Search Results (7)

Background: In young patients with suspected elevated intraocular pressure (IOP), examinations under general anesthesia remain the gold standard. This study aimed to compare the reliability of Goldmann applanation tonometry (Perkins), iCare rebound tonometry, and the Tono-Pen in young children under general anesthesia in a clinical setting. Methods: This retrospective study included patients under six years of age requiring an ophthalmic examination under general anesthesia. IOP measurements were performed using all three devices, and central corneal thickness (CCT) was recorded for each patient. Results: A total of 38 eyes of 19 children (mean age, 1.8 ± 2.1 years) were included. IOP values of all three devices ranged from 5 to 43 mmHg, with a mean CCT of 645.6 ± 135 µm. The Tono-Pen recorded significantly higher IOP values than the Perkins tonometer (15.2 ± 5.5 mmHg vs. 11.1 ± 4.8 mmHg; p = 0.002), while no significant differences were observed between Perkins and iCare. CCT was significantly correlated with iCare (r = 0.344, p = 0.032) and the Tono-Pen (r = 0.519, p = 0.001) but not with Perkins (r = 0.247, p = 0.129). Bland–Altman analysis showed a significant slope for inter-device differences, but when excluding IOP values >25 mmHg, the slope was no longer significant. Conclusions: Among the devices tested, the Perkins tonometer was the least affected by other parameters such as CCT and IOP values in young patients under general anesthesia, particularly when IOP exceeded 25 mmHg or corneal thickness was increased. In patients with normal corneas and IOP below 25 mmHg, iCare provided comparable accuracy to Perkins, while the Tono-Pen consistently overestimated IOP compared to both devices. Full article

Background/Objectives: This study investigated intraocular pressure (IOP) changes after a blood draw in older adults considering sex, age, and baseline IOP. Methods: Fifty-three subjects (54.7% females; age: 68.50 ± 4.46 years; Visual Function Index [VF14]: 94.50 ± 7.50 points; mean contrast sensitivity function (CSF) for both eyes in each spatial frequency [cdp]: 1.5 cdp [1.41 ± 0.20 log], 3 cdp [1.57 ± 0.29 log], 6 cdp [1.45 ± 0.39 log], 12 cdp [1.04 ± 0.40 log], 18 cdp [0.63 ± 0.31 log]) voluntarily participated. Subjects fasted for at least 8 h before attending the laboratory. First, IOP was measured in a seated position using a portable rebound tonometer. Ten minutes after the initial measurement, two 10 mL tubes of blood were drawn. Five minutes after the blood draw IOP was measured again following the same procedure as the initial measurement. We evaluated the differences using an analysis of variance. Results: Significant, but not clinically relevant, decreases were found in the right eye, with small effect sizes (p = 0.013–0.079, d = 0.35). Only males and subjects older than 68 years showed trends toward IOP reduction in the right eye. Subjects with baseline IOP ≥ 14 mmHg experienced significant IOP reductions in both eyes, with moderate effect sizes (p = 0.001–0.002, d = 0.56–0.69). Conclusions: Our findings suggest that a blood draw of 20 mL is safe for the IOP levels of older adults with baseline IOP between 11 and 21 mmHg. Variations in IOP were observed based on baseline IOP, sex, and age, suggesting the importance of personalized clinical assessments. The primary factor influencing IOP changes appears to be the baseline IOP level. Full article

Glaucoma is a leading cause of irreversible blindness, and early detection and treatment are crucial for preventing vision loss. This review aims to provide an overview of current diagnostic and treatment standards, recent medical and technological advances, and current challenges and future outlook for wearable glaucoma diagnostics and therapeutics. Conventional diagnostic techniques, including the rebound tonometer and Goldmann Applanation Tonometer, provide reliable intraocular pressure (IOP) measurement data at single-interval visits. The Sensimed Triggerfish and other emerging contact lenses provide continuous IOP tracking, which can improve diagnostic IOP monitoring for glaucoma. Conventional therapeutic techniques include eye drops and laser therapies, while emerging drug-eluting contact lenses can solve patient noncompliance with eye medications. Theranostic platforms combine diagnostic and therapeutic capabilities into a single device. Advantages of these platforms include real-time monitoring and personalized medication dosing. While there are many challenges to the development of wearable glaucoma diagnostics and therapeutics, wearable technologies hold great potential for enhancing glaucoma management by providing continuous monitoring, improving medication adherence, and reducing the disease burden on patients and healthcare systems. Further research and development of these technologies will be essential to optimizing patient outcomes. Full article

Elevated intraocular pressure (IOP) in glaucoma causes retinal ganglion cell (RGC) loss and damage to the optic nerve. Although IOP is controlled pharmacologically, no treatment is available to restore retinal and optic nerve function. In this paper, we aimed to develop a novel gene therapy for glaucoma using an AAV2-based thioredoxin 2 (Trx2)-exoenzyme C3 transferase (C3) fusion protein expression vector (scAAV2-Trx2-C3). We evaluated the therapeutic effects of this vector in vitro and in vivo using dexamethasone (DEX)-induced glaucoma models. We found that scAAV2-Trx2-C3-treated HeLa cells had significantly reduced GTP-bound active RhoA and increased phosphor-cofilin Ser3 protein expression levels. scAAV2-Trx2-C3 was also shown to inhibit oxidative stress, fibronectin expression, and alpha-SMA expression in DEX-treated HeLa cells. NeuN immunostaining and TUNEL assay in mouse retinal tissues was performed to evaluate its neuroprotective effect upon RGCs, whereas changes in mouse IOP were monitored via rebound tonometer. The present study showed that scAAV2-Trx2-C3 can protect RGCs from degeneration and reduce IOP in a DEX-induced mouse model of glaucoma, while immunohistochemistry revealed that the expression of fibronectin and alpha-SMA was decreased after the transduction of scAAV2-Trx2-C3 in murine eye tissues. Our results suggest that AAV2-Trx2-C3 modulates the outflow resistance of the trabecular meshwork, protects retinal and other ocular tissues from oxidative damage, and may lead to the development of a gene therapeutic for glaucoma. Full article

Purpose: To investigate how many tests need to be performed to adequately assess intraocular pressure (IOP) diurnal change using a self-measuring rebound tonometer among glaucoma patients. Subjects and Methods: Adult patients with primary open-angle glaucoma were included. IOP was measured in the morning (6 AM to 9 AM), afternoon (12 PM to 3 PM), and at night (6 PM to 9 PM) for seven consecutive days. Twenty-four (7 males and 17 females, mean age 59.5 ± 11.0 years) patients who successfully measured IOP at least three times per day during the correct time periods for four days were subjected to analysis. Results: The IOP rhythm was significantly greater on the first day of measurement (6.6 ± 3.6 mmHg) than that averaged during subsequent days (4.4 ± 2.2 mmHg). The time of the highest and lowest IOP measurements on the first day of IOP measurement and during the entire measurement period coincided in 72.9% and 64.6% of cases, respectively. The concordance rate of the highest IOP time between the whole measurement period and each measurement day was less than 60%. Conclusion: The diurnal IOP rhythm measured by the patients themselves was not consistent, and multiple days of measurements may be necessary to correctly assess diurnal IOP rhythm. Full article

This study aimed to compare intraocular pressures (IOP) using different tonometers, Goldmann applanation (IOP_GAT), non-contact (IOP_NCT), and rebound (IOP_RBT), and to assess the effects of aging and central corneal thickness (CCT) on the measurements. The IOP_GAT, IOP_NCT, IOP_RBT, mean patient age (65.1 ± 16.2 years), and CCT (521.7 ± 39.2 µm) were collected retrospectively from 1054 eyes. The differences among IOPs were compared by the paired t-test. Possible correlations between devices, age, and CCT were assessed by linear regression analyses. The effects of age and CCT on the IOP reading were assessed by mixed-effects regression models. The IOP_GAT values were 2.4 and 1.4 mmHg higher than IOP_NCT and IOP_RBT, respectively; the IOP_NCT was 1.0 mmHg lower than IOP_RBT (p < 0.0001 for all comparisons). The IOPs measured by each tonometer were highly correlated with each other (r = 0.81–0.90, t = 45.2–65.5). The linear regression analyses showed that age was negatively correlated with IOP_NCT (r = −0.12, t = −4.0) and IOP_RBT (r = −0.14, t = −4.5) but not IOP_GAT (r = 0.00, t = −0.2); the CCT was positively correlated with IOP_GAT (r = 0.13, t = 4.3), IOP_NCT (r = 0.29, t = 9.8), and IOP_RBT (r = 0.22, t = 7.2). The mixed-effect regression models showed significant negative correlations between age and IOP_NCT (t = −2.6) and IOP_RBT (t = −3.4), no correlation between age and IOP_GAT (t = 0.2), and a significant positive correlation between CCT and the tonometers (t = 3.4–7.3). No differences between IOP_GAT and IOP_RBT were seen at the age of 38.8 years. CCT affects IOPs from all tonometers; age affects IOP_NCT and IOP_RBT in different degrees. IOP_RBT tended to be higher than IOP_GAT in young subjects, but this stabilized in middle age and became higher in older subjects. Full article

Background and Objectives: It has been established that body position can play an important role in intraocular pressure (IOP) fluctuation. IOP has been previously shown to increase significantly when lying down, relative to sitting; this type of investigation has not been extensively reported for the standing (ST) position. Therefore, this study aims to look for eventual significant IOP changes while ST, sitting, and lying down. Materials and Methods: An Icare PRO was used to measure the IOP of 120 eyes of 60 healthy individuals, with age ranging from 21 to 55 years (mean 29.22 ± 9.12 years), in sitting, supine and ST positions; IOP was measured again, 5 min after standing (ST-5m). Results: Mean IOP difference between sitting and ST position was 0.39 ± 1.93 mmHg (95% CI: 0.04 to 0.74 mmHg) (p = 0.027); between sitting and ST-5m, it was −0.48 ± 1.79 mmHg (95% CI: −0.8 to −0.16 mmHg) (p = 0.004); between the sitting and supine position, it was −1.16±1.9 mmHg (95% CI: −1.5 to −0.82 mmHg) (p < 0.001); between the supine and ST position, it was 1.55 ± 2.04 mmHg (95% CI: 1.18 to 1.92 mmHg) (p < 0.001); between supine and ST-5m, it was 0.68 ± 1.87 mmHg (95% CI: 0.34 to 1.02 mmHg) (p < 0.001); and between ST-5m and ST, it was 0.94 ± 1.95 mmHg (95% CI: 0.58 to 1.29 mmHg) (p < 0.001). Mean axial eye length was 24.45 mm (95% CI: 24.22 to 24.69 mm), and mean central corneal thickness was 535.30 μm (95% CI: 529.44 to 541.19 μm). Conclusion: Increased IOP in the ST-5m position suggests that IOP measurements should be performed in this position too. The detection of higher IOP values in the ST-5m position than in the sitting one, may explain the presence of glaucoma damage or progression in apparently normal-tension or compensated patients. Full article