy. PMID:22194895

  4. Effect of persistent high intraocular pressure on microstructure and hydraulic permeability of trabecular meshwork

    NASA Astrophysics Data System (ADS)

    Mei, Xi; Ren, Lin; Xu, Qiang; Zheng, Wei; Liu, Zhi-Cheng

    2015-05-01

    As the aqueous humor leaves the eye, it first passes through the trabecular meshwork (TM). Increased flow resistance in this region causes elevation of intraocular pressure (IOP), which leads to the occurrence of glaucoma. To quantitatively evaluate the effect of high IOP on the configuration and hydraulic permeability of the TM, second harmonic generation (SHG) microscopy was used to image the microstructures of the TM and adjacent tissues in control (normal) and high IOP conditions. Enucleated rabbit eyes were perfused at a pressure of 60 mmHg to achieve the high IOP. Through the anterior chamber of the eye, in situ images were obtained from different depths beneath the surface of the TM. Porosity and specific surface area of the TM in control and high IOP conditions were then calculated to estimate the effect of the high pressure on the permeability of tissue in different depths. We further photographed the histological sections of the TM and compared the in situ images. The following results were obtained in the control condition, where the region of depth was less than 55 μm with crossed branching beams and large pores in the superficial TM. The deeper meshwork is a silk-like tissue with abundant fluorescence separating the small size of pores. The total thickness of pathway tissues composed of TM and juxtacanalicular (JCT) is more than 100 μm. After putting a high pressure on the inner wall of the eye, the TM region progressively collapses and decreases to be less than 40 μm. Fibers of the TM became dense, and the porosity at 34 μm in the high IOP condition is comparable to that at 105 μm in the control condition. As a consequent result, the permeability of the superficial TM decreases rapidly from 120 μm2 to 49.6 μm2 and that of deeper TM decreases from 1.66 μm2 to 0.57 μm2. Heterogeneity reflected by descent in permeability reduces from 12.4 μm of the control condition to 3.74 μm of the high IOP condition. The persistently high IOP makes the TM

  5. Posterior fixation keratoprostheses and mechanical biocompatibility: determination of critical intraocular pressure causing aqueous humor leak and/or keratoprosthesis extrusion

    NASA Astrophysics Data System (ADS)

    Tahi, Hassan; Duchesne, Bernard; Parel, Jean-Marie A.; Nose, Izuru; Denham, David B.; Villain, Franck L.; Lacombe, Emmanuel

    1997-05-01

    The effect of increased intraocular pressure (IOP) in human cadaver eyes implanted with posterior fixation keratoprosthesis was evaluated. Experiments were carried out with six fresh pairs of human cadaver eyes. One eye of each pair was implanted with a PCL-5 keratoprosthesis (8.60 mm diameter with an optic of 5.60 nm diameter) and the contralateral eye was used as a control. The keratoprosthesis was inserted through a 6 mm diameter opening trephined in the cornea. The resistance of the implanted eye to pressure on `aqueous humor' leak and/or keratoprosthesis extrusion was tested by infusing water at a constant flow of 60 mmHg/second into the anterior chamber. IOP variations were recorded with a transducer connected to a computer. IOP could be increased up to 1520 to 2324 mmHg before aqueous humor leaks occurred. Leaks were always located at the keratoprosthesis-cornea interface. No prosthesis extrusion was observed. Implanted eyes that did not leak aqueous and control eyes tore at the sclera. All posterior fixation keratoprostheses implanted eyes resisted more than 100 times the normal physiological intraocular pressure and on this standpoint is safe. Additional experiments were needed to assess the influence of suture fixation and wound healing in an animal model.

  6. [Intraocular Pressure Sensor Based on a Contact Lens].

    PubMed

    Guo, Xuhong; Pet, Weihua; Yao, Zhaolin; Chen, Yuanfang; Hu, Xiaohui; Chen, Hongda; Zhu, Jingyuan; Wu, Huijuan

    2016-02-01

    Intraocular pressure detection has a great significance for understanding the status of eye health, prevention and treatment of diseases such as glaucoma. Traditional intraocular pressure detection needs to be held in the hospital. It is not only time-consuming to doctors and patients, but also difficult to achieve 24 hour-continuous detection. Microminiaturization of the intraocular pressure sensor and wearing it as a contact lens, which is convenient, comfortable and noninvasive, can solve this problem because the soft contact lens with an embedded micro fabricated strain gauge allows the measurement of changes in corneal curvature to correlate to variations of intraocular pressure. We fabricated a strain gauge using micro-electron mechanical systems, and integrated with the contact lens made of polydimethylsiloxane (PDMS) using injection molding. The experimental results showed that the sensitivity was 100. 7 µV/µm. When attached to the corneal surface, the average sensitivity of sensor response of intraocular pressure can be 125.8 µV/mm Hg under the ideal condition. PMID:27382734

  7. Effects of 2-alkynyladenosine derivatives on intraocular pressure in rabbits.

    PubMed

    Konno, Takashi; Ohnuma, Shin-ya; Uemoto, Kazuhiro; Uchibori, Takehiro; Nagai, Akihiko; Kogi, Kentaro; Endo, Kazuki; Hosokawa, Tomokazu; Nakahata, Norimichi

    2004-02-23

    We evaluated the activities of 2-alkynyladenosine derivatives, relatively selective adenosine A2 receptor agonists, in the intraocular pressure regulation in rabbits. An adenosine A2 receptor agonist 2-[p-(2-carboxyethyl)phenylethylamino]-5'-N-ethylcarboxamidoadenosine (CGS-21680) decreased intraocular pressure, while another A2 receptor agonist 2-(phenylamino)adenosine transiently increased it. The first group of 2-alkynyladenosine derivatives (1-hexyn-1-yl derivatives) caused a transient increase followed by decrease in intraocular pressure, while the second group (1-octyn-1-yl and 6-cyano-1-hexyn-1-yl derivatives) only decreased it. The second group is also effective in the ocular hypertensive models induced by water-loading and alpha-chymotrypsin. The outflow facility was increased by a 1-octyn-1-yl derivative. Both increase and decrease in intraocular pressure induced by 2-alkynyladenosine derivatives were inhibited by an adenosine A2 receptor antagonist 3,7-dimethyl-1-propargylxanthine, but not by an adenosine A1 receptor antagonist 8-cyclopentyl-1,3-dipropyl xanthine. These findings suggest that 2-alkynyladenosine derivatives may affect intraocular pressure via adenosine A2 receptor, and 2-alkynyladenosine derivative-induced ocular hypotension is due to the increase of outflow facility. PMID:14985053

  8. Comparison of intra-ocular pressure changes with liquid or flat applanation interfaces in a femtosecond laser platform

    PubMed Central

    Williams, G. P.; Ang, H. P.; George, B. L.; Liu, Y. C.; Peh, G.; Izquierdo, L.; Tan, D. T.; Mehta, J. S.

    2015-01-01

    Cataract surgery is the most common surgical procedure and femtosecond laser assisted cataract surgery (FLACS) has gained increased popularity. FLACS requires the application of a suction device to stabilize the laser head and focus the laser beam accurately. This may cause a significant escalation in intra-ocular pressure (IOP), which poses potential risks for patients undergoing cataract surgery. In this study we aimed to assess the effect of the Ziemer LDV Z8 femtosecond cataract machine on IOP. We demonstrated through a porcine model that IOP was significantly higher with a flat interface but could be abrogated by reducing surgical compression and vacuum. Pressure was lower with a liquid interface, and further altering angulation of the laser arm could reduce the IOP to 36 mmHg. A pilot series in patients showed comparable pressure rises with the porcine model (30 mmHg). These strategies may improve the safety profile in patients vulnerable to high pressure when employing FLACS with the Ziemer LDV Z8. PMID:26439499

  9. Comparison of intra-ocular pressure changes with liquid or flat applanation interfaces in a femtosecond laser platform.

    PubMed

    Williams, G P; Ang, H P; George, B L; Liu, Y C; Peh, G; Izquierdo, L; Tan, D T; Mehta, J S

    2015-01-01

    Cataract surgery is the most common surgical procedure and femtosecond laser assisted cataract surgery (FLACS) has gained increased popularity. FLACS requires the application of a suction device to stabilize the laser head and focus the laser beam accurately. This may cause a significant escalation in intra-ocular pressure (IOP), which poses potential risks for patients undergoing cataract surgery. In this study we aimed to assess the effect of the Ziemer LDV Z8 femtosecond cataract machine on IOP. We demonstrated through a porcine model that IOP was significantly higher with a flat interface but could be abrogated by reducing surgical compression and vacuum. Pressure was lower with a liquid interface, and further altering angulation of the laser arm could reduce the IOP to 36 mmHg. A pilot series in patients showed comparable pressure rises with the porcine model (30 mmHg). These strategies may improve the safety profile in patients vulnerable to high pressure when employing FLACS with the Ziemer LDV Z8. PMID:26439499

  10. Intraocular Pressure-Lowering Potential of Subthreshold Selective Laser Trabeculoplasty in Patients with Primary Open-Angle Glaucoma

    PubMed Central

    Yang, Yang Fan; Xu, Jian Gang

    2016-01-01

    Purpose. To compare the efficacy of subthreshold and conventional selective laser trabeculoplasty (SLT) in lowering intraocular pressure (IOP) in the patients with primary open-angle glaucoma (POAG). Methods. Fifty-two eyes from fifty-two POAG patients were randomized into two groups, one group treated with subthreshold SLT using two-thirds of the conventional energy and the other one treated with the conventional energy. IOP was measured with the Goldmann tonometer and the anterior chamber inflammation was determined using laser flare meter. Results. The initial energy dosage used in subthreshold SLT group was significantly lower than the amount of the energy used in conventional SLT group (0.4 ± 0.1 mJ versus 0.6 ± 0.1 mJ, P = 0.030). The total energy dosage was also significantly lower in subthreshold SLT group compared to the other group (37.6 ± 3.3 mJ versus 51.8 ± 5.7 mJ, P = 0.036). However, the level of inflammation in aqueous humor, amount of reduction in IOP, and the success rate in controlling IOP was the same in both groups. Conclusion. The efficacy of subthreshold SLT group in reducing IOP in POAG patients is comparable to the efficacy of conventional SLT group. PMID:27529032

  11. Selectively bonded polymeric glaucoma drainage device for reliable regulation of intraocular pressure.

    PubMed

    Moon, Seunghwan; Im, Seongmin; An, Jaeyong; Park, Chang Ju; Kim, Hwang Gyun; Park, Sang Woo; Kim, Hyoung Ihl; Lee, Jong-Hyun

    2012-04-01

    A novel glaucoma drainage device (GDD) using a polymeric micro check valve with no reverse flow is presented for the effective regulation of intraocular pressure (IOP). A significant functional improvement was achieved by reducing the possible incidence of hypotony, as the proposed GDD only drains aqueous humor at a certain cracking pressure or higher. The device consists of three biocompatible polymer layers: a top layer (cover), an intermediate layer (membrane), and a bottom layer (base plate with a cannula). All three layers, made of soft polydimethylsiloxane (PDMS), were bonded together to realize the thin GDDs. The bottom layer was selectively coated with chromium (Cr)/gold (Au) to prevent stiction between the valve seat and the valve orifice so that the device could show enhanced reliability in operation and high yield in production. Two types of polymeric devices were fabricated; one was a glaucoma drainage device for humans (GDDH) and the other was a glaucoma drainage device for animals (GDDA). From subsequent in vitro tests, the cracking pressures were 18.33 ± 0.66 mmHg (mean ± standard deviation) for GDDH and 12.42 mmHg for GDDA, both of which were very close to the corresponding normal IOPs. From in vivo tests of GDDA, the IOP of all implanted devices was properly regulated within the target pressure (10-15 mmHg). The experimental results showed that the proposed polymeric GDD has high potential for use in the treatment of glaucoma disease in terms of its repeatability of the cracking pressure and patients' relief from post-operative discomfort. PMID:22094823

  12. Effect of 3 years of treatment with a dorzolamide/timolol (1%/0.5%) combination on intraocular pressure

    PubMed Central

    Takeda, Sakurako; Mimura, Tatsuya; Matsubara, Masao

    2014-01-01

    Purpose We aimed to evaluate the effect on the intraocular pressure (IOP) of a dorzolamide/timolol (1%/0.5%) fixed combination (DTFC) ophthalmic agent for 3 years. Participants A total of 19 consecutive patients who had previously been treated with mono-therapy or any combination of a beta-blocker, carbonic anhydrase inhibitor, or prostaglandin analog, for primary open-angle glaucoma (POAG) (n=5) or normal tension glaucoma (N=14) were enrolled. Methods Patients were switched to DTFC from their prior glaucoma therapy. The IOP was measured at intervals of 4–6 weeks for 3 years. Treatment failure was defined as an increase of IOP by ≥10% from baseline after switching to DTFC. Results The average IOP decreased significantly from 14.1±2.9 mmHg at baseline to 12.2±2.2, 11.8±2.4, 12.1±2.5, 11.6±1.8, and 12.1±2.7 mmHg at 3, 6, 12, 24, and 36 months, respectively, after switching therapy (all P<0.05). The mean percent decrease of IOP was 12.0%±13.0%, 14.5%±14.2%, 12.2%±18.7%, 16.0%±12.8%, and 12.8%±15.2% at 3, 6, 12, 24, and 36 months, respectively, after switching. Univariate or multivariate analysis revealed the percent decrease of IOP was associated with the type of glaucoma (POAG) at 3 and 12 months, and with the baseline IOP at 3, 12, 24, and 36 months. Kaplan–Meier analysis demonstrated that the percentage of patients who remained on treatment with DTFC was 94.7%, 94.7%, 84.2%, 78.9%, and 78.9% at 3, 6, 12, 24, and 36 months, respectively. Cox proportional hazards analysis showed that the type of glaucoma (POAG) was associated with an increased risk of failure to control the IOP. Conclusion The IOP-lowering effect of DTFC was demonstrated for 3 years in this study. The baseline IOP had an important influence on the reduction of IOP achieved by DTFC. PMID:25228795

  13. Elevated intraocular pressure decreases response sensitivity of inner retinal neurons in experimental glaucoma mice

    PubMed Central

    Pang, Ji-Jie; Frankfort, Benjamin J.; Gross, Ronald L.; Wu, Samuel M.

    2015-01-01

    Glaucoma is the second leading cause of blindness in the United States and the world, characterized by progressive degeneration of the optic nerve and retinal ganglion cells (RGCs). Glaucoma patients exhibit an early diffuse loss of retinal sensitivity followed by focal loss of RGCs in sectored patterns. Recent evidence has suggested that this early sensitivity loss may be associated with dysfunctions in the inner retina, but detailed cellular and synaptic mechanisms underlying such sensitivity changes are largely unknown. In this study, we use whole-cell voltage-clamp techniques to analyze light responses of individual bipolar cells (BCs), AII amacrine cells (AIIACs), and ON and sustained OFF alpha-ganglion cells (ONαGCs and sOFFαGCs) in dark-adapted mouse retinas with elevated intraocular pressure (IOP). We present evidence showing that elevated IOP suppresses the rod ON BC inputs to AIIACs, resulting in less sensitive AIIACs, which alter AIIAC inputs to ONαGCs via the AIIAC→cone ON BC→ONαGC pathway, resulting in lower ONαGC sensitivity. The altered AIIAC response also reduces sOFFαGC sensitivity via the AIIAC→sOFFαGC chemical synapses. These sensitivity decreases in αGCs and AIIACs were found in mice with elevated IOP for 3–7 wk, a stage when little RGC or optic nerve degeneration was observed. Our finding that elevated IOP alters neuronal function in the inner retina before irreversible structural damage occurs provides useful information for developing new diagnostic tools and treatments for glaucoma in human patients. PMID:25675503

  14. Serial Multifocal Electroretinograms during Long-term Elevation and Reduction of Intraocular Pressure in Non-human Primates

    PubMed Central

    Nork, T. Michael; Kim, Charlene B. Y.; Heatley, Gregg A.; Kaufman, Paul L.; Lucarelli, Mark J.; Levin, Leonard A.; Ver Hoeve, James N.

    2010-01-01

    The purpose of this study was to evaluate the relationship between elevations of intraocular pressure (IOP) and the multifocal electroretinogram (mfERG) in non-human primates. Experimental glaucoma was induced in 4 rhesus and 4 cynomolgus monkeys by laser trabecular meshwork destruction (LTD) in one eye. To evaluate the contribution of ganglion cells to mfERG changes, one monkey of each species had previously underwent unilateral optic nerve transection (ONT). After ≥ 44 weeks of elevation, the IOP was reduced by trabeculectomy in 2 non-transected animals. In the intact (non-transected) animals there was an increase in the amplitude of the early mfERG waveforms (N1 and P1) of the first order kernel (K1) throughout the period of IOP elevation in all of the rhesus, but not all of the cynomolgus monkeys. A species difference was also present as a decrease of the second order kernel, first slice (K2.1) in all of the cynomolgus monkeys but only in 1 of the rhesus monkeys (the 1 with the ONT). Similar IOP effects on the mfERG were seen in the ONT animals. Surgical lowering of IOP resulted in a return of the elevated K1 amplitudes to baseline levels. However, the depressed K2.1 RMS in the cynomolgus monkeys did not recover. These results demonstrate species-specific changes in cone-driven retinal function during periods of elevated IOP. These IOP-related effects can occur in the absence of retinal ganglion cells and may be reversible. PMID:20422254

  15. Feasibility study of sustained-release travoprost punctum plug for intraocular pressure reduction in an Asian population

    PubMed Central

    Perera, Shamira A; Ting, Daniel SW; Nongpiur, Monisha E; Chew, Paul T; Aquino, Maria Cecilia D; Sng, Chelvin CA; Ho, Sue-Wei; Aung, Tin

    2016-01-01

    Purpose To investigate the efficacy and safety of a punctum plug-based sustained drug release system for a prostaglandin analog, travoprost (OTX-TP), for intraocular pressure (IOP) reduction in an Asian population. Methods This is an initial feasibility, prospective, single-arm study involving 26 eyes and a bioresorbable punctum plug containing OTX-TP. An OTX-TP was placed in the vertical portion of the superior or inferior canaliculus of patients with primary open-angle glaucoma or ocular hypertension. The main outcome measure was the IOP-lowering efficacy of OTX-TP at 3 (8 am) and 10, 20, and 30 days (8 am, 10 am, and 4 pm), compared to baseline. Results A total of 26 OTX-TP were inserted for 17 subjects. The mean (standard deviation) age was 57.2 (13.8) years. At 10 days, all plugs were still present, and the IOP reduction from baseline was 6.2 (23%), 5.4 (21%), and 7.5 mmHg (28%) at 8 am, 10 am, and 4 pm, respectively. At 10 days, the mean IOP (standard error of mean) was 21.2 (1.2), 20.4 (0.8), and 19.7 (1.0) at 8 am, 10 am, and 4 pm, respectively, showing no discernible IOP trend during the course of the day. At 30 days, plug retention had declined to 42%, and the overall IOP reduction had decreased to 16%. Conclusion The sustained-release OTX-TP is able to reduce IOP by 24% (day 10) and 15.6% (day 30), respectively. It is a potentially well-tolerable ocular hypotensive for glaucoma patients with a history of poor compliance. PMID:27175058

  16. Effect of Melatonin and 5-Methoxycarbonylamino-N-Acetyltryptamine on the Intraocular Pressure of Normal and Glaucomatous Mice.

    PubMed

    Martínez-Águila, Alejandro; Fonseca, Begoña; Pérez de Lara, María J; Pintor, Jesús

    2016-05-01

    Melatonin is a neurohormone that is produced not only by the pineal gland but also by several ocular structures. One of the main physiologic roles of melatonin is the reduction of intraocular pressure (IOP). Using both control C57BL/6J and glaucomatous DBA/2J mice as well as TonoLab tonometry, this study evaluated the effect of melatonin and 5-methoxycarbonylamino-N-acetyltryptamine (5-MCA-NAT) when glaucomatous pathology was fully established and compared pharmacological behavior in treated mice versus control mice. In addition, 5-MCA-NAT was tested to determine its effects on ameliorating increased IOP in a glaucoma model. The results demonstrate that melatonin and 5-MCA-NAT can reduce IOP in a concentration-dependent manner. The EC50values for melatonin in control and glaucomatous animals were 34µM and 50µM, respectively. Interestingly, melatonin decreased IOP in 19.4% ± 3.7% and 32.6% ± 6.0% of control and glaucomatous mice, respectively, when the animals were studied at age 12 months. 5-MCA-NAT reduced IOP in the same manner and was able to stop IOP progression in glaucomatous mice. Use of melatonin receptor antagonists showed that hypotensive effects were blocked by the MT2receptor antagonists luzindole and 4-phenyl-2-propionamidotetralin in the case of melatonin and by only 4-phenyl-2-propionamidotetralin in the case of 5-MCA-NAT. In conclusion, melatonin and 5-MCA-NAT can effectively reduce IOP in a glaucoma model, and their hypotensive effects are more profound in the glaucoma model than in control animals. PMID:26941171

  17. Characterization of intraocular pressure pattern and changes of retinal ganglion cells in DBA2J glaucoma mice

    PubMed Central

    Wang, Jing; Dong, Yu

    2016-01-01

    AIM To characterize the pattern of intraocular pressure (IOP) change and the deficit of retinal ganglion cells (RGCs) in DBA2J, which is most well-characterized chronic glaucoma mouse model and wild type (WT) C57bl/6 mice, and to study the relationship between IOP change and RGCs deficit. METHODS IOP was monitored with a rebound tonometer in WT C57bl/6 and DBA2J mice from 3 to 15-month-old. Retinal function was evaluated by dark-adapted electroretinogram (ERG) in DBA2J and WT mice of 15-month-old. A dye (Neurobiotin) was applied to optic nerve stump to retrograde label RGCs. TO-PRO-3 visualized all nuclei of cells in the RGC layer. RESULTS The IOP in WT mice was 9.03±0.6 mm Hg on average and did not increase significantly as aging. The IOP in DBA2J mice, arranging from 7.2 to 28 mm Hg, was increasing significantly as aging, and it was normal at 3-month-old compared with WT mice, slightly increased from 7-month-old and increased in 50% animals at 11-month-old and in 38% animals at 15-month-old. The RGCs density in DBA2J mice started reducing by 7-month-old, continuously decreased until reached about 20% of RGC in WT retina by 15-month-old. RGC density was not linearly correlated with IOP in 15-month-old DBA2J mice. The amplitude of positive scotopic threshold response, and negative scotopic threshold response of ERG were significantly reduced in DBA2J mice of 15-month-old than that in age-paired WT mice. CONCLUSION The present study found that DBA2J mice display pathological and functional deficits of the retina that was not linearly correlated with IOP. PMID:26949637

  18. Comparison of intraocular pressure measurement with Scheimpflug-based noncontact tonometer with and without hydrogel contact lenses

    PubMed Central

    Kumar, Mukesh; Shetty, Rohit; Jayadev, Chaitra; Dutta, Debarun; Nicolsan, Maneck D; Nagaraj, Sriharsha; Kumar, Rajesh S

    2015-01-01

    Objectives: The objective was to determine the repeatability of intraocular pressure (IOP) measurements made through a soft contact lens (CL) using the Scheimpflug noncontact tonometry in healthy subjects. Methods: This prospective, randomized, single-center study included one eye of 88 subjects (40 male and 48 female). Only participants without glaucoma or any other ocular pathology were included in this study. Three consecutive IOP measurements by the Scheimpflug noncontact tonometry were performed with and without daily disposable hydrogel CLs (−0.50 DS) (Dailies-nelfilcon A, 69% water, 8.7 mm base curve, 14 mm diameter, center thickness 0.10 mm) by a single operator. To avoid any bias arising from diurnal variation, all measurements were made at a similar time of day (11 am ± 1 h). The repeatability of IOP measurements using the Scheimpflug noncontact tonometry with and without CLs was evaluated using Pearson's correlation analysis. Bland-Altman plotting was used to assess the limits of agreement between the measurements with and without CLs. Results: The mean (± standard deviation) IOPs with and without CL were 13.80 ± 2.70 and 13.79 ± 2.54 mm of Hg respectively. The mean difference was 0.01 ± 0.16 (95% confidence interval, +1.97 to − 2.00) mm Hg. Statistical analysis via paired t-test showed no statistical difference between the two groups with (P = 0.15). A good correlation was found for IOP measurements with and without CL (r = 0.93, P < 0.001). Good test-retest reliability was found when IOP was measured with and without CL. Conclusion: There was no significant difference between IOP measured with and without CLs by Scheimpflug noncontact tonometry. PMID:26044471

  19. Intra-ocular pressure normalization technique and equipment

    NASA Technical Reports Server (NTRS)

    Baehr, E. F. (Inventor)

    1979-01-01

    A method and apparatus is described for safely reducing abnormally high intraocular pressure in an eye during a predetermined time interval. This allows maintenance of normal intraocular pressure during glaucoma surgery. A pressure regulator of the spring-biassed diaphragm type is provided with additional bias by a column of liquid. The hypodermic needle can be safely inserted into the anterior chamber of the eye. Liquid is then bled out of the column to reduce the bias on the diaphragm of the pressure regulator and, consequently, the output pressure of the regulator. This lowering pressure of the regulator also occurs in the eye by means of a small second bleed path provided between the pressure regulator and the hypodermic needle.

  20. Telemedicine in the control of intra-ocular pressure.

    PubMed

    Michelson, G; Striebel, W; Prihoda, W; Schmidt, V

    2000-01-01

    Glaucoma is one of the most common causes of blindness in the Western world and a major risk factor is increased intra-ocular pressure. We therefore used telemedicine in its control. Patients measured their intra-ocular pressure several times a day with a portable instrument and the values were then entered into a portable digital assistant. These data were transmitted by a modem to a central server. If the intra-ocular pressure was pathologically high, an email message was automatically sent to the ophthalmologist. The pressure curve, including a statistical analysis, was displayed in an easily readable chart format. Ten patients with glaucoma participated in a trial. Self-tonometry with telemedicine enabled continuous evaluation of the patient by the ophthalmologist. This approach offered the advantage of controlling the treatment remotely. Advantages for the patient were that the measurements were easily done at home under normal conditions, and the patient could control when the measurement and data transmission would be performed. Telemedicine is a cost-effective technique enabling the early diagnosis of pathologically increased intra-ocular pressure. PMID:10793996

  1. Accuracy of Schiotz Tonometry in Measuring the Intraocular Pressure After Corneal Refractive Surgery

    PubMed Central

    Rosa, Nicola; Lanza, Michele; Cennamo, Gilda; Capasso, Luigi; Iaccarino, Gennarfrancesco; Borrelli, Maria; Fusco, Fabrizia; Flagiello, Antimo

    2010-01-01

    Purpose To test the accuracy of Schiotz tonometry (ST) in patients that underwent photorefractive keratectomy (PRK). Methods 175 eyes previously treated with PRK for myopia, myopic astigmatism or mixed astigmatism, with a mean preoperative spherical equivalent (SE) of −4.27±2.83 diopters (range: -13 to −0.25 diopters), had their intraocular pressure (IOP) measured, at least 3 months after PRK, with Goldmann applanation tonometry (GAT) and ST with both 5.5-g and 10-g load and also utilizing the Friedenwald nomogram. These measurements were retrospectively compared to the IOP readings obtained with GAT before surgery. Results Before PRK the mean IOP, as measured with GAT, was 14.7±2.63 mmHg. After PRK, the mean IOP readings were 10.9±2.85 mmHg (P<0.001) with GAT, 13.58±3.42 mmHg (P<0.001) with 5.5-g load ST; 12.32±3.67 mmHg (P<0.001) with 10-g load ST, and 16.19±5.63 mmHg (P<0.001) with the Friedenwald nomogram. The different methods showed a poor agreement, the worst one being between GAT before surgery and the Friedenwald nomogram (r2=0.05). Moreover, ST with both 5.5 g and 10 g load showed an underestimation (more pronounced for the 10-g than for the 5.5-g load) that increased with the amount of treatment. Conclusions Although ST with a 5.5 g load seems to be more accurate to measure the true IOP in patients that have undergone PRK compared to the Goldmann technique, it cannot be considered to be accurate in a sufficient number of cases. IOP measurement after refractive surgery is still a problem, and further studies are needed to overcome it.

  2. Estimated Trans-Lamina Cribrosa Pressure Differences in Low-Teen and High-Teen Intraocular Pressure Normal Tension Glaucoma: The Korean National Health and Nutrition Examination Survey

    PubMed Central

    Lee, Si Hyung; Kwak, Seung Woo; Kang, Eun Min; Kim, Gyu Ah; Lee, Sang Yeop; Bae, Hyoung Won; Seong, Gong Je; Kim, Chan Yun

    2016-01-01

    Background To investigate the association between estimated trans-lamina cribrosa pressure difference (TLCPD) and prevalence of normal tension glaucoma (NTG) with low-teen and high-teen intraocular pressure (IOP) using a population-based study design. Methods A total of 12,743 adults (≥ 40 years of age) who participated in the Korean National Health and Nutrition Examination Survey (KNHANES) from 2009 to 2012 were included. Using a previously developed formula, cerebrospinal fluid pressure (CSFP) in mmHg was estimated as 0.55 × body mass index (kg/m2) + 0.16 × diastolic blood pressure (mmHg)—0.18 × age (years)—1.91. TLCPD was calculated as IOP–CSFP. The NTG subjects were divided into two groups according to IOP level: low-teen NTG (IOP ≤ 15 mmHg) and high-teen NTG (15 mmHg < IOP ≤ 21 mmHg) groups. The association between TLCPD and the prevalence of NTG was assessed in the low- and high-teen IOP groups. Results In the normal population (n = 12,069), the weighted mean estimated CSFP was 11.69 ± 0.04 mmHg and the weighted mean TLCPD 2.31 ± 0.06 mmHg. Significantly higher TLCPD (p < 0.001; 6.48 ± 0.27 mmHg) was found in the high-teen NTG compared with the normal group. On the other hand, there was no significant difference in TLCPD between normal and low-teen NTG subjects (p = 0.395; 2.31 ± 0.06 vs. 2.11 ± 0.24 mmHg). Multivariate logistic regression analysis revealed that TLCPD was significantly associated with the prevalence of NTG in the high-teen IOP group (p = 0.006; OR: 1.09; 95% CI: 1.02, 1.15), but not the low-teen IOP group (p = 0.636). Instead, the presence of hypertension was significantly associated with the prevalence of NTG in the low-teen IOP group (p < 0.001; OR: 1.65; 95% CI: 1.26, 2.16). Conclusions TLCPD was significantly associated with the prevalence of NTG in high-teen IOP subjects, but not low-teen IOP subjects, in whom hypertension may be more closely associated. This study suggests that the underlying mechanisms may differ

  3. Effect of chymase on intraocular pressure in rabbits.

    PubMed

    Konno, Takashi; Maruichi, Midori; Takai, Shinji; Oku, Hidehiro; Sugiyama, Tetsuya; Uchibori, Takehiro; Nagai, Akihiko; Kogi, Kentaro; Ikeda, Tsunehiko; Miyazaki, Mizuo

    2005-11-01

    Chymase is a chymotrypsin-like serine protease that is stored exclusively in the secretory granules of mast cells and converts big endothelins to endothelin-1 (1-31). The aim of this study was to evaluate the effect of chymase on intraocular pressure in rabbits. Chymase injection (3 and 10 mU) resulted in a trend toward increased intraocular pressure and a significant increase in intraocular pressure at a dose of 10 mU compared with the control. A specific chymase inhibitor, Suc-Val-Pro-Phe(P)(OPh)(2), attenuated the ocular hypertension induced by chymase. Endothelin-1 (1-31) also caused ocular hypertension, which was inhibited by a selective endothelin ET(A) receptor antagonist, cyclo(D-Asp-Pro-D-Val-Leu-D-Trp) (BQ-123). Moreover, chymase-induced ocular hypertension was inhibited by BQ-123. These results suggest that chymase influences the regulation of intraocular pressure, and it is likely that the formation of endothelin-1 (1-31) and subsequent activation of endothelin ET(A) receptors are involved in the development of ocular hypertension induced by chymase. PMID:16253233

  4. Intraocular pressure and tear production in five herbivorous wildlife species.

    PubMed

    Ofri, R; Horowitz, I H; Raz, D; Shvartsman, E; Kass, P H

    2002-08-31

    The intraocular pressure and rate of tear production were measured in 18 addax antelopes (Addax nasomaculatus), four impalas (Aepyceros melampus), 11 wide-lipped rhinoceroses (Ceratotherium simum), 10 white-tailed wildebeests (Connochaetes gnou) and seven scimitar-horned oryxes (Oryx dammah). The animals were anaesthetised with an intramuscular injection of etorphine hydrochloride and acepromazine maleate, and the Schirmer tear test I was used to evaluate tear production, and applanation tonometry was used to evaluate the intraocular pressure. The mean (sd) rate of tear production ranged from 17.6 (3.1) mm/minute in the rhinoceros to 28.8 (8.3) mm/minute in the addax. The intraocular pressure ranged from 8.0 (1.2) mmHg in the impala to 32.1 (10.4) mmHg in the rhinoceros. The rate of tear production in the addax and the intraocular pressure in the rhinoceros appear to be the highest values of these variables to have been reported in any species. PMID:12233828

  5. A Miniature-Implantable RF-Wireless Active Glaucoma Intraocular Pressure Monitor.

    PubMed

    Chow, Eric Y; Chlebowski, Arthur L; Irazoqui, Pedro P

    2010-12-01

    Glaucoma is a detrimental disease that causes blindness in millions of people worldwide. There are numerous treatments to slow the condition but none are totally effective and all have significant side effects. Currently, a continuous monitoring device is not available, but its development may open up new avenues for treatment. This work focuses on the design and fabrication of an active glaucoma intraocular pressure (IOP) monitor that is fully wireless and implantable. Major benefits of an active IOP monitoring device include the potential to operate independently from an external device for extended periods of time and the possibility of developing a closed-loop monitoring and treatment system. The fully wireless operation is based off using gigahertz-frequency electromagnetic wave propagation, which allows for an orientation independent transfer of power and data over reasonable distances. Our system is comprised of a micro-electromechanical systems (MEMS) pressure sensor, a capacitive power storage array, an application-specific integrated circuit designed on the Texas Instruments (TI) 130 nm process, and a monopole antenna all assembled into a biocompatible liquid-crystal polymer-based tadpole-shaped package. PMID:23850751

  6. Monothiocarbamates Strongly Inhibit Carbonic Anhydrases in Vitro and Possess Intraocular Pressure Lowering Activity in an Animal Model of Glaucoma.

    PubMed

    Vullo, Daniela; Durante, Mariaconcetta; Di Leva, Francesco Saverio; Cosconati, Sandro; Masini, Emanuela; Scozzafava, Andrea; Novellino, Ettore; Supuran, Claudiu T; Carta, Fabrizio

    2016-06-23

    A series of monothiocarbamates (MTCs) were prepared from primary/secondary amines and COS as potential carbonic anhydrase (CA, EC 4.2.1.1) inhibitors, using the dithiocarbamates, the xanthates, and the trithiocarbonates as lead compounds. The MTCs effectively inhibited the pharmacologically relevant human (h) hCAs isoforms I, II, IX, and XII in vitro and showed KIs spanning between the low and medium nanomolar range. By means of a computational study, the MTC moiety binding mode on the CAs was explained. Furthermore, a selection of MTCs were evaluated in a normotensive glaucoma rabbit model for their intraocular pressure (IOP) lowering effects and showed interesting activity. PMID:27253845

  7. Intraocular pressure-lowering effects of commonly used fixed combination drugs with timolol in the management of primary open angle glaucoma

    PubMed Central

    Ozer, Murat Atabey; Acar, Mutlu; Yildirim, Cem

    2014-01-01

    AIM To evaluate intraocular pressure (IOP)-lowering effect and ocular tolerability of brimonidine/timolol, dorzolamide/timolol and latanoprost/timolol fixed combination therapies in the management of primary open angle glaucoma. METHODS Each drug was administered for two months, after which a circadian tonometric curve was recorded using a Goldmann applanation tonometer. Ocular discomfort (conjunctival hyperemia, burning or stinging, foreign body sensation, itching, ocular pain) of each eye was assessed by the subject on a standardized ocular discomfort scale. RESULTS Among the three study groups, there were no significant differences in the mean baseline IOP measurements, mean 2nd mo IOP measurements, and mean (%) change of IOPs from baseline. Among the three study groups, there were no significant differences in the mean IOP measurements obtained at circadian tonometric curves at baseline and at two months controls. In sum brimonidine/timolol, dorzolamide/timolol and latanoprost/timolol fixed combination therapies showed similar effects on IOP levels. CONCLUSION Brimonidine/timolol, dorzolamide/timolol and latanoprost/timolol fixed combination therapies showed similar lowering efficaties on IOP levels whereas there was no any difference between each other. PMID:25349802

  8. Effect on intraocular pressure of switching from latanoprost and travoprost monotherapy to timolol fixed combinations in patients with normal-tension glaucoma.

    PubMed

    Igarashi, Ryoko; Togano, Tetsuya; Sakaue, Yuta; Yoshino, Takaiko; Ueda, Jun; Fukuchi, Takeo

    2014-01-01

    Purpose. To evaluate the effect on intraocular pressure (IOP) of switching from latanoprost and travoprost monotherapy to timolol fixed combinations in Japanese patients with normal-tension glaucoma (NTG). Methods. 27 NTG patients (54 eyes) were compared IOP, superficial punctuate keratitis (SPK) scores, and conjunctival injection scores in eyes treated with prostaglandin (PG) or PG analog/beta-blocker (PG/b) fixed-combination 6 months after the change in therapy. Results. The mean baseline intraocular pressure was 17.4 ± 1.59 mmHg in eyes receiving PG therapy only and 17.4 ± 1.69 mmHg in eyes switched to PG/b. Switching to fixed combination therapy from PG monotherapy, the mean IOP was 13.1 ± 1.79 mmHg (P < 0.001)  (-24.71% reduction from baseline) at 6 months. The mean conjunctival injection score was 0.69 for eyes on PG monotherapy and 0.56 for eyes on fixed combination therapy (P = 0.028). The mean SPK scores were 0.46 and 0.53. This difference was not statistically significant (P = 0.463). Conclusions. Switching from PG monotherapy to PG/b fixed combination therapy for NTG resulted in a greater intraocular pressure reduction than PG alone without increasing the number of instillations. PMID:25505978

  9. Prophylactic use of timolol maleate to prevent intraocular pressure elevation after Nd-YAG laser posterior capsulotomy

    NASA Astrophysics Data System (ADS)

    Cai, Jiping; Wei, Ruili; Ma, Xiaoye; Zhu, Huang; Li, You; Cheng, Jinwei; Jiang, Feng

    2005-07-01

    Objective: To evaluate the effective prophylaxis of topical 0.5% timolol maleate for the intraocular pressure rise following Nd-YAG laser posterior capsulotomy. Subjects and Methods: One hundred and ninety eyes of 184 patients undergoing Nd-YAG laser posterior capsulotomy were randomly assigned to pretreatment with either topical 0.5% timolol maleate (therapy group) or nothing (control group). Results: The mean IOP of the therapy group was 14.8+/-3.0 mmHg before capsulotomy and 15.7+/-3.4 mmHg after capsulotomy (P>0.05), whereas 15.1+/-3.3 mmHg and 17.2+/-4.3 mmHg (P<0.05) of the control group. There was no statistically significant difference between the two groups with regard to mean IOP before capsulotomy (P>0.05), but statistically significant difference between two groups after capsulotomy (P<0.05). Six of 91 eyes (6.6%, 2 aphakias included) of the therapy group had an IOP elevation greater than 6 mmHg compared with 14 of 99 eyes (14.1%, 8 aphakias included) of the control group (P<0.01). Conclusion: The pretreatment with topical 0.5% timolol maleate is effective in preventing IOP elevation after Nd-YAG laser posterior capsulotomy.

  10. Clinical utility and differential effects of prostaglandin analogs in the management of raised intraocular pressure and ocular hypertension

    PubMed Central

    Lee, Anne J; McCluskey, Peter

    2010-01-01

    Prostaglandin analogs (PGA) are powerful topical ocular hypotensive agents available for the treatment of elevated intraocular pressure (IOP). Latanoprost 0.005% and travoprost 0.004% are prodrugs and analogs of prostaglandin F2α. Bimatoprost 0.03% is regarded as a prostamide, and debate continues as to whether it is a prodrug. The free acids of all 3 PGAs reduce IOP by enhancing uveoscleral and trabecular outflow via direct effects on ciliary muscle relaxation and remodeling of extracellular matrix. The vast majority of clinical trials demonstrate IOP-lowering superiority of latanoprost, bimatoprost and travoprost compared with timolol 0.5%, brimonidine 0.2%, or dorzolamide 2% monotherapy. Bimatoprost appears to be more efficacious in IOP-lowering compared with latanoprost, with weighted mean difference in IOP reduction documented in one meta-analysis of 2.59% to 5.60% from 1- to 6-months study duration. PGAs reduce IOP further when used as adjunctive therapy. Fixed combinations of latanoprost, bimatoprost or travoprost formulated with timolol 0.5% and administered once daily are superior to monotherapy of its constituent parts. PGA have near absence of systemic side effects, although do have other commonly encountered ocular adverse effects. The adverse effects of PGA, and also those found more frequently with bimatoprost use include ocular hyperemia, eyelash growth, and peri-ocular pigmentary changes. Iris pigmentary change is unique to PGA treatment. Once daily administration and near absence of systemic side effects enhances tolerance and compliance. PGAs are often prescribed as first-line treatment for ocular hypertension and open-angle glaucoma. PMID:20689791

  11. Comparing acromegalic patients to healthy controls with respect to intraocular pressure, central corneal thickness, and optic disc topography findings

    PubMed Central

    Sen, Emine; Tutuncu, Yasemin; Elgin, Ufuk; Balikoglu-Yilmaz, Melike; Berker, Dilek; Aksakal, F. Nur; Ozturk, Faruk; Guler, Serdar

    2014-01-01

    Aims: The aim was to compare the intraocular pressure (IOP), central corneal thickness (CCT), and optic disc topography findings of biochemically controlled acromegalic patients and the control group and to evaluate the effect of the duration of acromegaly and serum growth hormone and insulin-like growth factor-1 (IGF-1) levels on these ocular parameters. Materials and Methods: IOP measurement with Goldmann applanation tonometry, CCT measurement with ultrasonic pachymetry, and topographic analysis with Heidelberg retinal tomograph III were performed on 35 biochemically controlled acromegalic patients and 36 age- and gender-matched controls. Results: Mean IOP and CCT were 14.7 ± 2.9 mmHg and 559.5 ± 44.9 μm in the acromegaly patients and 13.0 ± 1.6 mmHg and 547.1 ± 26.7 μm in controls (P = 0.006 and P = 0.15, respectively). A significant moderate correlation was found between the duration of acromegaly and CCT (r = 0.391) and IOP (r = 0.367). Mean retinal nerve fiber layer (RNFL) thickness was significantly lower in the acromegalic patients (0.25 ± 0.05 mm) as compared to controls (0.31 ± 0.09 mm) (P = 0.01). A significant moderate correlation was detected between IGF-1 level and disc area (r = 0.362), cup area (r = 0.389) and cup volume (r = 0.491). Conclusion: Biochemically controlled acromegalic patients showed significantly higher CCT and IOP levels and lower RNFL thickness compared to healthy controls and the duration of disease was correlated with CCT and IOP levels. PMID:25230958

  12. Effects of angiotensin, vasopressin and atrial natriuretic peptide on intraocular pressure in anesthetized rats

    NASA Technical Reports Server (NTRS)

    Palm, D. E.; Shue, S. G.; Keil, L. C.; Balaban, C. D.; Severs, W. B.

    1995-01-01

    The effects of atrial natriuretic peptide (ANP), vasopressin (AVP) and angiotensin (ANG) on blood and intraocular pressures of pentobarbital anesthetized rats were evaluated following intravenous, intracerebroventricular or anterior chamber routes of administration. Central injections did not affect intraocular pressure. Equipressor intravenous infusions of ANG raised, whereas AVP decreased, intraocular pressure. Direct infusions of a balanced salt solution (0.175 microliter/min) raised intraocular pressure between 30 and 60 min. Adding ANG or ANP slightly reduced this solvent effect but AVP was markedly inhibitory. An AVP-V1 receptor antagonist reversed the blunting of the solvent-induced rise by the peptide, indicating receptor specificity. Acetazolamide pretreatment lowered intraocular pressure, but the solvent-induced rise in intraocular pressure and inhibition by AVP still occurred without altering the temporal pattern. Thus, these effects appear unrelated to aqueous humor synthesis rate. The data support the possibility of intraocular pressure regulation by peptides acting from the blood and aqueous humor.

  13. Changes in intraocular pressures during laparoscopy: a comparison of propofol total intravenous anesthesia to desflurane-thiopental anesthesia.

    PubMed

    Asuman, Arslan Onuk; Baris, Arslan; Bilge, Karsli; Bozkurt, Selen; Nurullah, Bülbüler; Meliha, Kahraman; Umit, Celik

    2013-02-01

    The aim of the study was to examine intraocular pressure (IOP) changes during laparoscopic cholecystectomy performed under either desflurane-thiopental anesthesia or propofol total intravenous anesthesia (TIVA). 36 patients who will undergo elective laparoscopic cholecystectomy were enrolled in the study. The patients were randomly divided into one of two groups: desflurane (Group D, n=18) or propofol (Group P, n=18). All patients received fentanyl 2 micro/kg IV, and then breathed 100% oxygen for 3 minutes prior to induction of anesthesia. Anesthesia was induced by using thiopental 5 mg/kg IV in Group D and 2 mg/kg IV propofol in group P. Neuromuscular block was achieved with rocuronium 0.6 mg/kg IV. Anesthesia was maintained with desflurane 3-6% in group D and propofol infusion 5-10 mg/kg/h in group P. Desflurane and propofol concentrations were adjusted to maintain mean arterial pressure witihin 20% of the preinduction value. During anaesthesia, fractionated doses of fentanyl 0.5-1 micro g /kg IV and maintenance doses of muscle relaxants were used. In both groups, the the mixture 60% nitrous oxide and 40% oxygen was administered used. Arterial pressure, heart rate, ETCO2, SpO2 and IOP were recorded at the predefined time points. Creation of pneumoperitoneum resulted in a significant increase in IOP which remained elevated throughout the operation in both groups. Also, we recorded a similar IOP changes with both techniques except at five minutes after pneumoperitoneum in 15 degrees reverse Trendelenburg position during desflurane-thiopental anesthesia. In c6nclusion, desflurane-thiopental anesthesia maintains the IOP at least at similar levels compared to propofol TIVA anesthesia. PMID:23833850

  14. Comparison of intraocular pressure measurements with different contact tonometers in young healthy persons

    PubMed Central

    Galgauskas, Saulius; Strupaite, Rasa; Strelkauskaite, Ernesta; Asoklis, Rimvydas

    2016-01-01

    AIM To analyze the correlation of Goldmann applanation tonometer (GAT), I-Care tonometer and Tono-Pen tonometer results in young healthy persons, and to investigate the influence of central corneal thickness (CCT) on intraocular pressure (IOP) measurements recorded with these tonometers. METHODS We conducted a pilot clinical study in 78 eyes of 78 subjects aged 22-28 years old (44 women and 34 men; mean age 23.8±1.19y). IOP was measured using GAT, I-Care and Tono-Pen tonometers, followed by measurements of CCT. Statistical analysis was performed using SPSS 20.0. RESULTS The mean IOPs and standard deviation (±SD) for GAT, I-Care and Tono-Pen were 15.62±2.281 mm Hg, 16.29±2.726 mm Hg and 16.32±2.393 mm Hg, respectively. The mean CCT was 555.15±29.648 µm. Clear positive correlations between GAT and I-Care, GAT and Tono-Pen, and I-Care and Tono-Pen tonometers were found (r=0.867, P<0.001; r=0.861, P<0.001; r=0.915, P<0.001, respectively). In comparison between devices, Bland–Altman analysis showed a significant mean difference (MD) in the measurements by GAT and I-Care of −0.679 mm Hg and by GAT and Tono-Pen of −0.705 mm Hg ( P<0.001), but there was no significant difference between I-Care and Tono-Pen ( P>0.05). Both non-gold standard tonometers were affected by CCT; that is, both I-Care and Tono-Pen tonometer values were significantly higher with higher CCT means (>555 µm; MD=−1.282, P<0.001; MD=−0.949, P<0.001, respectively) compared with GAT. CONCLUSION Both I-Care and Tono-Pen tonometers overestimated IOP compared with the GAT values. Either the I-Care or Tono-Pen tonometer could be used instead of GAT because there was no significant difference between their results. Higher CCT values (>555 µm) were associated with overestimated IOP values. PMID:26949614

  15. Intra-ocular pressure normalization technique and equipment

    NASA Technical Reports Server (NTRS)

    Mcgannon, W. J. (Inventor)

    1980-01-01

    A method and apparatus for safely reducing abnormally high intraocular pressure in an eye during a predetermined time interval is presented. This allows maintenance of normal intraocular pressure during glaucoma surgery. According to the invention, a pressure regulator of the spring biased diaphragm type is provided with additional bias by a column of liquid. The height of the column of liquid is selected such that the pressure at a hypodermic needle connected to the output of the pressure regulator is equal to the measured pressure of the eye. The hypodermic needle can then be safely inserted into the anterior chamber of the eye. Liquid is then bled out of the column to reduce the bias on the diaphragm of the pressure regulator and, consequently, the output pressure of the regulator. This lowering pressure of the regulator also occurs in the eye by means of a small second bleed path provided between the pressure regulator and the hypodermic needle. Alternately, a second hypodermic needle may be inserted into the eye to provide a controlled leak off path for excessive pressure and clouded fluid from the anterior chamber.

  16. Not only pregnancy but also the number of fetuses in the uterus affects intraocular pressure

    PubMed Central

    Saylık, Metin; Saylık, Safiye A

    2014-01-01

    Aim: To investigate whether, intraocular pressure (IOP) is affected when there is a second fetus in the uterus during pregnancy. Materials and Methods: Eighty eyes of 40 twin pregnancies (TwPs), 80 eyes of 40 singleton pregnancies (SiPs) and 80 eyes of 40 non-pregnant females (NoPs) were included in the study. Statistical Analysis: Repeated measurements analysis of variance with two factors, one-way analysis of variance (ANOVA) and theTukey's multiple comparison test were used. Results: The mean IOP (MIOP) values in TwPs were 14.29 ± 1.28, 11.48 ± 1.20, and 9.81 ± 1.36 mmHg and the MIOP values in SiPs were 14.42 ± 0.95, 13.12 ± 0.75, and 10.97 ± 0.89 mmHg in subsequent trimesters. The MIOP values in NoPs were 14.77 ± 1.18, 14.92 ± 1.33, and 15.08 ± 0.89 mmHg in subsequent 3-month measurements. The results show that the MIOP values for the TwPs group were significantly lower than the SiPs in all trimesters. Conclusions: During pregnancy, the number of fetuses in the uterus is an indirectly important factor that influences the decrease in IOP. We hypothesize that the increased ocular hypotensive effect of TwPs is most likely related to the presence of higher levels of hormones, particularly estrogen, progesterone and relaxin compared with SiPs. PMID:24178401

  17. Does patient comfort influence the choice of tonometer for the measurement of intraocular pressure?

    PubMed

    Ugalahi, Mary O; Seidu, Mukaila A; Olusanya, Bolutife A; Baiyeroju, Aderonke M

    2016-06-01

    The purpose of this study was to compare patient comfort and preference between the use of Icare tonometer and Goldmann applanation tonometer for the measurement of intraocular pressure (IOP). This was a prospective study carried out at the Eye clinic of the University College Hospital, Ibadan on volunteers aged 18 years and above. Demographic information of the participants was collected using a proforma. All participants had Icare tonometry and Goldmann applanation tonometry (GAT) performed on them in sequence within a 15-min period. After the measurements, participants were asked to report their assessment of the level of comfort with each method and to state their preferred choice for IOP measurement. One hundred subjects participated in the study; 45 (45 %) were males, and the mean age was 47.1 (± 17.4) years. Forty-three subjects (43 %) reported that Icare was either much more comfortable or more comfortable than GAT, while 31 (31 %) stated that Goldmann applanation was either much more or more comfortable. Twenty-six participants (26 %) reported that the level of comfort was the same with the two instruments. With regard to which of the instruments will be preferred for IOP check at another clinic visit, 53 (53 %) of the respondents preferred the Goldmann applanation tonometer. Some of the participants preferred GAT because they believed it was more sophisticated, while the main reported reason for preferring Icare was the stinging sensation of the anesthetic eye drop when using GAT. Although more participants reported the Icare tonometer to be more comfortable, the Goldmann tonometer was preferred by majority of the respondents. PMID:26471789

  18. Haploinsufficient Bmp4 ocular phenotypes include anterior segment dysgenesis with elevated intraocular pressure

    PubMed Central

    Chang, Bo; Smith, Richard S; Peters, Maureen; Savinova, Olga V; Hawes, Norman L; Zabaleta, Adriana; Nusinowitz, Steven; Martin, Janice E; Davisson, Muriel L; Cepko, Constance L; Hogan, Brigid LM; John, Simon WM

    2001-01-01

    Background Glaucoma is a blinding disease usually associated with high intraocular pressure (IOP). In some families, abnormal anterior segment development contributes to glaucoma. The genes causing anterior segment dysgenesis and glaucoma in most of these families are not identified and the affected developmental processes are poorly understood. Bone morphogenetic proteins (BMPs) participate in various developmental processes. We tested the importance of Bmp4 gene dosage for ocular development and developmental glaucoma. Results Bmp4+/- mice have anterior segment abnormalities including malformed, absent or blocked trabecular meshwork and Schlemm's canal drainage structures. Mice with severe drainage structure abnormalities, over 80% or more of their angle's extent, have elevated IOP. The penetrance and severity of abnormalities is strongly influenced by genetic background, being most severe on the C57BL/6J background and absent on some other backgrounds. On the C57BL/6J background there is also persistence of the hyaloid vasculature, diminished numbers of inner retinal cells, and absence of the optic nerve. Conclusions We demonstrate that heterozygous deficiency of BMP4 results in anterior segment dysgenesis and elevated IOP. The abnormalities are similar to those in human patients with developmental glaucoma. Thus, BMP4 is a strong candidate to contribute to Axenfeld-Rieger anomaly and other developmental conditions associated with human glaucoma. BMP4 also participates in posterior segment development and wild-type levels are usually critical for optic nerve development on the C57BL/6J background. Bmp4+/- mice are useful for studying various components of ocular development, and may allow identification of strain specific modifiers affecting a variety of ocular phenotypes. PMID:11722794

  19. A Case of Sustained Intraocular Pressure Elevation after Multiple Intravitreal Injection of Ranibizumab and Aflibercept for Neovascular Age-Related Macular Degeneration

    PubMed Central

    Matsubara, Hisashi; Miyata, Ryohei; Kobayashi, Maki; Tsukitome, Hideyuki; Ikesugi, Kengo; Kondo, Mineo

    2016-01-01

    Intravitreal injections of anti-vascular endothelial growth factor (VEGF) agents are widely used to treat neovascular age-related macular degeneration (nAMD). Although these treatments are effective, multiple injections have recently been recommended to ensure that there is a good long-term prognosis. However, sustained intraocular pressure (IOP) elevations have been reported to develop after multiple injections of anti-VEGF agents. We present our findings of a case of uncontrolled and persistent IOP elevation after switching from intravitreal ranibizumab injections to intravitreal aflibercept injections. A 74-year-old Japanese man without a history of glaucoma underwent 22 ranibizumab injections for nAMD and suddenly developed an elevated IOP after the 22nd injection. Although the subsequent medical treatment led to normalization of his IOP, the subretinal fluid under the central fovea remained even after the 25th injection of ranibizumab. Thus, ranibizumab treatment was switched to bimonthly intravitreal aflibercept injections in conjunction with glaucoma medications. His IOP recovered to within the normal range; however, after the 11th aflibercept injection, there was a sudden elevation of his IOP in spite of the continued glaucoma medications. Due to this sustained IOP elevation, his aflibercept injections were suspended for 16 weeks. Because his IOP could not be normalized by a full glaucoma medication regimen, the patient underwent trabeculotomy, which resulted in a lowering of the IOP to normal levels. We conclude that patients who receive serial intravitreal injections of anti-VEGF agents need to be closely monitored because severe and sustained ocular hypertension can develop. PMID:27462248

  20. Changes in Day 1 Post-Operative Intraocular Pressure Following Sutureless 23-Gauge and Conventional 20-Gauge Pars Plana Vitrectomy

    PubMed Central

    Gosse, Emily; Newsom, Richard; Hall, Peter; Lochhead, Jonathan

    2013-01-01

    Background/Aims: The benefits associated with transconjunctival sutureless vitrectomy techniques are continuing to be defined. The purpose of this study was to compare the incidence of extreme changes in day 1 intraocular pressure (IOP) following 23-gauge sutureless vitrectomy compared with conventional 20-gauge vitrectomy. Methods: Fifty consecutive 23-gauge and 50 consecutive 20-gauge cases were included; eyes with a history of previous vitreoretinal surgery were excluded. 23-gauge surgery was completed with passive fluid air exchange where no long acting tamponade was indicated. The surgery remained sutureless unless a leak was visible at the end of the procedure. Data were collected by retrospective case note review. Statistical analysis was carried out using Fisher’s exact and chi-square tests. Results: Twenty-two percent (11/50) of 23-gauge vitrectomies required suturing of one or more ports. On the first post-operative day hypotony (IOP<5mmHg) occurred in 1/50 eyes in the 20- and 23-gauge groups. Raised pressure (IOP>21mmHg) occurred in 30% (15/50) of eyes in the 20-gauge group and 8% (4/50) of eyes in the 23-gauge group; IOP>30mmHg only occurred in the 20-gauge group (3/50). Conclusion: Fluid air exchange following 23-gauge vitrectomy is associated with very low risk of day 1 hypotony. This predominantly sutureless technique appears to reduce the incidence and magnitude of early post-operative IOP elevation compared with conventional 20-gauge vitrectomy. PMID:24015163

  1. Raised intraocular pressure with topical steroids after trabeculectomy.

    PubMed

    Thomas, R; Jay, J L

    1988-01-01

    A prospective study of 87 eyes of 52 patients with primary open-angle glaucoma showed a significant steroid-induced rise in intraocular pressure in the 4 weeks after trabeculectomy in 23% of eyes. The steroid response rate was lower (17%) in those eyes that had trabeculectomy without a prior trial of medical therapy than in those who had surgery only after failure of medical therapy (36%), but this difference just failed to reach statistical significance. The responders were not significantly different from the non-responders as regards level of intraocular pressure or severity of visual field loss at diagnosis. The frequency of response was lower than that expected in the normal and in the glaucoma population and fell further in the late post-operative period when only 3 of 8 previously responsive eyes submitted to re-challenge with topical steroids showed persisting responsiveness. Topical steroids may be the commonest cause of high intraocular pressure in the first weeks or even days after trabeculectomy. Decisions about long-term supplementary medical therapy should therefore only be taken several weeks after withdrawal of the post-operative steroid drops. PMID:3169586

  2. Effects of inner materials on the sensitivity and phase depth of wireless inductive pressure sensors for monitoring intraocular pressure

    NASA Astrophysics Data System (ADS)

    Jang, Cheol-In; Shin, Kyeong-Sik; Kim, Mi Jeung; Yun, Kwang-Seok; Park, Ki Ho; Kang, Ji Yoon; Lee, Soo Hyun

    2016-03-01

    In this research, we developed wireless, inductive, pressure sensors with high sensitivity and investigated the effects of the inner materials (copper or ferrite) on the performance of the sensors. The proposed sensor is comprised of two parts, i.e., the top and the bottom parts. The top part includes a micro coil and a capacitor for the wireless transfer of data, and the bottom part includes the inner materials and a thick or thin flexible membrane to induce changes in the inductance. An anchor is used to assemble the top and bottom parts. The behavior of the sensor with copper was based on the eddy current effect, and, as the pressure increased, its resonance frequency increased, while its phase depth decreased exponentially. The principle of the sensor with ferrite was related to the effective permeability between a ferrite and a coil, and its response was the opposite of that with copper, i.e., as the pressure increased, the resonance frequency decreased linearly, and the phase depth increased linearly. These different operational mechanisms can be explained by the changes in the equations of inductance presented in this paper. After characterizing four different types of inductive pressure sensors in ambient air, one type of inductive pressure sensor was used to monitor the intraocular pressure (IOP) of a rabbit's eye as a biomedical application. The results showed that, in the animal tests, the measured responsivity and sensitivity were 16.7 kHz/mmHg and 1340 ppm/mmHg, respectively. These data indicate that the proposed sensor is a good candidate for monitoring IOP.

  3. The Cross-Species A3 Adenosine-Receptor Antagonist MRS 1292 Inhibits Adenosine-Triggered Human Nonpigmented Ciliary Epithelial Cell Fluid Release and Reduces Mouse Intraocular Pressure

    PubMed Central

    Yang, Hui; Avila, Marcel Y.; Peterson-Yantorno, Kim; Coca-Prados, Miguel; Stone, Richard A.; Jacobson, Kenneth A.; Civan, Mortimer M.

    2012-01-01

    Purpose Antagonists to A3 adenosine receptors (ARs) lower mouse intraocular pressure (IOP), but extension to humans is limited by species variability. We tested whether the specific A3AR antagonist MRS 1292, designed to cross species, mimicks the effects of other A3AR antagonists on cultured human nonpigmented ciliary epithelial (NPE) cells and mouse IOP. Methods NPE cell volume was monitored by electronic cell sorting. Mouse IOP was measured with the Servo-Null Micropipette System. Results Adenosine triggered A3AR-mediated shrinkage of human NPE cells. Shrinkage was blocked by MRS 1292 (IC50 = 42 ± 11 nM, p < 0.01) and by another A3AR antagonist effective in this system, MRS 1191. Topical application of the A3AR agonist IB-MECA increased mouse IOP. MRS 1292 reduced IOP by 4.0 ± 0.8 mmHg at 25-μM droplet concentration (n = 10, p < 0.005). Conclusions MRS 1292 inhibits A3AR-mediated shrinkage of human NPE cells and reduces mouse IOP, consistent with its putative action as a cross-species A3 antagonist. PMID:16146920

  4. Evaluation of the associations between changes in intraocular pressure and metabolic syndrome parameters: a retrospective cohort study in Japan

    PubMed Central

    Yokomichi, Hiroshi; Kitamura, Kazuyoshi; Yoda, Yoshioki; Tsuji, Masahiro; Sato, Miri; Mizorogi, Sonoko; Suzuki, Kohta; Yamagata, Zentaro

    2016-01-01

    Objective The contributions of highly correlated cardiovascular risk factors to intraocular pressure (IOP) are not clear due to underlying confounding problems. The present study aimed to determine which metabolic syndrome parameters contribute to elevating IOP and to what extent. Design Retrospective cohort study. Setting A private healthcare centre in Japan. Participants Individuals who visited a private healthcare centre and underwent comprehensive medical check-ups between April 1999 and March 2009 were included (20 007 in the cross-sectional study and 15 747 in the longitudinal study). Primary and secondary outcome measures Changes in IOP were evaluated in terms of ageing and changes in metabolic syndrome parameters. Pearson's correlation coefficients and mixed-effects models were used to examine the relationship of changes in IOP with ageing and changes in metabolic syndrome parameters in cross-sectional and longitudinal studies, respectively. Results In the cross-sectional study, IOP was negatively correlated with age and positively correlated with waist circumference, high-density lipoprotein cholesterol (HDL-C) levels, triglyceride levels, systolic blood pressure (SBP), diastolic blood pressure (DBP) and fasting plasma glucose (FPG) levels. In the longitudinal multivariate analysis, the associated IOP changes were −0.12 (p<0.0001) mm Hg with male sex; −0.59 (p<0.0001) mm Hg with 10 years of ageing; +0.42 (p<0.0001) mm Hg with 1 mmol/L increase in HDL-C levels; +0.092 (p<0.0001) mm Hg with 1 mmol/L increase in triglyceride levels; +0.090 (p<0.0001) mm Hg with 10 mm Hg increase in SBP; +0.085 (p<0.0001) mm Hg with 10 mm Hg increase in DBP; and+0.091 (p<0.0001) mm Hg with 1 mmol/L increase in FPG levels. Conclusions Elevation of IOP was related to longitudinal worsening of serum triglyceride levels, blood pressure and FPG and improvement in serum HDL-C levels. PMID:27013596

  5. Influence of transient intraocular pressure elevation during laser in situ keratomileusis on rabbit retina thickness

    PubMed Central

    Zhao, Hai-Xia; Liu, Hui; Niu, Chun-Mei; Guan, Wen-Ying

    2015-01-01

    AIM To utilize tissue micro measurement to study the effect of transient high intraocular pressure (IOP) induced by different durations of suction during laser in situ keratomileusis (LASIK) on rabbit retina thickness. METHODS Sixty healthy New Zealand white rabbits were randomly divided into a control group, and 3 negative-pressure suction groups (20s group, 45s group, and 3min group) and each group was comprised of 15 rabbits (30 eyes); the latter 3 groups were the transient high IOP models. The retinal tissue around the papilledema was separated. Hematoxylin and eosin (HE) staining was carried out to generate slices for light microscopy. The changes in the retina thickness values of each layer were measured for all animals in each group at different postoperative recovery periods and compared with the values recorded for the animals in the control group. The thickness of the retinal tissue showed a normal distribution. The ANOVA was performed by using SPSS13.0 statistic software. RESULTS In the comparison between the 20s and 45s negative-pressure suction groups and the control group, no significant differences were observed, except at 14d. Significant difference was observed between the 3min negative-pressure suction group and the control group, and the retina thickness value of each layer reached a peak at 14d after repair. CONCLUSION Conventional negative suction during LASIK may not lead to significant changes in retinal tissue thickness; however, if the suction duration is increased to 3min, it will cause significant changes in retinal tissue thickness. PMID:26682153

  6. Intraocular Pressure Measurements Referring to the Corneal Thickness in Keratoconic Eyes After Corneal Crosslinking with Riboflavin and Ultraviolet A

    PubMed Central

    Kasumovic, Sanja Sefic; Mavija, Milka; Kasumovic, Aida; Lepara, Orhan; Duric-Colic, Belkisa; Cabric, Emir; Muhamedagic, Lejla; Sakovic-Racic, Adisa; Jankov, Mirko

    2015-01-01

    Aim: To determine the possible relation between intraocular pressure (IOP), central corneal thickness (CCT) and corneal resistance (CR) in kerotoconic eyes before, 3,6 and 12 months after collagen crosslinking procedure (CXL) with aim to find out does the thicker cornea means already more resistance cornea followed with higher IOP. Methods: Thirty eyes (30 patients) with central keratoconus (KC)were evaluated in retrospective cross sectional study. The corneal biomechanical parameters were taken with Wave Light Allegro Oculyzer produced by Alcon before the CXL, 3, 6 and 12 months after the procedure. IOP were checked by Goldmann applanation tonometry (GAT) before, 3, 6 and 12 months after CXL. Results: The value of IOP before the CXL was 12,0 mmHg (10,62-15,25 mmHg), 3 months later 13,5 mmHg (11,0-16,0 mmHg), 6 months 14,0 mmHg (11,0-16,0 mmHg) and 12 months later 15,0 mmHg (10,37-17,25 mmHg) and was statistically significant higher (p=0,015) comparing to the value of IOP 3 months after the CXL, IOP 12 months after CXL procedure was statistically significant higher comparing to preoperative values (p=0,010). There were no statistically significant difference between the values 3 and 6 months after CXL. The CCT before the CXL procedure was 449 (433-505,75 microns), 3 months after CXL was 420 (383-473microns, p < 0,005), 6 months later 437 (401,25-480,25, p=0,001), 12 months after CXL 437 (401-503 microns, p=0,001). However there is statistically significant difference in CCT 12 months after CXL 437 (401-503microns p=0,032) and the value of CCT 3 months later the procedure (p=0,004) and the CCT 12 months after CXL and the value of CXL 6 months after CXL (p=0,036). The value of CCT did not show any statistically significant difference 3 and 6 months postoperatively. Conclusion: After riboflavin-UVA CXL in eyes with KC there was significant decrease in central corneal thickness 3 and 6 months after the procedure and the thickness is almost the same 12 months later

  7. Analysis of the effects of non-supine sleeping positions on the stress, strain, deformation and intraocular pressure of the human eye

    NASA Astrophysics Data System (ADS)

    Volpe, Peter A.

    This thesis presents analytical models, finite element models and experimental data to investigate the response of the human eye to loads that can be experienced when in a non-supine sleeping position. The hypothesis being investigated is that non-supine sleeping positions can lead to stress, strain and deformation of the eye as well as changes in intraocular pressure (IOP) that may exacerbate vision loss in individuals who have glaucoma. To investigate the quasi-static changes in stress and internal pressure, a Fluid-Structure Interaction simulation was performed on an axisymmetrical model of an eye. Common Aerospace Engineering methods for analyzing pressure vessels and hyperelastic structural walls are applied to developing a suitable model. The quasi-static pressure increase was used in an iterative code to analyze changes in IOP over time.

  8. sCD44 overexpression increases intraocular pressure and aqueous outflow resistance

    PubMed Central

    Giovingo, Michael; Nolan, Michael; McCarty, Ryan; Pang, Iok-Hou; Clark, Abbot F.; Beverley, Rachel M.; Schwartz, Steven; Stamer, W. Daniel; Walker, Loyal; Grybauskas, Algis; Skuran, Kevin; Kuprys, Paulius V.; Yue, Beatrice Y.J.T.

    2013-01-01

    Purpose CD44 plays major roles in multiple physiologic processes. The ectodomain concentration of the CD44 receptor, soluble CD44 (sCD44), is significantly increased in the aqueous humor of primary open-angle glaucoma (POAG). The purpose of this study was to determine if adenoviral constructs of CD44 and isolated 32-kDa sCD44 change intraocular pressure (IOP) in vivo and aqueous outflow resistance in vitro. Methods Adenoviral constructs of human standard CD44 (Ad-CD44S), soluble CD44 (Ad-sCD44), and empty viral cDNA were injected into the vitreous of BALB/cJ mice, followed by serial IOP measurements. Overexpression of CD44S and sCD44 was verified in vitro by enzyme-linked immunosorbent assay (ELISA) and western blot analysis. Anterior segments of porcine eyes were perfused with the isolated sCD44. sCD44-treated human trabecular meshwork (TM) cells and microdissected porcine TM were examined by confocal microscopy and Optiprep density gradient with western blot analysis to determine changes in lipid raft components. Results Intravitreous injection of adenoviral constructs with either Ad-CD44S or Ad-sCD44 vectors caused prolonged ocular hypertension in mice. Eight days after vector injection, Ad-CD44S significantly elevated IOP to 28.3±1.2 mmHg (mean±SEM, n=8; p<0.001); Ad-sCD44 increased IOP to 18.5±2.6 mmHg (n=8; p<0.01), whereas the IOP of uninjected eyes was 12.7±0.2 mmHg (n=16). The IOP elevation lasted more than 50 days. Topical administration of a γ-secretase inhibitor normalized Ad-sCD44-induced elevated IOP. sCD44 levels were significantly elevated in the aqueous humor of Ad-CD44S and Ad-sCD44 eyes versus contralateral uninjected eyes (p<0.01). Anterior segment perfusion of isolated 32-kDa sCD44 significantly decreased aqueous outflow rates. Co-administration of isolated sCD44 and CD44 neutralizing antibody or of γ-secretase inhibitor significantly enhanced flow rates. sCD44-treated human TM cells displayed cross-linked actin network formation

  9. Optic nerve head and intraocular pressure in the guinea pig eye.

    PubMed

    Ostrin, Lisa A; Wildsoet, Christine F

    2016-05-01

    The guinea pig is becoming an increasingly popular model for studying human myopia, which carries an increased risk of glaucoma. As a step towards understanding this association, this study sought to characterize the normal, developmental intraocular pressure (IOP) profiles, as well as the anatomy of the optic nerve head (ONH) and adjacent sclera of young guinea pigs. IOP was tracked in pigmented guinea pigs up to 3 months of age. One guinea pig was imaged in vivo with OCT and one with a fundus camera. The eyes of pigmented and albino guinea pigs (ages 2 months) were enucleated and sections from the posterior segment, including the ONH and surrounding sclera, processed for histological analyses - either hematoxylin and eosin (H&E) staining of paraffin embedded, sectioned tissue (n = 1), or cryostat sectioned tissue, processed for immunohistochemistry (n = 3), using primary antibodies against collagen types I-V, elastin, fibronectin and glial fibrillary acidic protein (GFAP). Transmission and scanning electron microscopy (TEM, SEM) studies of ONHs were also undertaken (n = 2 & 5 respectively). Mean IOPs ranged from 17.33 to 22.7 mmHg, increasing slightly across the age range studied, and the IOPs of individual animals also exhibited diurnal variations, peaking in the early morning (mean of 25.8, mmHg, ∼9 am), and decreasing across the day. H&E-stained sections showed retinal ganglion cell axons organized into fascicles in the prelaminar and laminar region of the ONHs, with immunostained sections revealing collagen types I, III, IV and V, as well as elastin, GFAP and fibronectin in the ONHs. SEM revealed a well-defined lamina cribrosa (LC), with radially-oriented collagen beams. TEM revealed collagen fibrils surrounding non-myelinated nerve fiber bundles in the LC region, with myelination and decreased collagen posterior to the LC. The adjacent sclera comprised mainly crimped collagen fibers in a crisscross arrangement. Both the sclera and LC were

  10. Joint Effects of Intraocular Pressure and Myopia on Risk of Primary Open-Angle Glaucoma: The Singapore Epidemiology of Eye Diseases Study.

    PubMed

    Tham, Yih-Chung; Aung, Tin; Fan, Qiao; Saw, Seang-Mei; Siantar, Rosalynn Grace; Wong, Tien Y; Cheng, Ching-Yu

    2016-01-01

    We examined the joint effects of intraocular pressure (IOP) and myopia on the risk of primary open angle glaucoma (POAG) in a multi-ethnic Asian population. A total of 9,422 participants (18,469 eyes) in the Singapore Epidemiology of Eye Diseases Study were included. Of them, 213 subjects (273 eyes) had POAG. All participants underwent standardised examinations. The independent and joint effects of IOP and myopia on POAG were examined using logistic regression models. Generalised estimating equation models were used to account for correlation between eyes. Higher IOP, longer axial length, and more negative spherical equivalent were independently associated with POAG, after adjusting for relevant covariates (all P ≤ 0.005). Significant interaction between IOP and myopia on POAG was observed (P interaction = 0.025). Eyes with moderate-to-high myopia (<-3.0 dioptres) with high IOP (≥20 mmHg) were 4.27 times (95% CI, 2.10-8.69) likely to have POAG, compared to eyes without myopia (>-0.5 dioptres) and with IOP <20 mmHg. Eyes with AL of ≥25.5 mm and high IOP (≥20 mmHg) were 16.22 times (95% CI, 7.73 to 34.03) likely to have POAG, compared to eyes with shorter AL (<23.5 mm) and lower IOP (<20 mmHg). These findings may provide additional insights into the pathophysiology of POAG and are particularly relevant for Asian populations. PMID:26758554

  11. Joint Effects of Intraocular Pressure and Myopia on Risk of Primary Open-Angle Glaucoma: The Singapore Epidemiology of Eye Diseases Study

    PubMed Central

    Tham, Yih-Chung; Aung, Tin; Fan, Qiao; Saw, Seang-Mei; Siantar, Rosalynn Grace; Wong, Tien Y.; Cheng, Ching-Yu

    2016-01-01

    We examined the joint effects of intraocular pressure (IOP) and myopia on the risk of primary open angle glaucoma (POAG) in a multi-ethnic Asian population. A total of 9,422 participants (18,469 eyes) in the Singapore Epidemiology of Eye Diseases Study were included. Of them, 213 subjects (273 eyes) had POAG. All participants underwent standardised examinations. The independent and joint effects of IOP and myopia on POAG were examined using logistic regression models. Generalised estimating equation models were used to account for correlation between eyes. Higher IOP, longer axial length, and more negative spherical equivalent were independently associated with POAG, after adjusting for relevant covariates (all P ≤ 0.005). Significant interaction between IOP and myopia on POAG was observed (P interaction = 0.025). Eyes with moderate-to-high myopia (<−3.0 dioptres) with high IOP (≥20 mmHg) were 4.27 times (95% CI, 2.10–8.69) likely to have POAG, compared to eyes without myopia (>−0.5 dioptres) and with IOP <20 mmHg. Eyes with AL of ≥25.5 mm and high IOP (≥20 mmHg) were 16.22 times (95% CI, 7.73 to 34.03) likely to have POAG, compared to eyes with shorter AL (<23.5 mm) and lower IOP (<20 mmHg). These findings may provide additional insights into the pathophysiology of POAG and are particularly relevant for Asian populations. PMID:26758554

  12. Role of nitric oxide in optic nerve head blood flow regulation during an experimental increase in intraocular pressure in healthy humans.

    PubMed

    Schmidl, Doreen; Boltz, Agnes; Kaya, Semira; Palkovits, Stefan; Told, Reinhard; Napora, Katarzyna Jadwiga; Cherecheanu, Alina Popa; Werkmeister, René Marcel; Garhofer, Gerhard; Schmetterer, Leopold

    2013-11-01

    The present study set out to investigate whether nitric oxide, a potent vasodilator, is involved in the regulatory processes in optic nerve head blood flow during an experimental increase in intraocular pressure (IOP). The study was conducted in a randomized, double-masked, placebo-controlled, three way cross-over design. 12 healthy subjects were scheduled to receive either L-NMMA (an unspecific nitric oxide synthase inhibitor), phenylephrine (an α-adrenoceptor agonist) or placebo on three different study days. Optic nerve head blood flow was measured using laser Doppler flowmetry and IOP was increased stepwise with a suction cup. Mean arterial pressure (MAP) and IOP were measured non-invasively and ocular perfusion pressure (OPP) was calculated as OPP = 2/3 MAP-IOP. Administration of L-NMMA and phenylephrine significantly increased MAP and therefore OPP at rest (p < 0.01). L-NMMA significantly reduced baseline blood flow in the optic nerve head (p < 0.01). Application of the suction cup induced a significant increase in IOP and a decrease in OPP (p < 0.01). During the stepwise increase in IOP, some autoregulatory potential was observed until OPP decreased approximately -30% below baseline. None of the administered substances had an effect on this autoregulatory behavior (p = 0.49). The results of the present study confirm that the human optic nerve head shows some regulatory capacity during a decrease in OPP. Nitric oxide is involved in the regulation of basal vascular tone in the optic nerve head but does not seem to be involved in the regulatory mechanisms during an acute increase in IOP in young healthy subjects. PMID:24060346

  13. The applicability of correction factor for corneal thickness on non-contact tonometer measured intraocular pressure in LASIK treated eyes

    PubMed Central

    Jethani, Jitendra; Dave, Paaraj; Jethani, Monica; Desai, Yogesh; Patel, Purvi

    2015-01-01

    Purpose To determine the applicability of central corneal thickness (CCT) based correction factor for non-contact tonometer (NCT) measured intraocular pressure (IOP) readings. Method A prospective, non-randomized study involved 346 eyes of 173 consecutive patients with age ⩾21 years undergoing laser-assisted in situ keratomileusis (LASIK) for myopia and/or myopic astigmatism. The CCT and IOP were measured before and after the LASIK procedure. The IOP pre and post-LASIK was compared after applying the correction factor for CCT. Patients not completing the 3 month postoperative follow-up were excluded. Results The median spherical equivalent before undergoing LASIK was −4.25D (inter-quartile range, −3.25D). The mean preoperative CCT was 536.82 ± 33.71 μm which reduced to 477.55 ± 39.3 μm (p < 0.01) post-LASIK. The mean IOP reduced from a preoperative value of 14.6 ± 2.32 mmHg to 10.64 ± 2.45 mmHg postoperatively (p < 0.01). On applying correction for the corneal thickness, the pre and postoperative IOP was 15.14 ± 2.8 mmHg and 15.37 ± 2.65 mmHg (p = 0.06) respectively with a strong positive correlation (r = 0.7, p < 0.01). Three hundred eyes (86.7%) had an absolute difference in IOP of less than 3.0 mmHg post-CCT correction which is within the retest variability of NCT. Only 46 eyes (13.3%) had an absolute difference of more than 3.0 mmHg. Conclusion The modified Ehler’s correction algorithm used in this study can be effectively applied in the normal IOP range in a majority of patients. PMID:26949354

  14. Effect of prophylactic timolol 0.1% gel on intraocular pressure after an intravitreal injection of ranibizumab: a randomized study

    PubMed Central

    Pece, Alfredo; Allegrini, Davide; Montesano, Giovanni; Dimastrogiovanni, Andrea Fabio

    2016-01-01

    Purpose The purpose of this study is to make a prospective evaluation of the effect of timolol 0.1% eye gel on short-term intraocular pressure (IOP) after an intravitreal injection (IVI) of ranibizumab. Participants and methods One hundred and fifty eyes of 150 IVI-naïve patients with macular edema caused by various pathological conditions (age-related macular degeneration, central or branch retinal vein occlusion, and diabetic retinopathy) were scheduled to undergo an IVI of ranibizumab (0.5 mg/0.05 cc). The patients were randomly divided into three groups: 50 were not treated with timolol before the IVI (group 1); 50 received an instillation of timolol 0.1% eye gel the evening before the IVI (group 2); and 50 received an instillation of timolol 0.1% eye gel 2 hours before the IVI (group 3). The incidence of clinically significant intraocular hypertensive spikes (>25 mmHg and >40 mmHg) was then assessed. Results Our findings showed that mean IOP at baseline was significantly higher than at both 5 and 60 minutes after IVI (P<0.01). Spikes of >25 mmHg were recorded at either time in 27 patients (54%) in group 1, 23 patients (44%) in group 2, and 24 patients (48%) in group 3. None of the between-group differences were significant. Spikes of >40 mmHg (which were only detected 5 minutes after IVI) were recorded in nine (18%), eight (16%), and one patient (2%) in groups 1, 2, and 3, respectively. The only significant difference was between the control and group 3 (P=0.012). Conclusion An increase in IOP after antivascular endothelial growth factor IVI is a frequent complication. The prophylactic use of timolol 0.1% gel effectively reduced the mean IOP when administered 2 hours before IVI and was also effective in preventing dangerous IOP spikes of >40 mmHg. It is therefore recommended before IVIs as a means of preventing emergency procedures and preserving the health of the optic nerve. PMID:27382246

  15. Comparison of Intraocular Pressure before and after Laser In Situ Keratomileusis Refractive Surgery Measured with Perkins Tonometry, Noncontact Tonometry, and Transpalpebral Tonometry

    PubMed Central

    Cacho, Isabel; Sanchez-Naves, Juan; Batres, Laura; Pintor, Jesús; Carracedo, Gonzalo

    2015-01-01

    Purpose. To compare the intraocular pressure (IOP) before and after Laser In Situ Keratomileusis (LASIK), measured by Diaton, Perkins, and noncontact air pulse tonometers. Methods. Fifty-seven patients with a mean age of 34.88 were scheduled for myopia LASIK treatment. Spherical equivalent refraction (SER), corneal curvature (K), and central corneal thickness (CCT) and superior corneal thickness (SCT) were obtained before and after LASIK surgery. IOP values before and after surgery were measured using Diaton, Perkins, and noncontact air pulse tonometers. Results. The IOP values before and after LASIK surgery using Perkins tonometer and air tonometers were statistically significant (p < 0.05). However, no significant differences were found (p > 0.05) for IOP values measured with Diaton tonometer. CCT decreases significantly after surgery (p < 0.05) but no statistical differences were found in SCT (p = 0.08). Correlations between pre- and postsurgery were found for all tonometers used, with p = 0.001 and r = 0.434 for the air pulse tonometer, p = 0.008 and r = 0.355 for Perkins, and p < 0.001 and r = 0.637 for Diaton. Conclusion. Transpalpebral tonometry may be useful for measuring postsurgery IOP after myopic LASIK ablation because this technique is not influenced by the treatment. PMID:26167293

  16. ATP-Sensitive Potassium (KATP) Channel Activation Decreases Intraocular Pressure in the Anterior Chamber of the Eye

    PubMed Central

    Chowdhury, Uttio Roy; Bahler, Cindy K.; Hann, Cheryl R.; Chang, Minhwang; Resch, Zachary T.; Romero, Michael F.

    2011-01-01

    Purpose. ATP-sensitive potassium channel (KATP) openers target key cellular events, many of which have been implicated in glaucoma. The authors sought to determine whether KATP channel openers influence outflow facility in human anterior segment culture and intraocular pressure (IOP) in vivo. Methods. Anterior segments from human eyes were placed in perfusion organ culture and treated with the KATP channel openers diazoxide, nicorandil, and P1075 or the KATP channel closer glyburide (glibenclamide). The presence, functionality, and specificity of KATP channels were determined by RT-PCR, immunohistochemistry, and inside-out patch clamp in human trabecular meshwork (TM) tissue or primary cultures of normal human trabecular meshwork (NTM) cells. The effect of diazoxide on IOP in anesthetized Brown Norway rats was measured with a rebound tonometer. Results. KATP channel openers increased outflow facility in human anterior segments (0.14 ± 0.02 to 0.26 ± 0.09 μL/min/mm Hg; P < 0.001) compared with fellow control eyes (0.22 ± 0.11 to 0.21 ± 0.11 μL/min/mm Hg; P > 0.5). The effect was reversible, with outflow facility returning to baseline after drug removal. The addition of glyburide inhibited diazoxide from increasing outflow facility. Electrophysiology confirmed the presence and specificity of functional KATP channels. KATP channel subunits Kir6.1, Kir6.2, SUR2A, and SUR2B were expressed in TM and NTM cells. In vivo, diazoxide significantly lowered IOP in Brown Norway rats. Conclusions. Functional KATP channels are present in the trabecular meshwork. When activated by KATP channel openers, these channels increase outflow facility through the trabecular outflow pathway in human anterior segment organ culture and decrease IOP in Brown Norway rat eyes. PMID:21743021

  17. Regulation of Adherens Junctions in Trabecular Meshwork Cells by Rac GTPase and their influence on Intraocular Pressure.

    PubMed

    Pattabiraman, Padmanabhan P; Epstein, David L; Rao, Ponugoti Vasantha

    2013-06-01

    Intercellular adherens junctions and cell-extracellular matrix interactions are presumed to influence aqueous humor (AH) drainage via the conventional route, however, their direct role in modulation of intraocular pressure (IOP) is not well understood. Here, we investigated the role of Rac GTPase signaling in basal and growth factor-induced formation of adherens junctions in human trabecular meshwork (HTM) cells as compared to human umbilical vascular endothelial cells, and evaluated the effects of inhibition of Rac GTPase activity on IOP in rabbits. Expression of a constitutively active Rac1 GTPase or treatment with platelet derived growth factor (PDGF), a known activator of Rac GTPase, induced formation of β-catenin-based adherens junctions, actin cytoskeletal reorganization and membrane ruffle in HTM cells. In contrast, treatment of HTM cells with inhibitors of Rac GTPase caused cell-cell separation, a decrease in adherens junctions, and reorganization of actin stress fibers to the cell cortical regions and focal adhesion to the cell leading edges. Both, constitutively active Rac1 and PDGF stimulated generation of Reactive Oxygen Species (ROS) in HTM cells, and ROS were found to increase adherens junction formation and transendothelial electrical resistance (TEER) in HTM cells. Topical application of Rac GTPase inhibitors (EHT1864 and NSC23766), however, only marginally influenced IOP in rabbit eyes. Taken together, these data reveal that while Rac GTPase signaling plays a significant role in regulation of adherens junctions, ROS production and TEER in cells of the AH outflow pathway, Rac inhibitors showed only a marginal influence on IOP in live rabbits. PMID:24932460

  18. Association of biometric factors with anterior chamber angle widening and intraocular pressure reduction after uneventful phacoemulsification for cataract

    PubMed Central

    Huang, Guofu; Gonzalez, Eduardo; Lee, Roland; Chen, Yi-Chun; He, Mingguang; Lin, Shan C.

    2011-01-01

    PURPOSE To evaluate anterior chamber biometric factors associated with the degree of angle widening and intraocular pressure (IOP) reduction after phacoemulsification. SETTING University of California, San Francisco, California, USA. DESIGN Case series. METHODS Anterior chamber parameters obtained by anterior segment coherence tomography were compared preoperatively and 3 months postoperatively. Measurements included the angle opening distance 500 μm anterior to the scleral spur (AOD500), trabecular–iris space area 500 μm from the scleral spur (TISA500), iris curvature (I-Curv), anterior chamber angle (ACA), trabecular–iris space area, anterior chamber volume, anterior chamber width, and lens vault (LV). RESULTS The study enrolled 73 eyes. The mean patient age was 77.45 years ± 7.84 (SD); 65.75% of patients were women. From preoperatively to 3 months postoperatively, the mean AOD500 increased significantly (0.254 ± 0.105 to 0.433 ± 0.108 mm) and the mean IOP decreased significantly (14.97 ± 3.35 to 12.62 ± 3.37 mm Hg) (P < .001). The reduction in IOP was correlated with the increase in AOD500 (r = 0.240, P = .041) and preoperative LV (r = 0.235, P = .045). After adjusting for related factors, AOD500 widening was positively correlated with LV (β = 0.458, P = .044) and I-Curv (β = 0.235, P = .043) and negatively correlated with preoperative TISA500 (β = −0.269, P = .025) and ACA (β = −0.919, P = .027). CONCLUSIONS Surgically induced AOD widening was significantly correlated with anterior chamber biometric factors. Preoperative LV appears to be a significant factor in angle widening and IOP reduction after phacoemulsification. PMID:22055073

  19. Regulation of Adherens Junctions in Trabecular Meshwork Cells by Rac GTPase and their influence on Intraocular Pressure

    PubMed Central

    Pattabiraman, Padmanabhan P; Epstein, David L; Rao, Ponugoti Vasantha

    2013-01-01

    Intercellular adherens junctions and cell-extracellular matrix interactions are presumed to influence aqueous humor (AH) drainage via the conventional route, however, their direct role in modulation of intraocular pressure (IOP) is not well understood. Here, we investigated the role of Rac GTPase signaling in basal and growth factor-induced formation of adherens junctions in human trabecular meshwork (HTM) cells as compared to human umbilical vascular endothelial cells, and evaluated the effects of inhibition of Rac GTPase activity on IOP in rabbits. Expression of a constitutively active Rac1 GTPase or treatment with platelet derived growth factor (PDGF), a known activator of Rac GTPase, induced formation of β-catenin-based adherens junctions, actin cytoskeletal reorganization and membrane ruffle in HTM cells. In contrast, treatment of HTM cells with inhibitors of Rac GTPase caused cell-cell separation, a decrease in adherens junctions, and reorganization of actin stress fibers to the cell cortical regions and focal adhesion to the cell leading edges. Both, constitutively active Rac1 and PDGF stimulated generation of Reactive Oxygen Species (ROS) in HTM cells, and ROS were found to increase adherens junction formation and transendothelial electrical resistance (TEER) in HTM cells. Topical application of Rac GTPase inhibitors (EHT1864 and NSC23766), however, only marginally influenced IOP in rabbit eyes. Taken together, these data reveal that while Rac GTPase signaling plays a significant role in regulation of adherens junctions, ROS production and TEER in cells of the AH outflow pathway, Rac inhibitors showed only a marginal influence on IOP in live rabbits. PMID:24932460

  20. Diurnal Variations in Intraocular Pressure, Central Corneal Thickness, and Macular and Retinal Nerve Fiber Layer Thickness in Diabetics and Normal Individuals

    PubMed Central

    Sharifipour, Farideh; Farrahi, Fereidoun; Moghaddasi, Alireza; Idani, Aida; Yaseri, Mehdi

    2016-01-01

    Purpose: To evaluate diurnal variations in intraocular pressure (IOP), central corneal thickness (CCT), and macular and retinal nerve fiber layer (RNFL) thickness in diabetic patients and normal individuals. Methods: This study included 11 diabetic patients with macular edema and 11 healthy individuals. IOP, CCT, and macular and RNFL thickness were measured every 3 hours on a single day between 9 AM and 6 PM. Diurnal variations in IOP, CCT, total macular volume (TMV), central macular thickness (CMT), average macular thickness (AMT), and RNFL thickness were measured. Results: None of the parameters showed a significant absolute or relative change over the course of the day. However, the following non-significant changes were observed. In the control group, all parameters demonstrated the highest values at 9 AM. The lowest IOP, TMV and AMT occurred at 12 PM; lowest CCT and RNFL at 6 PM; and the lowest CMT at 3 PM. Diabetic subjects had the highest values of RNFL, CMT and TMV at 9 AM, and that for IOP, CCT and AMT at 6 PM. The lowest RNFL and CMT values occurred at 6 PM; lowest IOP at 12 PM; and the lowest CCT, TMV and AMT were observed at 3 PM. In the diabetic group, TMV, CMT, AMT and CCT were significantly higher and RNFL was significantly lower than the control group at all time points (all P- values < 0.05). Conclusion: While there were slight decreases in IOP, RNFL thickness and CMT during the day, these changes were not significant between 9 AM and 6 PM and probably do not affect the interpretation of measurements. PMID:27195084

  1. Three experimental glaucoma models in rats: comparison of the effects of intraocular pressure elevation on retinal ganglion cell size and death.

    PubMed

    Urcola, J Haritz; Hernández, María; Vecino, Elena

    2006-08-01

    Glaucoma is a chronic and progressive optic nerve neuropathy involving the death of retinal ganglion cells (RGCs). Elevated intraocular pressure (IOP) is considered to be the major risk factor associated with the development of this neuropathy. The objective of the present study was to compare the effects on RGC survival of three different experimental methods to induce chronic elevation of IOP in rats. These methods were: (i) injections of latex microspheres into the eye anterior chamber; (ii) injections into the anterior chamber of a mixture of microspheres plus hydroxypropylmethylcellulose (HPM) and (iii) cauterization of three episcleral veins. The IOP of right (control) and left (glaucomatous) eyes was measured with an applanation tonometer in awake animals. Thirteen to 30 weeks later, RGCs were retrogradely labeled with 3% fluorogold. Subsequently, we analyzed the density of RGCs, as well as the major axis length and area of RGC soma resulting from the application of each method. A significant increase in IOP was found following application of each of the three methods. Cell death was evident in the glaucomatous eyes as compared to controls. However, no statistical differences were found between the extent of cell death associated with each of the three methods. IOP increase also induced a significant increase in the size of the soma of the remaining RGCs. In conclusion, the three methods used to increase IOP induce a similar degree of RGC death. Moreover, the extent of cell death was similar when the retinas were maintained under conditions of elevated IOP for 24 weeks in comparison to 13 weeks. PMID:16682027

  2. Extensive facial and orbital infantile hemangiomas associated with high intraocular pressure.

    PubMed

    Shatriah, Ismail; Norazizah, Mohd-Amin; Wan-Hitam, Wan-Hazabbah; Wong, Abd-Rahim; Yunus, Rohaizan; Leo, Seo-Wei

    2013-01-01

    High intraocular pressure is a rare ophthalmic condition associated with infantile hemangiomas that involves the orbit, eyelid, or both. Here, we describe a patient with extensive facial and orbital infantile hemangiomas associated with high intraocular pressure in the affected eye. The prompt management of this challenging condition is essential. PMID:22329437

  3. Simulation of eye deformation in the measurement of intraocular pressure

    NASA Astrophysics Data System (ADS)

    Khusainov, R. R.; Tsibul'Skii, V. R.; Yakushev, V. L.

    2011-02-01

    The procedure of measuring the intraocular pressure by an optical analyzer is numerically simulated. The cornea and the sclera are considered as axisymmetrically deformable shells of revolution with fixed boundaries; the space between these shells is filled with incompressible fluid. Nonlinear shell theory is used to describe the stressed and strained state of the cornea and sclera. The optical system is calculated from the viewpoint of the geometrical optics. Dependences between the pressure in the air jet and the area of the surface reflecting the light into a photodetector are obtained. The shapes of the regions on the cornea surface are found from which the reflected light falls on the photodetector. First, the light is reflected from the center of the cornea, but then, as the cornea deforms, the light is reflected from its periphery. The numerical results make it possible to better interpret the measurement data.

  4. Comparison of intraocular pressure adjusted by central corneal thickness or corneal biomechanical properties as measured in glaucomatous eyes using noncontact tonometers and the Goldmann applanation tonometer

    PubMed Central

    Yaoeda, Kiyoshi; Fukushima, Atsushi; Shirakashi, Motohiro; Fukuchi, Takeo

    2016-01-01

    Purpose To investigate the correlation coefficients between intraocular pressure (IOP) before and after adjusting for central corneal thickness (CCT) and corneal biomechanical properties. Patients and methods A total of 218 eyes of 218 patients with primary open-angle glaucoma (mean age =71.5 years; mean spherical equivalent =−0.51 D; mean deviation determined by Humphrey visual field analyzer =−3.22 dB) were included in this study. The tIOP and tIOPCCT, which were adjusted by the CCT (with tIOP meaning IOP not adjusted by CCT, as determined using the CT-1P; and tIOPCCT meaning IOP adjusted by CCT, as determined using the CT-1P), were determined using a noncontact tonometer. The IOPg and IOPCCT, which were adjusted by CCT, and IOPcc adjusted by corneal biomechanical properties were determined using a Reichert 7CR (with IOPg meaning IOP not adjusted by CCT or corneal biomechanical properties, as determined using the Reichert 7CR; IOPCCT meaning IOP adjusted by CCT, as determined using the Reichert 7CR; and IOPcc meaning IOP adjusted by corneal biomechanical properties, as determined using the Reichert 7CR). The GT and GTCCT adjusted by CCT were determined using a Goldmann applanation tonometer (with GT meaning IOP not adjusted by CCT, as determined using the Goldmann applanation tonometer; and with GTCCT meaning IOP adjusted by CCT, as determined using the GAT). Pearson’s correlation coefficients among the IOPs were calculated and compared. P-values <0.05 were considered as statistically significant. Results The tIOP, tIOPCCT, IOPg, IOPCCT, IOPcc, GT, and GTCCT were 14.8±2.5, 15.0±2.4, 13.1±3.2, 13.3±3.1, 13.7±2.9, 13.2±2.4, and 13.4±2.3 mmHg (mean ± standard deviation), respectively. The correlation coefficient between tIOPCCT and tIOP (r=0.979) was significantly higher than that between tIOPCCT and the other IOPs (r=0.668–0.852; P<0.001, respectively). The correlation coefficient between IOPCCT and IOPg (r=0.994) or IOPcc and IOPg (r=0.892) was

  5. Damage patterns of retinal nerve fiber layer in acute and chronic intraocular pressure elevation in primary angle closure glaucoma

    PubMed Central

    Liu, Xing; Li, Mei; Zhong, Yi-Min; Xiao, Hui; Huang, Jing-Jing; Kong, Xiang-Yun

    2010-01-01

    AIM To observe the differences of damage patterns of retinal nerve fiber layer (RNFL) between acute and chronic intraocular pressure (IOP) elevation in primary angle closure glaucoma (PACG) using optical coherence tomography (OCT). METHODS Twenty-four patients (48 eyes) with unilateral acute PACG (APACG) attack in the 6 months after admission and 36 patients (64 eyes) with chronic PACG (CPACG) were included in this prospective study. For all cases, IOP has been controlled under 21mmHg after treatment. Using stratus OCT, the RNFL thickness was assessed in eyes with PACG within 3 days, 2 weeks, 1, 3 and 6 months after IOP was controlled. Repeated measures ANOVA was used to examine the changes of RNFL thickness at different time after IOP being controlled in both acute attack eyes and unaffected fellow eyes of APACG and eyes with CPACG. RESULTS The mean RNFL thickness for the APACG-attacked eyes increased significantly within 3 days (121.49±23.84)µm after acute onset and then became thinner along with time [(107.22±24.72)µm at 2 weeks,(93.58±18.37)µm at 1 month, (84.10±19.89)µm at 3 months and (78.98±19.17)µm at 6 months]. In APACG-attacked eyes, there were significant differences of average RNFL thickness at 5 different times after IOP was controlled (P<0.001). In the APACG unaffected fellow eyes and CPACG eyes, there were no significant differences in mean RNFL thickness at 5 different times(F=0.450, P=0.104 in APACG unaffected fellow eyes and F=1.558, P=0.200 in CPACG eyes). There was significant difference for interaction between time periods and groups (F=1.912, P=0.003). CONCLUSION RNFL damage patterns are different under different IOP elevated courses. In APACG, RNFL was found to be swollen and thickening right after acute attack and then becomes thinning and atrophy along with the time, while RNFL was found to be diffused thinness in CPACG. PMID:22553541

  6. An observational study of bimatoprost 0.01% in patients on prior intraocular pressure-lowering therapy: the Canadian Lumigan® RC Early Analysis Review (CLEAR) trial

    PubMed Central

    Crichton, Andrew C; Nixon, Donald R; Simonyi, Susan; Bhogal, Meetu; Sigouin, Christopher S; Discepola, Marino J; Hutnik, Cindy ML; Baptiste, Darryl C; Yan, David B

    2014-01-01

    Purpose To evaluate the ocular hyperemia and intraocular pressure (IOP)-lowering efficacy of bimatoprost 0.01% in subjects with elevated IOP due to primary open-angle glaucoma (POAG) or ocular hypertension (OHT) in a real-world clinical setting. Subjects and methods This open-label, 12-week, observational study was conducted at 67 centers in Canada. Subjects with elevated IOP due to POAG or OHT instilled bimatoprost 0.01% as monotherapy once daily. Ocular hyperemia was graded by the investigator at baseline, week 6, and week 12 using a standardized photographic 5-point grading scale. Change in IOP from baseline was also evaluated at these time points. This analysis includes the subgroup of 268 subjects who had been previously treated with latanoprost 0.005%, bimatoprost 0.03%, travoprost 0.004%, and travoprost 0.004% with SofZia™ or nonselective beta-adrenergic receptor blockers prior to the study. Results After 12 weeks of treatment with 0.01% bimatoprost, ocular hyperemia was graded as none-to-mild hyperemia (grades 0, +0.5, or +1) for 94.1% of subjects and as moderate-to-severe hyperemia (grades +2 or +3) for 5.9%. No statistically significant shifts in ocular hyperemia ratings were observed at week 12 for any of the prior IOP-lowering therapies except bimatoprost 0.03%, in which 20.8% of subjects experienced an improvement. The mean percentage change from baseline IOP at week 12 following the switch to bimatoprost 0.01% monotherapy ranged from −2.3%±17.3% to −26.3%±12.4%. Furthermore, the decreased mean percentage change from baseline IOP was statistically significant across all prior IOP-lowering medications, except for bimatoprost 0.03% at the 6- and 12-week visits and travoprost 0.004% at the 6-week visit. Conclusion This observational study demonstrates that bimatoprost 0.01% was well tolerated among POAG and OHT subjects who switched from prior IOP-lowering medication. Furthermore, a switch in ocular hypertensive treatment to bimatoprost 0.01% was

  7. Central corneal thickness, intraocular pressure, and degree of myopia in an adult myopic population aged 20 to 40 years in southeast Spain: determination and relationships

    PubMed Central

    Garcia-Medina, Manuel; Garcia-Medina, Jose Javier; Garrido-Fernandez, Pablo; Galvan-Espinosa, Jose; Martin-Molina, Jesus; Garcia-Maturana, Carlos; Perez-Pardo, Sergio; Pinazo-Duran, Maria Dolores

    2011-01-01

    Objective: To determine the values of, and study the relationships among, central corneal thickness (CCT), intraocular pressure (IOP), and degree of myopia (DM) in an adult myopic population aged 20 to 40 years in Almeria (southeast Spain). To our knowledge this is first study of this kind in this region. Methods: An observational, descriptive, cross-sectional study was done in which a sample of 310 myopic patients (620 eyes) aged 20 to 40 years was selected by gender- and age-stratified sampling, which was proportionally fixed to the size of the population strata for which a 20% prevalence of myopia, 5% epsilon, and a 95% confidence interval were hypothesized. We studied IOP, CCT, and DM and their relationships by calculating the mean, standard deviation, 95% confidence interval for the mean, median, Fisher’s asymmetry coefficient, range (maximum, minimum), and the Brown-Forsythe’s robust test for each variable (IOP, CCT, and DM). Results: In the adult myopic population of Almeria aged 20 to 40 years (mean of 29.8), the mean overall CCT was 550.12 μm. The corneas of men were thicker than those of women (P = 0.014). CCT was stable as no significant differences were seen in the 20- to 40-year-old subjects’ CCT values. The mean overall IOP was 13.60 mmHg. Men had a higher IOP than women (P = 0.002). Subjects over 30 years (13.83) had a higher IOP than those under 30 (13.38) (P = 0.04). The mean overall DM was −4.18 diopters. Men had less myopia than women (P < 0.001). Myopia was stable in the 20- to 40-year-old study population (P = 0.089). A linear relationship was found between CCT and IOP (R2 = 0.152, P ≤ 0.001). CCT influenced the IOP value by 15.2%. However no linear relationship between DM and IOP, or between CCT and DM, was found. Conclusions: CCT was found to be similar to that reported in other studies in different populations. IOP tends to increase after the age of 30 and is not accounted for by alterations in CCT values. PMID:21468330

  8. A new device to noninvasively estimate the intraocular pressure produced during ocular compression

    PubMed Central

    Korenfeld, Michael S; Dueker, David K

    2016-01-01

    Purpose To describe a noninvasive instrument that estimates intraocular pressure during episodes of external globe compression and to demonstrate the accuracy and reliability of this device by comparing it to the intraocular pressures simultaneously and manometrically measured in cannulated eyes. Methods A thin fluid-filled bladder was constructed from flexible and inelastic plastic sheeting and was connected to a pressure transducer with high pressure tubing. The output of the pressure transducer was sent to an amplifier and recorded. This device was validated by measuring induced pressure in the fluid-filled bladder while digital pressure was applied to one surface, and the other surface was placed directly against a human cadaver eye or in vivo pig eye. The human cadaver and in vivo pig eyes were each cannulated to provide a manometric intraocular pressure control. Results The measurements obtained with the newly described device were within ~5% of simultaneously measured manometric intraocular pressures in both a human cadaver and in vivo pig eye model for a pressure range of ~15–100 mmHg. Conclusion This novel noninvasive device is useful for estimating the intraocular pressure transients induced during any form of external globe compression; this is a clinical setting where no other devices can be used to estimate intraocular pressure. PMID:26955260

  9. Effect of topical prostaglandin PGA2, PGA2 isopropyl ester, and PGF2 alpha isopropyl ester on intraocular pressure in normotensive and glaucomatous canine eyes.

    PubMed

    Gum, G G; Kingsbury, S; Whitley, R D; Garcia, A; Gelatt, K N

    1991-01-01

    Topical instillations of 1.0, 10, and 20 micrograms/50 microliters of prostaglandin PGA2, 0.5 and 1.0 microgram/50 microliters of PGA2 isopropyl ester, and 0.5, 1.0, 5.0 and 10.0 micrograms/50 microliters of PGF2 alpha isopropyl ester were evaluated in the normal dogs and glaucomatous beagles eyes. Each concentration of drug was evaluated for a seven day period. On Day 1 baseline values were obtained, days 2-4, the drug was instilled (once a day) and on days 5-7 post-treatment values were measured. All concentrations of PGA2 failed to lower intraocular pressure (IOP) in the normal and the glaucomatous (P greater than 0.72) dogs. PGA2 isopropyl ester decreased IOP in the normal dogs and in the glaucomatous beagles (P less than 0.01). The declines in IOP were significant at 1/2 to 1 hour and continued for up to 5 hours. No significant change in IOP occurred in the non-treated fellow eye of the normotensive dog (P less than 0.54) and the glaucomatous beagle (P less than 0.29). All concentrations of PGF2 alpha isopropyl ester significantly decreased IOP in the treated eyes of the normotensive dog (P less than 0.05) and the glaucomatous beagle (P less than 0.01). The significant change in IOP occurred within one hour after the instillation of PGF2 alpha isopropyl ester. The IOP remained lower than the baseline pressures 24 hours post-treatment for both the normotensive and glaucomatous dogs. Maximal change in IOP for normal dogs was a decrease of 9 mm Hg while the glaucomatous beagle had a decrease of 19 mm Hg. No significant change in IOP occurred in the non-treated fellow eye of the normotensive animal (P less than 0.16) and the glaucomatous beagle (P less than 0.40). The side effects of PGF2 alpha isopropyl ester were miosis and mild conjunctival irritation. PMID:1919268

  10. Short-Term Intraocular Pressure Elevations after Combined Phacoemulsification and Implantation of Two Trabecular Micro-Bypass Stents: Prednisolone versus Loteprednol

    PubMed Central

    Wang, Qianqian; Harasymowycz, Paul

    2015-01-01

    Objective. To compare the effects of prednisolone and of loteprednol after combined phacoemulsification and trabecular micro-bypass stent implantation (phaco-iStent). Methods. Patients who underwent phaco-iStent between April 2013 and November 2014 were identified by retrospective chart review. Postoperatively, they received either prednisolone (n = 38) or loteprednol (n = 58). Baseline data was compared. Primary outcomes including intraocular pressure (IOP) and number of glaucoma medications (NGM) were analyzed at preoperative visit, postoperative day 1, weeks 1-2, weeks 3-4, and months 2-3. Results. Both groups had similar preoperative parameters (p > 0.05). The mean IOP spike occurred at postoperative weeks 1-2 with an increase of 2.21 ± 7.30 mmHg in the loteprednol group and 2.54 ± 9.28 mmHg in the prednisolone group. It decreased by weeks 3-4 in both groups and continued to improve at months 2-3. NGM showed significant reduction (p < 0.0001) after the surgery and remained stable in both groups. No significant group effect or time-group interaction in IOP and NGM evolution was detected (p > 0.05). The proportions of patients needing paracentesis were similar between the two groups. Conclusion. Similar early IOP elevations after combined phaco-iStent occurred with both prednisolone and loteprednol. Facilitated glucocorticoid infusion, altered aqueous humor outflow, and local inflammation may be contributing factors. PMID:26266045

  11. A cross-sectional study to compare intraocular pressure measurement by sequential use of Goldman applanation tonometry, dynamic contour tonometry, ocular response analyzer, and Corvis ST

    PubMed Central

    Tejwani, Sushma; Dinakaran, Shoruba; Joshi, Anuja; Shetty, Rohit; Roy, Abhijit Sinha

    2015-01-01

    Objective: To study the correlation and effect of sequential measurement of intraocular pressure (IOP) with Goldmann applanation tonometer (GAT), ocular response analyzer (ORA), dynamic contour tonometer (DCT), and Corvis ST. Setting and Design: Observational cross-sectional series from the comprehensive clinic of a tertiary eye care center seen during December 2012. Methods: One hundred and twenty-five study eyes of 125 patients with normal IOP and biomechanical properties underwent IOP measurement on GAT, DCT, ORA, and Corvis ST; in four different sequences. Patients with high refractive errors, recent surgeries, glaucoma, and corneal disorders were excluded so as to rule out patients with evident altered corneal biomechanics. Statistical Analysis: Linear regression and Bland–Altman using MedCalc software. Results: Multivariate analysis of variance with repeated measures showed no influence of sequence of device use on IOP (P = 0.85). Linear regression r2 between GAT and Corvis ST, Corvis ST and Goldmann-correlated IOP (IOPg), and DCT and Corvis ST were 0.37 (P = 0.675), 0.63 (P = 0.607), and 0.19 (P = 0.708), respectively. The Bland–Altman agreement of Corvis ST with GAT, corneal compensated IOP, and IOPg was 2 mmHg (−5.0 to + 10.3), −0.5 mmHg (−8.1 to 7.1), and 0.5 mmHg (−6.2 to 7.1), respectively. Intraclass correlation coefficient for repeatability ranged from 0.81 to 0.96. Conclusions: Correlation between Corvis ST and ORA was found to be good and not so with GAT. However, agreement between the devices was statistically insignificant, and no influence of sequence was observed. PMID:26669331

  12. Clinical Options for the Reduction of Elevated Intraocular Pressure

    PubMed Central

    Crawley, Laura; Zamir, Sohaib M.; Cordeiro, Maria F.; Guo, Li

    2012-01-01

    Elevated IOP in clinical practice is usually seen in glaucoma or ocular hypertension. Glaucoma affects 60 million people worldwide and 8.4 million are bilaterally blind from this chronic disease.1 Options for reducing IOP rely on pharmacological agents, laser treatments and surgery which may be penetrating or non-penetrating. The last twenty years has seen significant changes in all of these strategies. This review aims to cover these clinical options and introduce some of the new technologies currently in development for the clinical lowering of IOP. PMID:23650457

  13. An examination of the hypothesis that intraocular pressure elevation episodes can have prognostic significance in glaucoma suspects.

    PubMed

    McMonnies, Charles

    2015-01-01

    The efficacy of intraocular pressure reduction in retarding the progression of glaucoma has been demonstrated. This review examines the potential for prognostic advantage for glaucoma suspects in reducing their optic nerve head exposure to elevated intraocular pressure associated with activities which have been shown to elevate intraocular pressure. In this observational study, patients examined at the Centre for Eye Health (University of New South Wales) with a diagnosis of glaucoma suspect were surveyed to determine their histories for participation in activities which are known to elevate intraocular pressure. The evidence regarding the pathological significance of these sources of elevation in susceptible patients was examined. Apart from the universality of sleep-related intraocular pressure elevations, the histories from 183 confirmed glaucoma suspects indicate a wide range and variation in frequency of participation in other intraocular pressure elevating activities. A reduction in exposure to elevated intraocular pressure may improve the prognosis for glaucoma suspects. Additional patient specific assessment of the results of this screening could provide an indication of the degree (frequency, intensity level and duration) of exposure to elevated intraocular pressure. Such information may provide the basis for improving a patient's prognosis by helping them to identify opportunities to reduce such exposure to elevated intraocular pressure. Any benefit of reduction of such exposure appears likely to be greater if activities which elevate intraocular pressure are of long duration, occur frequently, occur over a long period of time, and/or involve high levels of intraocular pressure elevation. PMID:25199440

  14. An examination of the hypothesis that intraocular pressure elevation episodes can have prognostic significance in glaucoma suspects

    PubMed Central

    McMonnies, Charles

    2014-01-01

    The efficacy of intraocular pressure reduction in retarding the progression of glaucoma has been demonstrated. This review examines the potential for prognostic advantage for glaucoma suspects in reducing their optic nerve head exposure to elevated intraocular pressure associated with activities which have been shown to elevate intraocular pressure. In this observational study, patients examined at the Centre for Eye Health (University of New South Wales) with a diagnosis of glaucoma suspect were surveyed to determine their histories for participation in activities which are known to elevate intraocular pressure. The evidence regarding the pathological significance of these sources of elevation in susceptible patients was examined. Apart from the universality of sleep-related intraocular pressure elevations, the histories from 183 confirmed glaucoma suspects indicate a wide range and variation in frequency of participation in other intraocular pressure elevating activities. A reduction in exposure to elevated intraocular pressure may improve the prognosis for glaucoma suspects. Additional patient specific assessment of the results of this screening could provide an indication of the degree (frequency, intensity level and duration) of exposure to elevated intraocular pressure. Such information may provide the basis for improving a patient's prognosis by helping them to identify opportunities to reduce such exposure to elevated intraocular pressure. Any benefit of reduction of such exposure appears likely to be greater if activities which elevate intraocular pressure are of long duration, occur frequently, occur over a long period of time, and/or involve high levels of intraocular pressure elevation. PMID:25199440

  15. Short-term intraocular pressure trends following intravitreal ranibizumab injections for neovascular age-related macular degeneration—the role of oral acetazolamide in protecting glaucoma patients

    PubMed Central

    Murray, C D; Wood, D; Allgar, V; Walters, G; Gale, R P

    2014-01-01

    Purpose To determine the effect of oral acetazolamide on lowering the peak and duration of intraocular pressure (IOP) rise in glaucoma and glaucoma suspect patients, following intravitreal injection of ranibizumab for neovascular age-related macular degeneration. Methods The study was an open-label, parallel, randomised, controlled trial (EudraCT Number: 2010-023037-35). Twenty-four glaucoma or glaucoma suspect patients received either 500 mg acetazolamide or no treatment 60–90 min before 0.5 mg ranibizumab. The primary outcome measure was the difference in IOP immediately after injection (T0) and 5, 10, and 30 min following injection. ANCOVA was used to compare groups, adjusting for baseline IOP. The study was powered to detect a 9-mm Hg difference at T0. Results The IOP at T0 was 2.3 mm Hg higher in the non-treated group (mean 44.5 mm Hg, range (19–86 mm Hg)) compared with the treated group (mean 42.2 mm Hg, range (25–58 mm Hg)), but was not statistically significant after adjusting for baseline IOP (P=0.440). At 30 min, IOP was 4.9 mm Hg higher in the non-treated group (mean 20.6 mm Hg, range (11–46 mm Hg)) compared with the treated group (mean 15.7 mm Hg, range (8–21 mm Hg)). This was statistically significant after adjusting for baseline IOP (P=0.013). Conclusions Although the primary end points were not reached, 500 mg oral acetazolamide, 60–90 min before intravitreal injection, results in a statistically significant reduction in IOP at 3O min post injection. Prophylactic treatment may be considered as an option to minimise neuro-retinal rim damage in high-risk glaucoma patients who are most vulnerable to IOP spikes and undergoing repeated intravitreal injections of ranibizumab. PMID:25081290

  16. Effects of topical travoprost 0.004% on intraocular pressure and corneal biomechanical properties in an animal model

    PubMed Central

    Lazcano-Gomez, Gabriel; Ancona-Lezama, David; Gil-Carrasco, Felix; Jimenez-Roman, Jesus

    2016-01-01

    Purpose To determine whether topical application of travoprost 0.004% induces changes in corneal biomechanical properties affecting intraocular pressure (IOP) values in rabbits. Methods Both eyes of 10 New Zealand rabbits were measured 3 times with the Ocular Response Analyzer (ORA) before treatment. Each measurement included corneal hysteresis (CH), corneal resistance factor (CRF), corneal-corrected IOP (IOPcc), and Goldmann equivalent IOP (IOPg). A drop of travoprost 0.004% was applied once daily in right eyes for 3 months; left eyes received no treatments. After 3 months of treatment both eyes of all rabbits were again measured 3 times. After complete keratectomy of both eyes, tissues prepared with hematoxylin-eosin stain were analyzed by means of light microscopy. Results The mean pre- and post-treatment IOPg, respectively, for right eyes was 9.92 ± 5.64 mm Hg and 7.62 ± 2.99 mm Hg (P = 0.027); IOPcc, 19.81 ± 5.25 mm Hg and 17.79 ± 4.09 mm Hg (P = 0.063); CRF, 1.65 ± 1.63 mm Hg and 2.18 ± 2.50 mm Hg (P = 0.266); and CH, 2.79 ± 1.74 mm Hg and 2.64 ± 2.08 mm Hg (P = 0.72). Mean post-treatment right and left eye IOPg values were, respectively, 7.62 ± 2.99 and 10.30 ± 4.40 (P = 0.002); IOPcc, 17.79 ± 4.09 mm Hg and 20.37 ± 4.32 mm Hg (P = 0.009); CRF, 1.65 ± 1.63 mm Hg and 2.17 ± 2.47 mm Hg (P = 0.274); and CH, 2.79 ± 1.74 mm Hg and 2.54 ± 2.08 mm Hg (P = 0.575). No difference in CH and CRF was observed between treated and untreated eyes. Conclusions Post-treatment reduction of IOP in treated eyes was a direct hypotensive effect of travoprost 0.004% and was not affected by changes in corneal biomechanical properties (CH and CRF), resulting in real lower IOP values. PMID:27330476

  17. Twenty-Four-Hour Intraocular Pressure Related Changes Following Adjuvant Selective Laser Trabeculoplasty for Normal Tension Glaucoma

    PubMed Central

    Lee, Jacky W.Y.; Fu, Lin; Chan, Jonathan C.H.; Lai, Jimmy S.M.

    2014-01-01

    Abstract To investigate intraocular pressure (IOP) related patterns before and after selective laser trabeculoplasty (SLT) for normal tension glaucoma (NTG). In this prospective cohort study, 18 NTG patients underwent SLT. Success was defined as IOP reduction ≥20% by Goldmann applanation tonometry. 24-hour IOP-related pattern recording with a contact lens sensor (CLS) (SENSIMED Triggerfish®, Sensimed, Switzerland) was done before (baseline) and 1 month after SLT. A cosine function was fitted to the mean CLS patterns for each individual in the SLT success and non-success groups and the amplitude before and after SLT was calculated. Diurnal, nocturnal, and 24-hour CLS pattern local variability was determined for pre- and post-SLT sessions. Cosine amplitude and variability were compared before and after SLT by group using paired t-tests, with α = 0.05. Patients (11 women, 7 men) had a mean age of 65.1 ± 13.7 years. Mean IOP was 15.3 ± 2.2 mm Hg at baseline and was reduced by 17.0% to 12.7 ± 1.8 mm Hg 1 month after SLT (P = 0.001). SLT was successful in 8 patients (44%). The amplitude of the fitted cosine was reduced by 24.6% in the success group, but displayed an amplitude increase of 19.2% post-SLT in the non-success group. Higher diurnal local variability of the CLS pattern was observed after SLT in non-success subjects (P = 0.002), while nocturnal variability showed no significant change. The increase in diurnal variability in the non-success group led to an increase in 24-hour variability in this group (P = 0.001). No change in local variability (diurnal, nocturnal, and 24-hour) was seen in the success group. The IOP-related pattern cosinor amplitude was reduced in NTG patients with a successful SLT treatment whereas the non-success group exhibited an increase of cosine amplitude. Higher diurnal and 24-hour CLS pattern variability was observed in non-success patients 1 month post-SLT. PMID:25501089

  18. Comparison study of intraocular pressure reduction efficacy and safety between latanoprost and tafluprost in Japanese with normal-tension glaucoma

    PubMed Central

    Ikeda, Yoko; Mori, Kazuhiko; Tada, Kaori; Ueno, Morio; Kinoshita, Shigeru; Sotozono, Chie

    2016-01-01

    Purpose To evaluate and compare the intraocular pressure (IOP) reduction efficacy and safety between the ophthalmic solutions 0.005% latanoprost (Lat) and 0.0015% tafluprost (Taf) in Japanese patients with normal-tension glaucoma (NTG). Methods In this randomized nonmasked study, we prospectively enrolled 30 Japanese NTG patients who had used Lat monotherapy for more than 4 weeks, and randomly divided them into the following two groups: 1) Lat-to-Taf group (LT group) and 2) Taf-to-Lat group (TL group). At the beginning of the study, both groups were switched from initial Lat to Lat or Taf for 12 weeks, and then switched over to the other drug (crossover) for 12 additional weeks. At 0, 4, 12, 16, and 24 weeks, we evaluated each patient’s IOP, conjunctival injection, and corneal epitheliopathy score, and at 0, 12, and 24 weeks, we evaluated their eyelash changes and pigmentation of the eyelids and irises. Results The mean IOP of the LT group (15 eyes) was 10.5, 10.6, and 11.1 mmHg, at 0, 12, and 24 weeks, respectively, whereas that of the TL group (15 eyes) was 11.7, 11.1, and 10.5 mmHg at 0, 12, and 24 weeks, respectively. No significant differences were found between the two groups and in the intragroup comparisons. Moreover, no significant differences were found between Lat and Taf in regard to the conjunctival injection score and corneal epitheliopathy score. Eyelash changes and eyelid and iris pigmentation were similar in both groups. Conclusion The findings of this study show that Lat and Taf have equivalent efficacy and safety in Japanese patients with NTG. PMID:27601879

  19. Argon laser trabeculoplasty as a means of decreasing intraocular pressure from ''normal'' levels in glaucomatous eyes

    SciTech Connect

    Sharpe, E.D.; Simmons, R.J.

    1985-06-15

    The authors conducted a retrospective study of 67 patients (85 eyes) with severe glaucoma to determine whether argon laser trabeculoplasty could reduce intraocular pressures below the ''normal'' range. All patients had initial intraocular pressures of less than or equal to 19 mm Hg. Success was defined as a decrease in intraocular pressure of at least 20%, no increase in medications, stable visual field, and no subsequent glaucoma surgery. After an average follow-up period of 30 months, treatment was successful in 31 cases. One half of the failures occurred by six months and 11 failures (30%) occurred after 12 months. Sixteen patients were able to decrease their medications. Two patients achieved intraocular pressures between 6 and 9 mm Hg and 20 between 10 and 12 mm Hg.

  20. Effect of preservative removal from fixed-combination bimatoprost/timolol on intraocular pressure lowering: a potential timolol dose–response phenomenon

    PubMed Central

    Shen, Jie; Bejanian, Marina

    2016-01-01

    Purpose Many patients with glaucoma require combination therapies to achieve target intraocular pressure (IOP) and preserve visual function. Ocular hypotensives often contain a preservative (eg, benzalkonium chloride [BAK]), but preservative-free (PF) formulations have been developed for patients with sensitivity. A Phase III study found the efficacy of bimatoprost 0.03%/timolol 0.5% (bim/tim, Ganfort®) PF to be equivalent to that of preserved bim/tim, although a trend favoring bim/tim PF was observed. As BAK is a corneal penetration enhancer, this literature review aims to explain these findings by exploring the relationship between timolol concentration and its IOP-lowering effect. Methods Systematic searches were performed in Scopus and PubMed for clinical trials published in English between 1960 and July 2014 using the keywords “timolol”, “intraocular pressure”, and the concentrations “1%, 0.5%, OR 0.25%”. Articles that directly compared IOP-lowering effects of ≥2 concentrations of timolol were identified by manual screening, and cross-checked for duplication. Results Seventeen studies that included 10–371 patients were evaluated; the majority were randomized (16/17), double-masked (14/17), and enrolled patients with open-angle glaucoma or ocular hypertension (12/17). All studies investigated timolol in preserved formulations. Timolol concentrations tested ranged from 0.008% to 1.5%. Of 13 studies comparing timolol 0.25% versus 0.5%, two found the 0.25% dose to have greater IOP-lowering effects, and three reported the opposite; eight reported similar IOP lowering. Results also indicate that timolol 0.5% may be more effective than higher concentrations. Conclusion The evidence suggests that timolol may have an inverted U-shaped dose–response curve, and that its optimal IOP-lowering concentration is between 0.25% and 0.5%. Compared with bim/tim, removal of the permeability enhancer BAK in bim/tim PF could have resulted in a lower timolol

  1. Intraocular pressure in very low birth weight preterm infants and its association with postconceptional age

    PubMed Central

    Lindenmeyer, Rodrigo L.; Farias, Lucas; Mendonça, Taís; Filho, João Borges Fortes; Procianoy, Renato S.; Silveira, Rita C.

    2012-01-01

    OBJECTIVE: To evaluate intraocular pressure in very low birth weight preterm infants and correlate it with postconceptional age. METHODS: The intraocular pressure in a prospective cohort of very low birth weight premature infants (defined as a birth weight ≤1,500 g and gestational age ≤32 weeks) admitted to Hospital de Clínicas de Porto Alegre, Brazil was evaluated weekly. The evaluated outcome was the variation in the intraocular pressure following changes in the postconceptional age (defined as the gestational age at birth plus the age in weeks at the time of examination) in the weeks following preterm birth. Mixed-effects models were used for the statistical analysis to determine the intraocular pressure variation according to postconceptional age, and means and 10th and 90th percentiles were calculated for the intraocular pressure values. RESULTS: Fifty preterm infants with a mean gestational age of 29.7±1.6 weeks and a mean birth weight of 1,127.7±222.7 g were evaluated. The mean intraocular pressure for the entire cohort considering both eyes was 14.9±4.5 mmHg, and 13.5% of all recorded intraocular pressure values were greater than 20 mmHg. The analysis revealed a mean reduction in the intraocular pressure of 0.29 mmHg for each increase in postconceptional age (p = 0.047; 95% CI: −0.58 to −0.0035). The mean intraocular pressure (P10–P90) decreased from 16.3 mmHg (10.52–22.16) at 26.3 weeks to 13.1 mmHg (7.28–18.92) at 37.6 weeks of postconceptional age. CONCLUSIONS: The mean intraocular pressure in very low birth weight preterm infants was 14.9±4.5 mmHg. This value decreased 0.29 mmHg per week as the postconceptional age increased. PMID:23184197

  2. Determination of the true intraocular pressure and modulus of elasticity of the human cornea in vivo.

    PubMed

    Orssengo, G J; Pye, D C

    1999-05-01

    The purpose of this study was to determine the true intraocular pressure and modulus of elasticity of the human cornea in vivo. The cornea was modeled as a shell, and the equations for the deformations of a shell due to applanating and intraocular pressures were combined to model the behavior of the cornea during applanation tonometry. At certain corneal dimensions called the calibration dimensions, the applanating and intraocular pressures are considered to be equal. This relationship was used to determine the modulus of elasticity of the cornea and the relationship between the applanating and intraocular pressures. The true intraocular pressure (IOPT) was found to be related to Goldmann's applanating pressure (IOPG) as IOPT = IOPG/K, where K is a correction factor. For the calibration corneal thickness of 0.52 mm, the modulus of elasticity E in MPa of the human cornea was found to be related to the true intraocular pressure IOPT in mmHg as E = 0.02291OPT. The generalization of the Imbert-Fick law that takes into account the effect of corneal dimensions and stiffness was found to be given by IOPT = 73.5W/(K A), where W is the applanating weight in gf (gram force) and A is the applanated area in mm2. The calculated true intraocular pressure and modulus of elasticity were found to agree with published experimental results. The mathematical model developed may therefore be used to improve results from applanation tonometry and to estimate the mechanical property of the cornea in vivo. PMID:17883231

  3. Six-month comparison of bimatoprost once-daily and twice-daily with timolol twice-daily in patients with elevated intraocular pressure.

    PubMed

    Sherwood, M; Brandt, J

    2001-05-01

    The efficacy and safety of bimatoprost, a member of a new class of pharmacological agents called prostamides, were compared with the efficacy and safety of timolol in patients with glaucoma or ocular hypertension. Pooled 6-month results from two ongoing, multicenter, randomized, double-masked, clinical trials were analyzed. Patients were randomized in a 2:2:1 ratio to treatment with bimatoprost 0.03% once a day ([QD] n = 474), bimatoprost 0.03% twice a day ([BID] n = 483), or timolol 0.5% BID (n = 241). Scheduled visits were at prestudy, baseline, week 2, week 6, month 3, and month 6. The primary outcome measure was in diurnal intraocular pressure ([IOP] 8 AM, 10 AM, 4 PM, 8 PM). Bimatoprost QD provided significantly greater mean IOP reductions from baseline than timolol at every time of the day and at each study visit (p IOP reductions than timolol at most timepoints, but was not as effective as QD dosing. The IOP lowering provided by bimatoprost QD was sustained for 6 months. At month 6, the mean IOP reduction from baseline at 10 AM was 8.1 mm Hg (33%) with bimatoprost QD, 6.3 mm Hg (26%) with bimatoprost BID, and 5.6 mm Hg (23%) with timolol. Low target pressures were achieved by a significantly higher percentage of patients in the bimatoprost QD group than in the timolol group. At 10 AM (peak timolol effect) at month 6, IOP

  4. Apparatus and method for non-contact, acoustic resonance determination of intraocular pressure

    DOEpatents

    Sinha, Dipen N.; Wray, William O.

    1994-01-01

    Apparatus and method for measuring intraocular pressure changes in an eye under investigation by detection of vibrational resonances therein. An ultrasonic transducer operating at its resonant frequency is amplitude modulated and swept over a range of audio frequencies in which human eyes will resonate. The output therefrom is focused onto the eye under investigation, and the resonant vibrations of the eye observed using a fiber-optic reflection vibration sensor. Since the resonant frequency of the eye is dependent on the pressure therein, changes in intraocular pressure may readily be determined after a baseline pressure is established.

  5. Intraocular/Intracranial pressure mismatch hypothesis for visual impairment syndrome in space.

    PubMed

    Zhang, Li-Fan; Hargens, Alan R

    2014-01-01

    Visual impairment intracranial pressure syndrome (VIIP) is considered a major risk for future human spaceflight. Loss of hydrostatic pressure gradients in vascular and cerebrospinal fluid systems due to the removal of gravity associated with subsequent intracranial and intraocular fluid shifts and the resulting intraocular/intracranial pressure mismatch might be important etiology factors causingVIIP syndrome. Acclimation changes in the ocular and cerebral circulation and the two fluid systems during chronic microgravity exposure and their underlying mechanisms need further elucidation. Relevant findings may help to validate the pressure differential hypothesis for VlIP syndrome and to evaluate whether a gravity based countermeasure is needed. PMID:24479265

  6. Apparatus and method for non-contact, acoustic resonance determination of intraocular pressure

    DOEpatents

    Sinha, D.N.; Wray, W.O.

    1994-12-27

    The apparatus and method for measuring intraocular pressure changes in an eye under investigation by detection of vibrational resonances therein. An ultrasonic transducer operating at its resonant frequency is amplitude modulated and swept over a range of audio frequencies in which human eyes will resonate. The output therefrom is focused onto the eye under investigation, and the resonant vibrations of the eye observed using a fiber-optic reflection vibration sensor. Since the resonant frequency of the eye is dependent on the pressure therein, changes in intraocular pressure may readily be determined after a baseline pressure is established. 3 figures.

  7. Intraocular pressure and glaucoma: Is physical exercise beneficial or a risk?

    PubMed

    McMonnies, Charles William

    2016-01-01

    Intraocular pressure may become elevated with muscle exertion, changes in body position and increased respiratory volumes, especially when Valsalva manoeuver mechanisms are involved. All of these factors may be present during physical exercise, especially if hydration levels are increased. This review examines the evidence for intraocular pressure changes during and after physical exercise. Intraocular pressure elevation may result in a reduction in ocular perfusion pressure with the associated possibility of mechanical and/or ischaemic damage to the optic nerve head. A key consideration is the possibility that, rather than being beneficial for patients who are susceptible to glaucomatous pathology, any intraocular pressure elevation could be detrimental. Lower intraocular pressure after exercise may result from its elevation causing accelerated aqueous outflow during exercise. Also examined is the possibility that people who have lower frailty are more likely to exercise as well as less likely to have or develop glaucoma. Consequently, lower prevalence of glaucoma would be expected among people who exercise. The evidence base for this topic is deficient and would be greatly improved by the availability of tonometry assessment during dynamic exercise, more studies which control for hydration levels, and methods for assessing the potential general health benefits of exercise against any possibility of exacerbated glaucomatous pathology for individual patients who are susceptible to such changes. PMID:26794458

  8. Intraocular Pressure and the Mechanisms Involved in Resistance of the Aqueous Humor Flow in the Trabecular Meshwork Outflow Pathways.

    PubMed

    Tamm, Ernst R; Braunger, Barbara M; Fuchshofer, Rudolf

    2015-01-01

    Intraocular pressure (IOP), the critical risk factor for glaucoma, is generated and maintained by the aqueous humor circulation system. Aqueous humor is secreted from the epithelial layers of the ciliary body and exits the eye through the trabecular meshwork or the uveoscleral outflow pathways. IOP builds up in response to a resistance to aqueous humor flow in the trabecular outflow pathways. The trabecular outflow resistance is localized in the inner wall region, which comprises the juxtacanalicular connective tissue (JCT) and the inner wall endothelium of Schlemm's canal (SC). Outflow resistance in this region is lowered through the relaxation of contractile myofibroblast-like cells in trabecular meshwork and the adjacent scleral spur, or the contraction of the ciliary muscle. In primary open-angle glaucoma, the most frequent form of glaucoma, outflow resistance of the inner wall region is typically higher than normal. There is evidence that the increase in resistance is related to characteristic biological changes in the resident cells of the JCT, which more and more acquire the structural and functional characteristics of contractile myofibroblasts. The changes involve an augmentation of their actin cytoskeleton and of their surrounding fibrillary extracellular matrix, which connects to JCT cells via integrins. This scenario leads to an overall stiffening of the inner wall region, and is modulated by transforming growth factor-β/connective tissue growth factor signaling. Essentially comparable changes appear to occur in SC endothelial cells. Stiffening of JCT and SC cells is very likely a critical causative factor for the increase in trabecular outflow resistance in POAG. PMID:26310162

  9. STS-41 crewmembers conduct DSO 0472 Intraocular Pressure on OV-103's middeck

    NASA Technical Reports Server (NTRS)

    1990-01-01

    STS-41 crewmembers conduct Detailed Supplementary Objective (DSO) 0472 Intraocular Pressure on the middeck of Discovery, Orbiter Vehicle (OV) 103. Mission Specialist (MS) William M. Shepherd rests his head on the stowed treadmill while Pilot Robert D. Cabana, holding Shepherd's eye open, prepares to measure Shepherd's intraocular pressure using a tono pen (in his right hand). Objectives include: establishing a database of changes in intraocular pressures that can be used to evaluate crew health; validating ten degree head down bedrest as a model for cephalad fluid shifts in microgravity; facilitating the interpretation of data by providing a quantative measure of microgravity induced cephalad fluid shifts; and validating the tono pen as an effective tool for diagnostic and scientific data collection.

  10. Higher intraocular pressure is associated with leukoaraiosis among middle-aged and elderly Koreans without glaucoma or dementia

    PubMed Central

    Park, B-J; Kim, J-K; Lee, Y-J

    2014-01-01

    Aim Leukoaraiosis and high intraocular pressure are strongly associated with cardiovascular disease, vascular angiopathy, and geriatric syndrome. Until now, little is known about the relationship between intraocular pressure and leukoaraiosis in its preclinical stage. The aim of this study was to evaluate the association between intraocular pressure and leukoaraiosis among middle-aged and elderly Koreans without glaucoma or dementia. Methods We examined the relationship of intraocular pressure with leukoaraiosis at a preclinical stage in 753 Korean adults (474 men, 279 women; mean age 57.8±6.6 years). A multiple logistic regression analysis was performed in order to determine whether intraocular pressure is an independent determinant for leukoaraiosis. Results The overall prevalence of leukoaraiosis was 7.3%. Mean ocular pressure (±SD) was significantly higher in the leukoaraiosis group than the control group (14.3±2.9 and 13.5±2.9, respectively; P=0.028). In multiple logistic regression analysis, the odds ratio for leukoaraiosis was 1.18 (95% confidence interval: 1.06–1.31) for each 1 mm Hg increase in intraocular pressure. Conclusion Intraocular pressure was found to be independently and positively associated with leukoaraiosis. This finding indicates that higher intraocular pressure may be a useful additional measure in assessing the risk of leukoaraiosis in the clinical setting. PMID:24675583