scholarly journals Mean amplitude of intraocular pressure excursions: a new assessment parameter for 24-h pressure fluctuations in glaucoma patients

Eye ◽  
2020 ◽  
Vol 35 (1) ◽  
pp. 326-333
Author(s):  
Ruyi Zhai ◽  
Jingyi Cheng ◽  
Huan Xu ◽  
Zhaobin Fang ◽  
Xu Chen ◽  
...  

Abstract Background Intraocular pressure (IOP) is important in the pathogenesis of glaucoma and its circadian fluctuations are important in the disease management; however, there are no adequate parameters to describe the fluctuations. This study investigates a new parameter, mean amplitude of intraocular pressure excursion (MAPE), and compares its ability in assessing 24-h IOP fluctuations with other ocular parameters. Methods Only the right eye was evaluated in each of the 79 healthy people and 164 untreated patients with primary open angle glaucoma (POAG). Each participant underwent 24-h IOP monitoring by measuring IOP every 2 h. IOP fluctuations were expressed as MAPE calculations and currently used parameters included mean IOP, standard deviation of IOP, max difference and area under the circadian IOP curve. Comprehensive ophthalmologic examinations were also performed. Associations between visual field deficits and IOP fluctuation parameters were investigated via partial least squares (PLS) regression. Diagnostic performance was evaluated with area under the receiver operating characteristic curves (ROC). Results Compared with healthy volunteers, the MAPE values in POAG patients were higher (4.16 ± 1.90 versus 2.45 ± 0.89, p < 0.01). In PLS regressions where visual field deficits were as dependent variable, MAPE had the highest score regarding variable importance in projection, and its standard regression coefficient was larger than other parameters. Diagnostic performance analysis showed the area under ROC of MAPE for glaucoma detection was 0.822 (0.768–0.868, p < 0.001). Conclusions MAPE might be an effective parameter in clinic to characterise IOP circadian fluctuations.

2019 ◽  
Vol 8 ◽  
pp. 1218
Author(s):  
Ebrahim Khalil BaniHabib ◽  
Ali Mostafai ◽  
Seyyed Mohammad Bagher Fazljou ◽  
Ghadir Mohammdi

Background: Open-angle glaucoma (OAG) is one of the leading causes of blindness worldwide. This study evaluates the therapeutic effects of hab shabyar in patients with open-angle glaucoma. Materials and Methods: In this clinical randomized controlled trial, 50 patients with OAG were randomized into two groups. The intervention group was received a drop of timolol plus 500 mg of hab shabyar every 12 hours. The placebo group was received a drop of timolol every 12 hours plus 500 mg of wheat germ as a placebo. The intraocular pressure in patients with OAG was measured in each group and compared at before the intervention (t1), one month (t2), and two months (t3) after the intervention. Results: The mean decrease in intraocular pressure for the right eye at three times in the intervention group was statistically significant, but the mean decrease in the placebo group was not significant. Similar results were obtained for the left eye at t1 when compared to t3. The patients in the intervention group expressed more satisfaction than the patients in the placebo group (P≤0.001). Conclusion: Our study demonstrated that consumption of timolol plus hab shabyar instead of consuming of timolol alone was probably more effective for reducing intraocular pressure in patients with OAG.[GMJ.2019;In press:e1218]


F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 762 ◽  
Author(s):  
Yalong Dang ◽  
Pritha Roy ◽  
Igor I. Bussel ◽  
Ralitsa T. Loewen ◽  
Hardik Parikh ◽  
...  

Prior glaucoma severity staging systems were mostly concerned with visual field function and retinal nerve fiber layer, but did not include intraocular pressure or medications to capture resistance to treatment. We recently introduced a simple index that combines pressure, medications, and visual field damage and applied it to stratify outcomes of trabectome surgery. In the analysis presented here, we combined data of trabectome alone and trabectome with same session cataract surgery to increase testing power and chances of effect discovery. This microincisional glaucoma surgery removes the primary resistance to outflow in glaucoma, the trabecular meshwork, and has been mostly used in mild glaucoma. Traditional glaucoma surgeries have a relatively high complication rate and have been reserved for more advanced disease stages. In the analysis presented here we include our data of trabectome combined with cataract surgery. This is a common practice pattern as both occur in the same age group with increasing frequency. For patients in higher glaucoma index (GI) groups, the intraocular pressure (IOP) reduction was 2.34+/-0.19 mmHg more than those in a GI group one level lower while holding everything else constant. Those who had undergone trabectome combined with phacoemulsification had an IOP reduction that was 1.29+/-0.39 mmHg less compared to those with trabectome alone. No statistically significant difference was found between genders and age groups while holding everything else constant. Hispanics had a 3.81+/-1.08 mmHg greater IOP reduction. Pseudoexfoliation and steroid glaucoma patients had an IOP reduction that was greater by 2.91+/-0.56 and 3.86+/-0.81 mmHg, respectively, than those with primary open angle glaucoma. These results suggest a role for trabectome-mediated ab interno trabeculectomy beyond mild forms of glaucoma. Additionally, the multifactorial glaucoma index demonstrates a role in staging patients when comparing glaucoma surgical modalities.


2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Mengwei Li ◽  
Bingxin Zheng ◽  
Qi Wang ◽  
Xinghuai Sun

Purpose. To compare the impact of visual field (VF) testing on intraocular pressure (IOP) change trends between healthy subjects and glaucoma patients. Methods. We recruited healthy volunteer subjects who did not have previous ocular diseases and open-angle glaucoma patients who were medically controlled well. IOP in both eyes of each participant was measured by using a noncontact tonometer at five time points: before, immediately after (0 minute), and 10, 30, and 60 minutes after the standard automated perimetry. Repeated measures ANOVA was used to analyze the effect of VF testing on IOP change trends in healthy and glaucoma eyes. Results. Forty healthy subjects (80 eyes) and 31 open-angle glaucoma patients (62 eyes) were included for the study. The baseline IOP of healthy and glaucoma eyes was 16.11 ± 3.01 mmHg and 15.78 ± 3.57 mmHg, respectively. After the VF testing, the IOP in healthy eyes was decreased by 1.5% at 0 minute, 6.5% at 10 minutes (P<0.001), 6.6% at 30 minutes (P<0.001), and 7.0% at 1 hour (P<0.001), indicating that this reduction was sustained for at least 1 hour. However, the IOP in glaucoma eyes was increased by 12.7% at 0 minute (P<0.001) and, then, returned towards initial values 1 hour after the VF testing. Conclusions. IOP change trends after VF field testing between healthy subjects and glaucoma patients were quite different. VF testing led to a mild and relatively sustained IOP decrease in healthy subjects, whereas IOP in open-angle glaucoma patients tended to significantly increase immediately after VF testing and, then, returned to pretest values after 1 hour. These findings indicate that the factors of VF testing should be considered in the clinical IOP measurements.


2015 ◽  
Vol 6 (3) ◽  
pp. 279-283 ◽  
Author(s):  
Alfonso Savastano ◽  
Maria Cristina Savastano ◽  
Laura Carlomusto ◽  
Silvio Savastano

In this report, we describe a particular condition of a 52-year-old man who showed advanced bilateral glaucomatous-like optic disc damage, even though the intraocular pressure resulted normal during all examinations performed. Visual field test, steady-state pattern electroretinogram, retinal nerve fiber layer and retinal tomographic evaluations were performed to evaluate the optic disc damage. Over a 4-year observational period, his visual acuity decreased to 12/20 in the right eye and counting fingers in the left eye. Visual fields were severely compromised, and intraocular pressure values were not superior to 14 mm Hg during routine examinations. An accurate anamnesis and the suspicion of this disease represent a crucial aspect to establish the correct diagnosis. In fact, our patient strongly rubbed his eyes for more than 10 h per day. Recurrent and continuous eye rubbing can induce progressive optic neuropathy, causing severe visual field damage similar to the pathology of advanced glaucoma.


1991 ◽  
Vol 111 (4) ◽  
pp. 491-500 ◽  
Author(s):  
Colm O'Brien ◽  
Bernard Schwartz ◽  
Takenori Takamoto ◽  
Da Ching Wu

Ophthalmology ◽  
1998 ◽  
Vol 105 (12) ◽  
pp. 2225-2230 ◽  
Author(s):  
Miguel A Teus ◽  
Miguel A Castejón ◽  
Miguel A Calvo ◽  
Patricia Pérez—Salaı́ces ◽  
Ana Marcos

2011 ◽  
Vol 22 (1) ◽  
pp. 117-120 ◽  
Author(s):  
Gábor Holló ◽  
Péter Kóthy ◽  
Anastasios G.P. Konstas

Purpose To present a case with co-existence of Cogan-Reese syndrome and exfoliation syndrome. Case report A 72-year-old Caucasian woman presented for consultation due to uncontrolled intraocular pressure (IOP) of the right eye. Clinical examination revealed the presence of Cogan-Reese syndrome and exfoliation syndrome OD. This eye exhibited elevated IOP, open anterior chamber angle, advanced glaucomatous optic nerve head damage, and severe glaucomatous visual field loss. The left eye was completely normal without IOP elevation or visual field damage. To our knowledge this is the first case report demonstrating the coexistence of the Cogan-Reese syndrome, exfoliation syndrome, and secondary open-angle glaucoma. Since both syndromes frequently lead to secondary open-angle glaucoma, it is not feasible to determine with certainty which condition was the cause of secondary open-angle glaucoma in our case. It is conceivable that both conditions contributed to glaucoma development. Conclusions Cogan-Reese syndrome, exfoliation syndrome and secondary open-angle glaucoma may present on the same eye.


Sign in / Sign up

Export Citation Format

Share Document