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Sikiric P, Kokot A, Kralj T, Zlatar M, Masnec S, Lazic R, Loncaric K, Oroz K, Sablic M, Boljesic M, Antunovic M, Sikiric S, Strbe S, Stambolija V, Beketic Oreskovic L, Kavelj I, Novosel L, Zubcic S, Krezic I, Skrtic A, Jurjevic I, Boban Blagaic A, Seiwerth S, Staresinic M. Stable Gastric Pentadecapeptide BPC 157-Possible Novel Therapy of Glaucoma and Other Ocular Conditions. Pharmaceuticals (Basel) 2023; 16:1052. [PMID: 37513963 PMCID: PMC10385428 DOI: 10.3390/ph16071052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/01/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
Recently, stable gastric pentadecapeptide BPC 157 therapy by activation of collateral pathways counteracted various occlusion/occlusion-like syndromes, vascular, and multiorgan failure, and blood pressure disturbances in rats with permanent major vessel occlusion and similar procedures disabling endothelium function. Thereby, we revealed BPC 157 cytoprotective therapy with strong vascular rescuing capabilities in glaucoma therapy. With these capabilities, BPC 157 therapy can recover glaucomatous rats, normalize intraocular pressure, maintain retinal integrity, recover pupil function, recover retinal ischemia, and corneal injuries (i.e., maintained transparency after complete corneal abrasion, corneal ulceration, and counteracted dry eye after lacrimal gland removal or corneal insensitivity). The most important point is that in glaucomatous rats (three of four episcleral veins cauterized) with high intraocular pressure, all BPC 157 regimens immediately normalized intraocular pressure. BPC 157-treated rats exhibited normal pupil diameter, microscopically well-preserved ganglion cells and optic nerve presentation, normal fundus presentation, nor- mal retinal and choroidal blood vessel presentation, and normal optic nerve presentation. The one episcleral vein rapidly upgraded to accomplish all functions in glaucomatous rats may correspond with occlusion/occlusion-like syndromes of the activated rescuing collateral pathway (azygos vein direct blood flow delivery). Normalized intraocular pressure in glaucomatous rats corresponded to the counteracted intra-cranial (superior sagittal sinus), portal, and caval hypertension, and aortal hypotension in occlusion/occlusion-like syndromes, were all attenuated/eliminated by BPC 157 therapy. Furthermore, given in other eye disturbances (i.e., retinal ischemia), BPC 157 instantly breaks a noxious chain of events, both at an early stage and an already advanced stage. Thus, we further advocate BPC 157 as a therapeutic agent in ocular disease.
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Affiliation(s)
- Predrag Sikiric
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Antonio Kokot
- Department of Anatomy and Neuroscience, Faculty of Medicine, J.J. Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Tamara Kralj
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Mirna Zlatar
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Sanja Masnec
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Ratimir Lazic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Kristina Loncaric
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Katarina Oroz
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Marko Sablic
- Department of Anatomy and Neuroscience, Faculty of Medicine, J.J. Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Marta Boljesic
- Department of Anatomy and Neuroscience, Faculty of Medicine, J.J. Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Marko Antunovic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Suncana Sikiric
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Sanja Strbe
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Vasilije Stambolija
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | | | - Ivana Kavelj
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Luka Novosel
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Slavica Zubcic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Ivan Krezic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Anita Skrtic
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Ivana Jurjevic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Alenka Boban Blagaic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Sven Seiwerth
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Mario Staresinic
- Department of Surgery, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
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Bennett K, Osinchuk S, Bauer B, Rao S, Sadar MJ. Ophthalmic Parameters and Ophthalmoscopy of Burrowing Owls (Athene cunicularia). J Avian Med Surg 2022; 36:192-199. [DOI: 10.1647/21-00046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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McDowell CM, Kizhatil K, Elliott MH, Overby DR, van Batenburg-Sherwood J, Millar JC, Kuehn MH, Zode G, Acott TS, Anderson MG, Bhattacharya SK, Bertrand JA, Borras T, Bovenkamp DE, Cheng L, Danias J, De Ieso ML, Du Y, Faralli JA, Fuchshofer R, Ganapathy PS, Gong H, Herberg S, Hernandez H, Humphries P, John SWM, Kaufman PL, Keller KE, Kelley MJ, Kelly RA, Krizaj D, Kumar A, Leonard BC, Lieberman RL, Liton P, Liu Y, Liu KC, Lopez NN, Mao W, Mavlyutov T, McDonnell F, McLellan GJ, Mzyk P, Nartey A, Pasquale LR, Patel GC, Pattabiraman PP, Peters DM, Raghunathan V, Rao PV, Rayana N, Raychaudhuri U, Reina-Torres E, Ren R, Rhee D, Chowdhury UR, Samples JR, Samples EG, Sharif N, Schuman JS, Sheffield VC, Stevenson CH, Soundararajan A, Subramanian P, Sugali CK, Sun Y, Toris CB, Torrejon KY, Vahabikashi A, Vranka JA, Wang T, Willoughby CE, Xin C, Yun H, Zhang HF, Fautsch MP, Tamm ER, Clark AF, Ethier CR, Stamer WD. Consensus Recommendation for Mouse Models of Ocular Hypertension to Study Aqueous Humor Outflow and Its Mechanisms. Invest Ophthalmol Vis Sci 2022; 63:12. [PMID: 35129590 PMCID: PMC8842499 DOI: 10.1167/iovs.63.2.12] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/08/2021] [Indexed: 01/07/2023] Open
Abstract
Due to their similarities in anatomy, physiology, and pharmacology to humans, mice are a valuable model system to study the generation and mechanisms modulating conventional outflow resistance and thus intraocular pressure. In addition, mouse models are critical for understanding the complex nature of conventional outflow homeostasis and dysfunction that results in ocular hypertension. In this review, we describe a set of minimum acceptable standards for developing, characterizing, and utilizing mouse models of open-angle ocular hypertension. We expect that this set of standard practices will increase scientific rigor when using mouse models and will better enable researchers to replicate and build upon previous findings.
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Affiliation(s)
- Colleen M. McDowell
- Department of Ophthalmology and Visual Sciences, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | | | - Michael H. Elliott
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
| | - Darryl R. Overby
- Department of Bioengineering, Imperial College London, United Kingdom
| | | | - J. Cameron Millar
- Department of Pharmacology & Neuroscience, and North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, Texas, United States
| | - Markus H. Kuehn
- Department of Ophthalmology and Visual Sciences and Institute for Vision Research, The University of Iowa; Center for the Prevention and Treatment of Visual Loss, Veterans Affairs Medical Center, Iowa City, Iowa, United States
| | - Gulab Zode
- Department of Pharmacology & Neuroscience, and North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, Texas, United States
| | - Ted S. Acott
- Ophthalmology and Biochemistry and Molecular Biology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
| | - Michael G. Anderson
- Department of Molecular Physiology and Biophysics and Department of Ophthalmology and Visual Sciences, The University of Iowa; Center for the Prevention and Treatment of Visual Loss, Veterans Affairs Medical Center, Iowa City, Iowa, United States
| | | | - Jacques A. Bertrand
- Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Terete Borras
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | | | - Lin Cheng
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, United States
| | - John Danias
- SUNY Downstate Health Sciences University, Brooklyn, New York, United States
| | - Michael Lucio De Ieso
- Department of Ophthalmology, Duke Eye Center, Duke University, Durham, North Carolina, United States
| | - Yiqin Du
- Department of Ophthalmology, University of Pittsburgh, Pennsylvania, United States
| | - Jennifer A. Faralli
- Department of Pathology and Laboratory Medicine, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Rudolf Fuchshofer
- Institute of Human Anatomy and Embryology, University of Regensburg, Regensburg, Germany
| | - Preethi S. Ganapathy
- Department of Ophthalmology and Visual Sciences, SUNY Upstate Medical University, Syracuse, New York, United States
| | - Haiyan Gong
- Department of Ophthalmology, Boston University School of Medicine, Boston, Massachusetts, United States
| | - Samuel Herberg
- Department of Ophthalmology and Visual Sciences, SUNY Upstate Medical University, Syracuse, New York, United States
| | | | - Peter Humphries
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Simon W. M. John
- Department of Ophthalmology, Columbia University, New York, New York, United States
| | - Paul L. Kaufman
- Department of Ophthalmology and Visual Sciences, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Kate E. Keller
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
| | - Mary J. Kelley
- Department of Ophthalmology and Department of Integrative Biosciences, Oregon Health & Science University, Portland, Oregon, United States
| | - Ruth A. Kelly
- Ocular Genetics Unit, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - David Krizaj
- Department of Ophthalmology, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - Ajay Kumar
- Department of Ophthalmology, University of Pittsburgh, Pennsylvania, United States
| | - Brian C. Leonard
- Department of Surgical and Radiological Sciences, University of California, Davis, Davis, California, United States
| | - Raquel L. Lieberman
- Department of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, Georgia, United States
| | - Paloma Liton
- Department of Ophthalmology and Department of Pathology, Duke University, Durham, North Carolina, United States
| | - Yutao Liu
- Department of Cellular Biology and Anatomy, James & Jean Culver Vision Discovery Institute, Augusta University, Augusta, Georgia, United States
| | - Katy C. Liu
- Duke Eye Center, Duke Health, Durham, North Carolina, United States
| | - Navita N. Lopez
- Department of Neurobiology, University of Utah, Salt Lake City, Utah, United States
| | - Weiming Mao
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
| | - Timur Mavlyutov
- Department of Ophthalmology and Visual Sciences, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Fiona McDonnell
- Duke Eye Center, Duke Health, Durham, North Carolina, United States
| | - Gillian J. McLellan
- Department of Surgical Sciences and Department of Ophthalmology and Visual Sciences, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Philip Mzyk
- Department of Ophthalmology and Visual Sciences, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | - Andrews Nartey
- College of Optometry, University of Houston, Houston, Texas, United States
| | - Louis R. Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Gaurang C. Patel
- Ophthalmology Research, Regeneron Pharmaceuticals, Tarreytown, New York, United States
| | | | - Donna M. Peters
- Department of Pathology and Laboratory Medicine, University of Wisconsin–Madison, Madison, Wisconsin, United States
| | | | - Ponugoti Vasantha Rao
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina, United States
| | - Naga Rayana
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
| | - Urmimala Raychaudhuri
- Department of Neurobiology, University of California, Irvine, Irvine, California, United States
| | - Ester Reina-Torres
- Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Ruiyi Ren
- Department of Ophthalmology, Boston University School of Medicine, Boston, Massachusetts, United States
| | - Douglas Rhee
- Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
| | - Uttio Roy Chowdhury
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, United States
| | - John R. Samples
- Washington State University, Floyd Elson College of Medicine, Spokane, Washington, United States
| | | | - Najam Sharif
- Santen Inc., Emeryville, California, United States
| | - Joel S. Schuman
- Department of Ophthalmology and Department of Physiology and Neuroscience, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, United States; Departments of Biomedical Engineering and Electrical and Computer Engineering, New York University Tandon School of Engineering, Brooklyn, New York, United States; Center for Neural Science, College of Arts and Science, New York University, New York, New York, United States
| | - Val C. Sheffield
- Department of Pediatrics and Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
| | - Cooper H. Stevenson
- Department of Pharmacology & Neuroscience, and North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, Texas, United States
| | - Avinash Soundararajan
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
| | | | - Chenna Kesavulu Sugali
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
| | - Yang Sun
- Veterans Affairs Palo Alto Health Care System, Stanford University, Palo Alto, California, United States
| | - Carol B. Toris
- Department of Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, Nebraska, United States; Department of Ophthalmology and Vision Sciences, The Ohio State University, Columbus, Ohio, United States
| | | | - Amir Vahabikashi
- Cell and Developmental Biology Department, Northwestern University, Chicago, Illinois, United States
| | - Janice A. Vranka
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
| | - Ting Wang
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, United States
| | - Colin E. Willoughby
- Genomic Medicine, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Chen Xin
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Hongmin Yun
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Hao F. Zhang
- Biomedical Engineering Department, Northwestern University, Evanston, Illinois, United States
| | - Michael P. Fautsch
- Biomedical Engineering Department, Northwestern University, Evanston, Illinois, United States
| | | | - Abbot F. Clark
- Department of Pharmacology and Neuroscience, North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, Texas, United States
| | - C. Ross Ethier
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology; Emory University School of Medicine, Emory University, Atlanta, Georgia, United States
| | - W. Daniel Stamer
- Duke Ophthalmology, Duke University, Durham, North Carolina, United States
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Kralj T, Kokot A, Zlatar M, Masnec S, Kasnik Kovac K, Milkovic Perisa M, Batelja Vuletic L, Giljanovic A, Strbe S, Sikiric S, Balog S, Sontacchi B, Sontacchi D, Buljan M, Lovric E, Boban Blagaic A, Skrtic A, Seiwerth S, Sikiric P. Stable Gastric Pentadecapeptide BPC 157 Therapy of Rat Glaucoma. Biomedicines 2022; 10:89. [PMID: 35052769 PMCID: PMC8773185 DOI: 10.3390/biomedicines10010089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/27/2021] [Accepted: 12/28/2021] [Indexed: 12/17/2022] Open
Abstract
Cauterization of three episcleral veins (open-angle glaucoma model) induces venous congestion and increases intraocular pressure in rats. If not upgraded, one episcleral vein is regularly unable to acquire and take over the whole function, and glaucoma-like features persist. Recently, the rapid upgrading of the collateral pathways by a stable gastric pentadecapeptide BPC 157 has cured many severe syndromes induced by permanent occlusion of major vessels, veins and/or arteries, peripherally and centrally. In a six-week study, medication was given prophylactically (immediately before glaucoma surgery, i.e., three episcleral veins cauterization) or as curative treatment (starting at 24 h after glaucoma surgery). The daily regimen of BPC 157 (0.4 µg/eye, 0.4 ng/eye; 10 µg/kg, 10 ng/kg) was administered locally as drops in each eye, intraperitoneally (last application at 24 h before sacrifice) or per-orally in drinking water (0.16 µg/mL, 0.16 ng/mL, 12 mL/rat until the sacrifice, first application being intragastric). Consequently, all BPC 157 regimens immediately normalized intraocular pressure. BPC 157-treated rats exhibited normal pupil diameter, microscopically well-preserved ganglion cells and optic nerve presentation, normal fundus presentation, normal retinal and choroidal blood vessel presentation and normal optic nerve presentation. As leading symptoms, increased intraocular pressure and mydriasis, as well as degeneration of retinal ganglion cells, optic nerve head excavation and reduction in optic nerve thickness, generalized severe irregularity of retinal vessels, faint presentation of choroidal vessels and severe optic nerve disc atrophy were all counteracted. In conclusion, we claim that the reversal of the episcleral veins cauterization glaucoma appeared as a consequence of the BPC 157 therapy of the vessel occlusion-induced perilous syndrome.
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Schlesener BN, Leonard BC, Miller PE, Kass PH, Hollingsworth SR, Cooper AE, Maggs DJ. Comparison of intraocular pressures estimated by rebound and applanation tonometry in dogs with lens instability: 66 cases (2012-2018). J Am Vet Med Assoc 2021; 259:1025-1031. [PMID: 34647480 DOI: 10.2460/javma.259.9.1025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare intraocular pressures (IOPs) estimated by rebound and applanation tonometry for dogs with lens instability. ANIMALS 66 dogs. PROCEDURES Medical records of dogs examined between September 2012 and July 2018 were reviewed for diagnoses of anterior (ALL) or posterior (PLL) lens luxation or lens subluxation. RESULTS Estimates of IOP obtained with rebound and applanation tonometry significantly differed from each other for all types of lens instability considered collectively (mean ± SE difference between tonometric readings, 8.1 ± 1.3 mm Hg) and specific types of lens instability considered individually (mean ± SE difference between tonometric readings: ALL, 12.8 ± 2.5 mm Hg; PLL, 5.9 ± 1.7 mm Hg; subluxation, 2.8 ± 0.8 mm Hg). Median (range) differences between rebound and applanation tonometer readings for dogs with ALL was 5 mm Hg (-9 to 76 mm Hg), with PLL was 3 mm Hg (-1 to 19 mm Hg), and with lens subluxation was 3 mm Hg (-9 to 18 mm Hg). In eyes with ALL, rebound tonometer readings exceeded applanation tonometer readings on 44 of 60 (73%) occasions. CONCLUSIONS AND CLINICAL RELEVANCE Rebound tonometry yielded higher estimates of IOP than did applanation tonometry in eyes with ALL and with all types of lens luxation considered collectively. Estimates of IOP in eyes with lens instability should ideally be obtained with both rebound and applanation tonometers. Veterinarians with only one type of tonometer should interpret results for dogs with lens instability concurrent with physical examination findings.
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Bertens CJF, van Mechelen RJS, Berendschot TTJM, Gijs M, Wolters JEJ, Gorgels TGMF, Nuijts RMMA, Beckers HJM. Repeatability, reproducibility, and agreement of three tonometers for measuring intraocular pressure in rabbits. Sci Rep 2021; 11:19217. [PMID: 34584185 PMCID: PMC8478901 DOI: 10.1038/s41598-021-98762-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/14/2021] [Indexed: 12/04/2022] Open
Abstract
The aim of this study was to evaluate repeatability, reproducibility, and agreement of three commonly used tonometers in animal research (TonoLab, TonoVet, and TonoPEN AVIA) in a cohort of 24 rabbits. Additionally, the impact of sedation on IOP was investigated in 21 New Zealand White rabbits with the TonoVet tonometer. Repeatability was determined using the coefficient of variation (CoV) for two observers. For the TonoLab (6.55%) and TonoVet (6.38%) the CoV was lower than for the TonoPEN AVIA (10.88%). The reproducibility was highest for the TonoVet (0.2 ± 3.3 mmHg), followed by the TonoLab (0 ± 12.89 mmHg) and lowest for the TonoPEN AVIA (− 1.48 ± 10.3 mmHg). The TonoLab and TonoVet showed the highest agreement (r = 0.85, R2 = 0.73). After sedation, a significant IOP reduction (often > 25%) was observed. Our results show that among the three tonometers tested, the TonoVet tonometer is best for use in rabbits while the TonoLab should be avoided. The impact of sedation on IOP was substantial and should be taken into account during experimentation.
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Affiliation(s)
- Christian J F Bertens
- Department of Ophthalmology, University Eye Clinic Maastricht, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, PO Box 5800, 6229 HX, Maastricht, The Netherlands. .,Chemelot Institute for Science and Technology (InSciTe), Gaetano Martinolaan 63-65, 6229 GS, Maastricht, The Netherlands.
| | - Ralph J S van Mechelen
- Department of Ophthalmology, University Eye Clinic Maastricht, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, PO Box 5800, 6229 HX, Maastricht, The Netherlands.,Chemelot Institute for Science and Technology (InSciTe), Gaetano Martinolaan 63-65, 6229 GS, Maastricht, The Netherlands
| | - Tos T J M Berendschot
- Department of Ophthalmology, University Eye Clinic Maastricht, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, PO Box 5800, 6229 HX, Maastricht, The Netherlands
| | - Marlies Gijs
- Department of Ophthalmology, University Eye Clinic Maastricht, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, PO Box 5800, 6229 HX, Maastricht, The Netherlands.,Chemelot Institute for Science and Technology (InSciTe), Gaetano Martinolaan 63-65, 6229 GS, Maastricht, The Netherlands
| | - Jarno E J Wolters
- Department of Ophthalmology, University Eye Clinic Maastricht, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, PO Box 5800, 6229 HX, Maastricht, The Netherlands.,Chemelot Institute for Science and Technology (InSciTe), Gaetano Martinolaan 63-65, 6229 GS, Maastricht, The Netherlands
| | - Theo G M F Gorgels
- Department of Ophthalmology, University Eye Clinic Maastricht, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, PO Box 5800, 6229 HX, Maastricht, The Netherlands.,Chemelot Institute for Science and Technology (InSciTe), Gaetano Martinolaan 63-65, 6229 GS, Maastricht, The Netherlands
| | - Rudy M M A Nuijts
- Department of Ophthalmology, University Eye Clinic Maastricht, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, PO Box 5800, 6229 HX, Maastricht, The Netherlands.,Chemelot Institute for Science and Technology (InSciTe), Gaetano Martinolaan 63-65, 6229 GS, Maastricht, The Netherlands
| | - Henny J M Beckers
- Department of Ophthalmology, University Eye Clinic Maastricht, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, PO Box 5800, 6229 HX, Maastricht, The Netherlands.,Chemelot Institute for Science and Technology (InSciTe), Gaetano Martinolaan 63-65, 6229 GS, Maastricht, The Netherlands
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Ren Q, Chen J, Li X, Lv Y, Niu X, Chen W, Gao Z. Effective elastic modulus of an intact cornea related to indentation behavior: A comparison between the Hertz model and Johnson-Kendall-Roberts model. Exp Eye Res 2021; 209:108670. [PMID: 34129848 DOI: 10.1016/j.exer.2021.108670] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 05/24/2021] [Accepted: 06/10/2021] [Indexed: 11/24/2022]
Abstract
In this study, a macro-indentation test on the submillimeter scale was performed to analyze the indentation behavior of an intact cornea under physiological pressures. The Hertz and Johnson-Kendall-Roberts (JKR) models were employed to solve the elastic modulus (E) of the intact cornea. The relevant detailed analysis showed that the JKR model, which accounted for the contribution from the adhesion energy, could be used to obtain the E values that were more than two-folds of those obtained from the Hertz model, which only considered the external force. Compared with the uniaxial tension test in vitro, unlike the elastic Hertz-model, the E values under physiological pressures that were obtained with the JKR model were between the lower and upper limits of corneal material. This phenomenon indicated that the JKR model could be used to obtain reasonably effective E values of an intact cornea under physiological pressures.
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Khanal S, Walton M, Davey PG. Evaluation of intraocular pressure estimates obtained using an iCare rebound tonometer. Clin Exp Optom 2021; 100:179-183. [DOI: 10.1111/cxo.12454] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 05/17/2016] [Accepted: 05/26/2016] [Indexed: 11/29/2022] Open
Affiliation(s)
- Safal Khanal
- School of Optometry and Vision Science, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand,
| | | | - Pinakin Gunvant Davey
- College of Optometry, Western University of Health Sciences, Pomona, California, USA,
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Lim J, Kang S, Park S, Park E, Nam T, Jeong S, Seo K. Intraocular Pressure Measurement by Rebound Tonometry (TonoVet) in Normal Pigeons ( Columba livia). J Avian Med Surg 2019; 33:46-52. [PMID: 31124611 DOI: 10.1647/2017-329] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We evaluated the applicability of a rebound tonometer (TonoVet) in pigeon eyes and established normal reference intraocular pressure (IOP) values in healthy pigeons; 20 eyes of euthanized pigeons were used for calibration of the TonoVet and 48 eyes of 24 adult pigeons were used for measurement of reference IOP. First, IOP of pigeon eyes ex vivo were measured using the 'd' and the 'p' modes of the TonoVet and compared to manometric IOP values from 5 to 80 mm Hg. Then, to establish normal reference values, IOP was measured from clinically normal pigeons in vivo. The 'd' and the 'p' modes of the TonoVet showed a strong linear correlation with the manometric IOP (R2 = .996 and .991, respectively). The obtained regression formulas were: y1 = 0.439x + 2.059 and y2 = 0.330x - 0.673, respectively (y1, 'd' mode of TonoVet; y2, 'p' mode of TonoVet; x, manometric IOP). The 'd' and the 'p' modes consistently measured one-half and one-third of the actual IOP, respectively. Therefore, the formula obtained through the 'd' mode was applied to obtain reference values. The calibrated IOP of normal pigeon eyes was 19.5 ± 4.4 mm Hg. The actual IOP could be calculated using the presented formula. Considering the limitations of the 'p' mode, use of the 'd' mode is more appropriate. Therefore, the TonoVet rebound tonometry under the 'd' mode is a reliable method for measuring IOP in pigeons.
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Affiliation(s)
- Jaegook Lim
- From the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Research Institute for Veterinary Science and BK 21 Creative Veterinary Research Center, Seoul National University, Gwanak-gu, Seoul, 08826, Korea
| | - Seonmi Kang
- From the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Research Institute for Veterinary Science and BK 21 Creative Veterinary Research Center, Seoul National University, Gwanak-gu, Seoul, 08826, Korea
| | - Sangwan Park
- From the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Research Institute for Veterinary Science and BK 21 Creative Veterinary Research Center, Seoul National University, Gwanak-gu, Seoul, 08826, Korea
| | - Eunjin Park
- From the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Research Institute for Veterinary Science and BK 21 Creative Veterinary Research Center, Seoul National University, Gwanak-gu, Seoul, 08826, Korea
| | - Taekjin Nam
- From the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Research Institute for Veterinary Science and BK 21 Creative Veterinary Research Center, Seoul National University, Gwanak-gu, Seoul, 08826, Korea
| | - Seowoo Jeong
- From the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Research Institute for Veterinary Science and BK 21 Creative Veterinary Research Center, Seoul National University, Gwanak-gu, Seoul, 08826, Korea
| | - Kangmoon Seo
- From the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Research Institute for Veterinary Science and BK 21 Creative Veterinary Research Center, Seoul National University, Gwanak-gu, Seoul, 08826, Korea
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Hwang J, Kang S, Seok S, Ahmed S, Yeon S. Ophthalmic findings in cinereous vultures (Aegypius monachus). Vet Ophthalmol 2019; 23:314-324. [PMID: 31774216 DOI: 10.1111/vop.12728] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 10/21/2019] [Accepted: 10/30/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the present study was to provide ophthalmic reference values under normal physiological conditions for Aegypius monachus (cinereous vulture). PROCEDURES Thirty-two eyes of sixteen adult captive cinereous vultures were used for this study. Tear tests and tonometry in conscious and anesthetized states, neuro-ophthalmic tests, measurement of corneal diameter, slit-lamp biomicroscopy, ophthalmoscopy, and funduscopy were performed. RESULTS Schirmer tear test (STT) value was 11.4 ± 2.6 and 11.5 ± 2.8 mm/min in the right (OD) and left eye (OS), respectively. Phenol red thread test (PRT) values were 22.3 ± 2.1 mm/15 s OD and 22.8 ± 3.0 mm/15 s OS. The results showed a strong correlation between STT and PRT in both eyes. Intraocular pressure (IOP) values were 32.8 ± 6.9 mm Hg OD and 31.9 ± 7.1 mm Hg OS with TonoVet and 20.7 ± 4.5 mm Hg OD and 19.5 ± 4.1 mm Hg OS with Tono-Pen. There were significant differences in IOPs between rebound and applanation tonometry in both OD and OS. Tear production and IOP values showed significant reductions with general anesthesia in both tear tests and both tonometry (P < .001). Horizontal corneal diameter (mm) was 15.56 ± 0.96 OD and 15.56 ± 0.96 OS. Vertical diameter (mm) was 14.13 ± 0.96 OD and 14.06 ± 1.06 OS. The horizontal diameter was significantly longer than vertical diameter (P < .001). CONCLUSIONS Ocular morphologic information and normal reference range values for various ophthalmic measurements were obtained in clinically healthy cinereous vultures, which can facilitate accurate diagnosis and better management of ophthalmic diseases in cinereous vultures.
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Affiliation(s)
| | - Seonmi Kang
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research, Institute for Veterinary Science, Seoul National University, Seoul, Korea
| | | | - Sohail Ahmed
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research, Institute for Veterinary Science, Seoul National University, Seoul, Korea
| | - Seongchan Yeon
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research, Institute for Veterinary Science, Seoul National University, Seoul, Korea
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Fonseca B, Martínez-Águila A, de Lara MJP, Pintor J. Diadenosine tetraphosphate as a potential therapeutic nucleotide to treat glaucoma. Purinergic Signal 2017; 13:171-7. [PMID: 27848070 DOI: 10.1007/s11302-016-9547-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Accepted: 10/27/2016] [Indexed: 12/15/2022] Open
Abstract
Glaucoma is a neurodegenerative disease that produces blindness. The main factor associated with this disease is an abnormally elevated intraocular pressure (IOP). To date, some attempts have been made to demonstrate the role of nucleotides modulating IOP, but never in a model of glaucoma. The DBA/2J mouse is an animal that develops the pathology spontaneously, starting from the typical rise in IOP at 9 months of age. Using this animal model, together with a control mouse, C57BL/6J, it has been possible to monitor the elevation in IOP in the glaucomatous mice and to check the ability of the dinucleotide diadenosine tetraphosphate AKA Ap4A to reduce IOP. The topical application of Ap4A when IOP is maximal (9-12 months) reduced IOP 30.6 ± 6.6% in the DBA/2J and 17.9 ± 4.0% in the C57BL/6J mice. Concentration response curves in both animal strains produced similar pD2 values; these being 4.9 ± 0.5 and 5.1 ± 0.4 for the normotensive C57BL/6J and the glaucomatous DBA/2J respectively. Antagonist studies showed differences between the control and the glaucomatous animals. In particular, the main receptor reducing IOP in the control animal was the P2Y1 receptor and in the glaucomatous model the P2Y6, although the participation of other P2 receptors cannot be ruled out. The long-term effect of Ap4A applied three times a week for 3 months showed a clear stop in the elevation of IOP in the glaucomatous model, thus indicating the possibility of using Ap4A as an effective compound for the treatment of glaucoma.
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Dubicanac M, Joly M, Strüve J, Nolte I, Mestre-Francés N, Verdier JM, Zimmermann E. Intraocular pressure in the smallest primate aging model: the gray mouse lemur. Vet Ophthalmol 2016; 21:319-327. [DOI: 10.1111/vop.12434] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Marko Dubicanac
- Institute of Zoology; University of Veterinary Medicine Hannover; Bünteweg 17 Hannover 30559 Germany
| | - Marine Joly
- Institute of Zoology; University of Veterinary Medicine Hannover; Bünteweg 17 Hannover 30559 Germany
| | - Julia Strüve
- Small Animal Clinic; University of Veterinary Medicine Hannover; Bünteweg 4 Hannover 30559 Germany
| | - Ingo Nolte
- Small Animal Clinic; University of Veterinary Medicine Hannover; Bünteweg 4 Hannover 30559 Germany
| | - Nadine Mestre-Francés
- Université Montpellier 2; Montpellier France
- Inserm U1198; Montpellier France
- EPHE; Paris France
| | - Jean-Michel Verdier
- Université Montpellier 2; Montpellier France
- Inserm U1198; Montpellier France
- EPHE; Paris France
| | - Elke Zimmermann
- Institute of Zoology; University of Veterinary Medicine Hannover; Bünteweg 17 Hannover 30559 Germany
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Espinheira Gomes F, Brandão J, Sumner J, Kearney M, Freitas I, Johnson J, Cutler D, Nevarez J. Survey of ophthalmic anterior segment findings and intraocular pressure in 95 North American box turtles (Terrapene spp.). Vet Ophthalmol 2015; 19:93-101. [PMID: 25683768 DOI: 10.1111/vop.12257] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe the ophthalmic biomicroscopy findings and intraocular pressures (IOP) in a captive population of box turtles and to determine whether a relationship exists between body morphometrics or health status and IOP. PROCEDURES Hundred and three box turtles (69 Gulf coast, 24 three-toed, one ornate, one eastern, and eight unidentified) were triaged into three different color-coded groups: green (healthy), yellow (abnormal physical examination with no need for immediate care), and red (immediate care required). Both eyes were evaluated by rebound tonometry and slit-lamp biomicroscopy. Body weight and morphometric data were recorded. RESULTS Intraocular pressures measurements were available for 190 eyes, slit-lamp biomicroscopy was available for 170 eyes, and morphometric data were available for 81 turtles. IOP in Gulf coast turtles (138 eyes) was 6.7 ± 1.4 mmHg OU. IOP in three-toed turtles (48 eyes) was 8.3 ± 1.5 mmHg OU, which was significantly higher than in Gulf coast turtles (P < 0.0001). No significant IOP differences were noted between genders in both subspecies (P = 0.768). There was a correlation between IOP and health status in three-toed turtles only. There was a mild negative correlation between morphometrics and IOP in Gulf coast and three-toed turtles. Fifteen of 87 turtles had unilateral corneal or lenticular opacities; 3/87 had bilateral corneal or lenticular disease; and 3/87 had adnexal abnormalities. CONCLUSIONS Different subspecies of box turtles have different normal intraocular pressures as measured by rebound tonometry, which was influenced by the animals' health status in one subspecies. Some morphometric parameters were found to be associated with IOP. Box turtles are often affected with ophthalmic abnormalities of unknown clinical significance.
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Affiliation(s)
- Filipe Espinheira Gomes
- Louisiana State University School of Veterinary Medicine, 1909 Skip Bertman Drive, Baton Rouge, LA 70803, USA
| | - João Brandão
- Louisiana State University School of Veterinary Medicine, 1909 Skip Bertman Drive, Baton Rouge, LA 70803, USA
| | - Julia Sumner
- Louisiana State University School of Veterinary Medicine, 1909 Skip Bertman Drive, Baton Rouge, LA 70803, USA
| | - Michael Kearney
- Louisiana State University School of Veterinary Medicine, 1909 Skip Bertman Drive, Baton Rouge, LA 70803, USA
| | - Inês Freitas
- Hospital Veterinário de Aveiro, Avenida da Universidade 215, 3810-489, Aveiro, Portugal
| | - James Johnson
- Louisiana State University School of Veterinary Medicine, 1909 Skip Bertman Drive, Baton Rouge, LA 70803, USA
| | - Daniel Cutler
- Louisiana State University School of Veterinary Medicine, 1909 Skip Bertman Drive, Baton Rouge, LA 70803, USA
| | - Javier Nevarez
- Louisiana State University School of Veterinary Medicine, 1909 Skip Bertman Drive, Baton Rouge, LA 70803, USA
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Abstract
AIM To assess the repeatability and reproducibility of Tonolab tonometer in rats with high intraocular pressure (IOP) and evaluate its ability to detect IOP changes in rats with general anaesthesia. METHODS Left eyes of adult Fischer rats (F344) were photocoagulated by 532 nm diode laser to induce high IOP. Hypertensive eyes of 30 conscious rats were randomly chosen to measure IOP on a single occasion. Two observers independently and alternately undertook IOP measurements consecutively for three times using the same Tonolab tonometer blind to the other observer's IOP measurements. The within subject standard deviation (Sw), coefficient of variation (CVw) (100×Sw/overall mean), and intraclass correlation coefficient (ICC) were calculated to evaluate intra-observer repeatability. Inter-observer difference was analysed by using 95% limits of agreement described by Bland-Altman and paired sample t-test. Also, another 13 normal F344 rats were intraperitoneally administrated with ketamine/xylazine or chloral hydrate, and IOPs of both eyes were measured by a single operator once every 5min until animals came to conscious. IOPs at various time points were compared by using one-way ANOVAs. RESULTS Mean IOP was 35.58 mm Hg (range 17.33 to 65.33 mm Hg). For intraobserver repeatability, the Sw, CVw and ICC of high IOP for two observers were 5.20 mm Hg/3.41 mm Hg, 9.98%/8.08% and 0.820/0.928 respectively. The inter-observer difference was 14.76%±19.76% of the mean IOP of two observers, with a 95% limits of agreement -23.97% to 53.50%, and the difference between mean IOP of these two observers was statistically significant (P=0.001). IOPs dropped slightly during the first 15min post-aneathesia, with a IOP change between 0.17 and 1.17 mm Hg. IOPs changed from basline of 11.75±2.05 mm Hg (n=12) to 8.75±1.06 mm Hg 20min post-anesthesia (P=0.001), and this hypotensive condition persisted until 80min post-anesthesia. CONCLUSION In this sample of hypertensive rats, Tonolab measurements demonstrated high levels of intraobserver repeatability, however, its interobserver reproducibility was poor. Longitudinal changes of IOP caused by genral anaesthesia can be sensitively detected by Tonolab. So we suggested that measurements of IOP using Tonolab are best measured by a single observer, and it could be included in experimental glaucoma.
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Affiliation(s)
- Li-Fang Liu
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou 515041, Guangdong Province, China
| | - Chu-Kai Huang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou 515041, Guangdong Province, China
| | - Ming-Zhi Zhang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou 515041, Guangdong Province, China
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Abstract
PURPOSE The purpose of this study was to measure the pressure difference between the anterior chamber (AC) and the vitreous cavity (VC) in eyes with and without pupillary block. MATERIALS AND METHODS Seven vitrectomized porcine eyes were used. Infusion pressures of 10-80 mmHg were generated with a vented gas forced infusion system. Measurements of pressure were obtained with digital manometry connected to 25-gauge catheters from the AC and VC simultaneously. After increasing AC pressure to each target pressure, VC pressure was recorded, and vice versa. Inspection was performed with portable slit-lamp biomicroscopy to identify the development of pupillary block at the end of each experiment. RESULTS When the AC pressure was increased, the VC pressure obtained was similar to the AC pressure in all cases. When the VC pressure increased, the AC pressure obtained was similar to that at a VC pressure of less than 50 mmHg. When the VC pressure was increased rapidly to 60, 70, and 80 mmHg, the AC pressures obtained were 57.6 ± 1.0, 64.0 ± 0.8, and 69.6 ± 2.4 mmHg, respectively. Thus, the VC pressures obtained were 1.5, 5.9, and 9.1 mmHg higher than pressures obtained from AC with target pressures of 60, 70, and 80 mmHg, respectively (p = 0.027, 0.001, and 0.001, respectively). Pupillary block was observed in cases where the VC pressure was increased to more than 50 mmHg. CONCLUSIONS The AC pressure could be significantly lower than the VC pressure in some eyes with pupillary block.
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Affiliation(s)
- Yong Joon Kim
- Department of Ophthalmology, Soonchunhyang University College of Medicine, Soonchunhyang University Seoul Hospital , Seoul , Republic of Korea
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Bliss CD, Aquino S, Woodhouse S. Ocular findings and reference values for selected ophthalmic diagnostic tests in the macaroni penguin (Eudyptes chrysolophus) and southern rockhopper penguin (Eudyptes chrysocome). Vet Ophthalmol 2013; 18 Suppl 1:86-93. [PMID: 24238103 DOI: 10.1111/vop.12123] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe ophthalmic examination findings and standard diagnostic test results in 2 penguin species. ANIMALS STUDIED Macaroni & Southern Rockhopper Penguins. PROCEDURE Complete ophthalmic examinations including Schirmer tear test (STT), modified phenol red thread test (PTT), tonometry, and echobiometry were performed on penguins housed at the Detroit Zoo. Mean and standard deviation of ophthalmic tests are reported and compared for significance using two sample t-tests with significance set at P < 0.05. Correlations between variables were assessed using Pearson's correlation coefficient. RESULTS Cataracts were the most common finding, present in 64% of Macaroni Penguins, and 68% of Rockhopper Penguins. There were anterior segment anomalies in all eyes with cataracts consistent with lens-induced uveitis. The mean modified PTT for the Macaronis was 24.7 ± 6.37 mm/15 s and 25.1 ± 7.07 mm/15 s in the Rockhoppers. The mean STT value for the Macaronis was 12.1 ± 5.43 mm/min and 11.0 ± 3.96 mm/min in the Rockhoppers. Mean intraocular pressure (IOP) for the Macaronis was 21.9 ± 7.05 mmHg measured by applanation tonometry and 29.1 ± 7.16 mmHg using rebound tonometry. The Rockhoppers had a mean IOP of 20.0 ± 5.77 mmHg and 24.1 ± 5.09 mmHg for applanation and rebound tonometry, respectively. In both populations, there was a significant difference in IOP measurement between the two instruments. In the Macaroni penguins, the presence of cataracts correlated significantly with increased age and lower IOP readings. Anterior chamber distance and axial globe length were significantly greater in males than in females in both penguin species.
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Affiliation(s)
- Cassandra D Bliss
- Michigan Veterinary Specialists, Blue Pearl Veterinary Partners Hospital, 1425 Michigan St NE, Grand Rapids, MI, 49503, USA
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Delgado C, Mans C, McLellan GJ, Bentley E, Sladky KK, Miller PE. Evaluation of rebound tonometry in red-eared slider turtles (Trachemys scripta elegans). Vet Ophthalmol 2013; 17:261-7. [PMID: 25097909 DOI: 10.1111/vop.12114] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate feasibility and accuracy of intraocular pressure (IOP) measurement by rebound tonometry in adult red-eared slider turtles and determine the effects of manual and chemical restraint on IOP. ANIMAL STUDIED Seventeen adult red-eared slider turtles. PROCEDURES Intraocular pressure was measured with TonoLab® and TonoVet® tonometers in conscious, unrestrained turtles. To evaluate the effects of manual restraint, turtles were restrained by digital pressure on the rostral head or proximal neck. The effect of two chemical restraint protocols (dexmedetomidine, ketamine, midazolam [DKM] and dexmedetomidine, ketamine [DK] subcutaneously) on IOP was evaluated. Triplicate TonoLab® and TonoVet® readings were compared with direct manometry in three ex vivo turtle eyes. RESULTS TonoLab® correlated better with manometry at IOPs < 45 mmHg than TonoVet® (linear regression slopes of 0.89 and 0.30, respectively). Mean (±SD) IOP in unrestrained conscious turtles was significantly lower (P < 0.01) with TonoLab® (10.02 ± 0.66 mmHg) than with TonoVet® (11.32 ± 1.57 mmHg). Manual neck restraint caused a significant increase in IOP (+6.31 ± 5.59 mmHg), while manual rostral head restraint did not. Both chemical restraint protocols significantly reduced IOP (DKM: −1.0 ± 0.76 mmHg; DK: −1.79 ± 1.17) compared with measurements in conscious unrestrained turtles. CONCLUSIONS Chemical and manual neck restraint affected IOP. Rostral head restraint had no significant effect on IOP and is, therefore, recommended as the appropriate restraint technique in red-eared slider turtles. TonoLab® measurements estimated actual IOP more accurately, within physiologic range, than measurements obtained using the TonoVet®.
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Affiliation(s)
- Cherlene Delgado
- Department of Surgical Sciences, School of Veterinary Medicine, 2015 Linden Drive, Madison, WI 53706, USA.
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Farrahi F, Sharifipour F, Malekahmadi M, Cheraghian B. Comparison of IOPen rebound tonometer with Goldmann applanation tonometer at different IOP levels. Int J Ophthalmol 2013; 6:637-40. [PMID: 24195039 DOI: 10.3980/j.issn.2222-3959.2013.05.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 07/29/2013] [Indexed: 11/02/2022] Open
Abstract
AIM To compare the accuracy of IOPen rebound tonometer with Goldmann applanation tonometer (GAT) in individuals with low, normal and high intraocular pressure (IOP) and to evaluate the effect of central corneal thickness (CCT) on IOP measurements. METHODS This cross-sectional study consisted of 159 participants. IOP of one eye of each subject was measured consecutively with IOPen and GAT. Then CCT was measured using an ultrasonic pachymeter. Based on GAT IOP readings, participants were divided into low, normal and high IOP groups. Correlation between tonometers and CCT was calculated by spearman's correlation coefficient. Agreement between tonometers was evaluated using Bland-Altman method. RESULTS Non-significant underestimation of IOP by IOPen was observed in low IOP group (Mean difference: 0.20mmHg; P=0.454) and also in normal IOP group (Mean difference: 0.56mmHg; P=0.065). However, IOPen significantly overestimated IOP in high IOP group (Mean difference: 1.06mmHg; P=0.038). The 95% limits of agreement (LoA) width between IOPen and GAT IOPs were 7.84, 8.57 and 14.27mmHg in low, normal and high IOP groups, respectively. Low IOP group had thinner corneas compared to high IOP group (P=0.034). IOP measurements taken by IOPen were not influenced by CCT (P=0.099) while poor correlation between CCT and GAT was found (R=0.17, P=0.032). Using receiver operating characteristic (ROC) curve, cutoff value of 18.75mmHg was determined for IOPen with sensitivity of 98.1 and specificity of 97.2%. CONCLUSION Accuracy of IOPen is comparable to GAT in patients with low or normal IOP but IOPen overestimates IOP at high IOP levels. CCT does not affect IOP readings with IOPen.
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Affiliation(s)
- Fereydoun Farrahi
- Department of Ophthalmology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Abstract
Ocular toxicology pertains to toxicologic effects of drugs administered topically, intraocularly, or systemically. It should also include evaluation of adverse effects of ophthalmic devices such as contact lenses, intraocular lenses, and glaucoma implants. The ophthalmic examination is able to provide detailed in-life information and is used in combination with clinical observations, clinical pathology, and histopathology to assess potential toxicologic effects. The ophthalmologist must be familiar with the wide range of species used in the field of toxicology, be familiar with the anatomic variations associated with these species, be able to determine what is an inherited or a breed-related finding from a study-related effect, be competent with the required ophthalmic equipment, and be capable of examining this wide range of animals.
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Affiliation(s)
- Brian C. Gilger
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina USA
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Selleri P, Di Girolamo N, Andreani V, Guandalini A, D'Anna N. Evaluation of intraocular pressure in conscious Hermann's tortoises (Testudo hermanni) by means of rebound tonometry. Am J Vet Res 2013; 73:1807-12. [PMID: 23106468 DOI: 10.2460/ajvr.73.11.1807] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine intraocular pressure (IOP) in healthy Hermann's tortoises (Testudo hermanni). ANIMALS 26 outdoor-housed Hermann's tortoises (13 males and 13 females); body weight ranged from 255 to 2,310 g, and age ranged from 4 to > 50 years. PROCEDURES After a preliminary ophthalmic evaluation was performed, IOP was measured by means of a rebound tonometer in both eyes of each tortoise. Three measurements were obtained for each eye; successive measurements were obtained from alternate eyes. Each measurement was based on the mean of 6 values automatically provided by the rebound tonometer. Statistical analysis was used to evaluate correlations between variables and to identify sex- or size-related IOP variations, and changes in IOP over multiple measurements. RESULTS Mean ± SEM IOP of the 52 eyes was 15.74 ± 0.20 mm Hg (range, 9 to 22 mm Hg). Results for t tests did not reveal significant differences in IOP between the right and left eyes or between males and females. A significant moderate negative correlation (r = -0.41; r(2) = 0.169) between IOP and body weight was detected. Results of repeated-measures ANOVA revealed a significant increase in IOP over multiple measurements. CONCLUSIONS AND CLINICAL RELEVANCE Rebound tonometry was a practical and rapid means of determining IOP in small- to medium-sized tortoises that required minimal manual restraint of the animals. Establishing IOP values in healthy Hermann's tortoises will provide a reference frame for use during complete ophthalmic examinations, thus allowing clinicians to diagnose a broader spectrum of ocular pathological conditions in tortoises.
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Affiliation(s)
- Paolo Selleri
- Clinica per Animali Esotici, Centro Veterinario Specialistico, Via Sandro Giovannini 53,00137 Rome, Italy
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Di Girolamo N, Andreani V, Guandalini A, Selleri P. Evaluation of intraocular pressure in conscious ferrets (Mustela putorius furo
) by means of rebound tonometry and comparison with applanation tonometry. Vet Rec 2013; 172:396. [DOI: 10.1136/vr.101086] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- N. Di Girolamo
- Clinica per Animali Esotici; Centro Veterinario Specialistico (CVS) Rome Italy
| | - V. Andreani
- Department of Ophthalmology; Centro Veterinario Specialistico (CVS); Via Sandro Giovannini 53 Rome 00137 Italy
| | - A. Guandalini
- Department of Ophthalmology; Centro Veterinario Specialistico (CVS); Via Sandro Giovannini 53 Rome 00137 Italy
| | - P. Selleri
- Clinica per Animali Esotici; Centro Veterinario Specialistico (CVS) Rome Italy
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Atorf J, Scholz M, Garreis F, Lehmann J, Bräuer L, Kremers J. Functional protective effects of long-term memantine treatment in the DBA/2J mouse. Doc Ophthalmol 2013; 126:221-32. [DOI: 10.1007/s10633-013-9380-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 03/04/2013] [Indexed: 01/02/2023]
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Wojick KB, Naples LM, Knapp CR. OCULAR HEALTH ASSESSMENT, TEAR PRODUCTION, AND INTRAOCULAR PRESSURE IN THE ANDROS ISLAND IGUANA ( CYCLURA CYCHLURA CYCHLURA ). J Zoo Wildl Med 2013; 44:116-23. [DOI: 10.1638/1042-7260-44.1.116] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Affiliation(s)
- J. M. Slack
- Department of Veterinary Clinical Sciences; Purdue University College of Veterinary Medicine; West Lafayette Indiana 47907 USA
| | - J. Stiles
- Department of Veterinary Clinical Sciences; Purdue University College of Veterinary Medicine; West Lafayette Indiana 47907 USA
| | - G. E. Moore
- Department of Comparative Pathobiology; Purdue University College of Veterinary Medicine; West Lafayette Indiana 47907 USA
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Thompson-Hom AL, Gerding Jr PA. Evaluation of intraocular pressure measurements obtained by use of a rebound tonometer and applanation tonometer in dogs before and after elective phacoemulsification. Am J Vet Res 2012; 73:709-13. [DOI: 10.2460/ajvr.73.5.709] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ghaffari MS, Hajikhani R, Sahebjam F, Akbarein H, Golezardy H. Intraocular pressure and Schirmer tear test results in clinically normal Long-Eared Hedgehogs (Hemiechinus auritus): reference values. Vet Ophthalmol 2011; 15:206-9. [PMID: 22050958 DOI: 10.1111/j.1463-5224.2011.00967.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The present study was undertaken to establish reference values for Schirmer tear test (STT) and intraocular pressure (IOP) in the long-eared hedgehog (Hemiechinus auritus). ANIMALS Fourteen healthy long-eared hedgehogs (H. auritus) of either sex were studied. PROCEDURES The hedgehogs were individually immobilized with an intramuscular injection of combined Ketamine (20 mg/kg) and Diazepam (0.5 mg/kg), and each animal underwent ophthalmic examinations including: STT, tonometry, biomicroscopy, and indirect ophthalmoscopy. RESULTS No significant effects of animal gender, weight, side (right vs. left eye) were found in this study. Mean (SD) STT values for all eyes (n = 28) were 1.7 ± 1.2 mm/1 min with a range of 0-4 mm/1 min. Mean STT in male animals was 2.2 ± 1.2. Mean STT in female Hedgehogs was 1.3 ± 1.1. Mean (SD) IOP values by applanation tonometry were 20.1 ± 4.0 mmHg (range 11.5-26.5 mmHg). Mean (SD) IOP values by applanation tonometry were 18.2 ± 4.0 and 22.0 ± 3.2 mmHg for males and females, respectively. CONCLUSIONS This study reports STT and IOP findings in long-eared hedgehogs (H. auritus).
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Affiliation(s)
- Masoud Selk Ghaffari
- Department of Clinical Sciences, School of Veterinary Medicine, Islamic Azad University-Karaj Branch, Karaj, Iran.
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Jorge J, Fernandes P, Queirós A, Ribeiro P, Ferreira A, Gonzalez-Meijome JM. Clinical evaluation of the IOPen® in a glaucomatous population. Ophthalmic Physiol Opt 2011; 30:860-4. [PMID: 21205273 DOI: 10.1111/j.1475-1313.2010.00783.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of this study was to evaluate the level of agreement of measurements of intraocular pressure (IOP) taken by a rebound tonometer (IOPen®), in comparison to a reference Goldmann applanation tonometer (GAT) in a glaucomatous population. Both eyes from 60 patients were assessed with the two tonometers, the induction tonometry was performed first by an experienced optometrist, and the GAT by an ophthalmologist. In this study, statistically significant differences were found when comparing the IOPen® tonometer with the GAT tonometer (p < 0.001), mean differences were -4.81 ± 4.31 and -4.76 ± 5.76 mmHg (mean ± S.D.) for the right eye and left eye respectively These values represent an underestimation in the present population by the IOPen® when compared with the GAT. Frequency distribution of differences demonstrated that in more than 71.6% of the measurements the IOP readings differed by more than 3 mmHg between the two tonometers. These results suggest that IOPen® should be used with great caution in the determination of IOP.
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Affiliation(s)
- J Jorge
- Center of Physics, School of Science, University of Minho, Campus de Gualtar, Braga, Portugal.
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Abstract
Doctors have not always associated elevated intraocular pressure with the vision loss from glaucoma. Although several individuals appear to have noted firmness of the eye in this condition as far back as the 10th century, elevated intraocular pressure was not routinely assessed until the latter part of the 19th century. von Graefe developed the first instrument for measuring intraocular pressure in 1865. The first reasonably accurate instrument was the Maklakoff applanation tonometer of the late 19th century; it was in widespread use throughout Eastern Europe until relatively recently. Schiötz developed an indentation tonometer that was widely used throughout the world during the first two thirds of the 20th century. Goldmann's applanation tonometer of 1950 began the era of truly accurate intraocular pressure measurement. It is still the most widely used tonometer in the world. Other devices such as the McKay-Marg tonometer (or its offspring the Tono-Pen), the pneumatonometer, and airpuff applanation tonometers are gaining adherents. The dynamic contour tonometer is the first totally new concept in tonometry in over 100 years. It is probably the most accurate of all the tonometers and is relatively independent of corneal biomechanical properties unlike its predecessors. Transpalpebral tonometers are attractive as they do not require topical anesthesia; however, they add the biomechanical properties of the eyelid to the list of potential errors and have not proven very accurate. The future should, hopefully, bring tonometers that can give diurnal or even longer indications of intraocular pressure variation. Although intraocular pressure elevation (or its absence) no longer can be counted on for diagnostic purposes, the role of intraocular pressure in the management of glaucomatous optic neuropathy remains critical.
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Pereira FQ, Bercht BS, Soares MG, da Mota MGB, Pigatto JAT. Comparison of a rebound and an applanation tonometer for measuring intraocular pressure in normal rabbits. Vet Ophthalmol 2011; 14:321-6. [DOI: 10.1111/j.1463-5224.2011.00879.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cuny CS, Joachim SC, Gramlich OW, Gottschling PF, Pfeiffer N, Grus FH. Repeated intraocular pressure measurement in awake Lewis rats does not bias retinal ganglion cell survival. Curr Eye Res 2011; 35:1034-9. [PMID: 20958192 DOI: 10.3109/02713683.2010.498654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The TonoPen applanation tonometry is an established method for intraocular pressure (IOP) measurement. The IOP is one of the main variables affecting retinal ganglion cell (RGC) loss in experimental animal models in ophthalmology and the main risk factor for human glaucoma. In this study, we examined if IOP measurements with the TonoPen itself lead to retinal ganglion cell loss or any other possible retina damages, such as intraocular bleedings or ablation, in Lewis rats. METHODS Three groups of rats (n = 5 each) were formed. IOP monitoring, using a TonoPen XL, was performed on groups 1 and 3. Animals in groups 1 and 2 received funduscopies before and after one and two weeks of the study, in order to detect possible abnormalities. After two weeks, retinal flatmounts were stained to detect ganglion cells. RGCs were manually counted in eight predefined areas to compare mean RGC densities between groups 1 and 2 (IOP readings vs. no readings), using student t-test. RESULTS No significant difference in RGC density between animals that underwent IOP readings and controls could be observed (p = 0.8). As expected, no IOP alterations were monitored in groups 1 and 3 throughout the study. No retinal abnormalities, such as bleeding or retina ablation, were detectable. CONCLUSION We could detect no effects on retinal ganglion cell survival in Lewis rats or any other damages to the retina caused by IOP measurements using a TonoPen XL. This study proposes that repeated applanation tonometry does not affect RGC numbers, one of the main monitored variables in most glaucoma model studies. Therefore, the use of a TonoPen XL for repeated IOP monitoring in Lewis rats can be considered harmless.
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Affiliation(s)
- C S Cuny
- Experimental Ophthalmology, Department of Ophthalmology, University Medical Center, Johannes Gutenberg University, Mainz, Germany
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Abstract
OBJECTIVE To examine the accuracy and reproducibility of intraocular pressure (IOP) measurements obtained by the TonoVet rebound tonometer. Animals studied Freshly enucleated healthy eyes of 44 free-ranging birds of prey out of the species Haliaeetus albicilla, Accipiter gentilis, Accipiter nisus, Buteo buteo, Falco tinnunculus, Strix aluco, Asio otus and Tyto alba euthanized because of unrelated health problems. PROCEDURES IOP readings from the TonoVet were compared with a manometric device, with IOP being set from 5 to 100 mmHg in steps of 5 mmHg by adjusting the height of a NaCl solution reservoir connected to the eye. Reproducibility of the TonoVet readings was determined by repeated measurements. RESULTS TonoVet and manometer values showed a strong linear correlation. In the Accipitridae, the TonoVet tended to increasingly overestimate IOP with increasing pressure, while in the other families, it increasingly underestimated it. In the Sparrowhawk, the values almost represent the ideal line. Reproducibility of TonoVet values decreases with increasing pressure in the clinically important range from 5 to 60 mmHg. CONCLUSION IOP values measured with the TonoVet demonstrated species specific deviation from the manometric measurements. These differences should be considered when interpreting IOP values. Using the regression formulae presented, corrected IOP values could be calculated in a clinical setting.
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Affiliation(s)
- Anne Reuter
- Small Animal Clinic, Faculty of Veterinary Medicine, Freie Universität Berlin, Oertzenweg 19b, Germany
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Abstract
PURPOSE To simultaneously measure, using manometry, the changes of intraocular pressure (IOP) in the anterior chamber and in the vitreous cavity of a single porcine eye, induced by an external column of water. METHODS We prospectively measured IOP simultaneously in seven freshly enucleated porcine eyes in both the anterior chamber and the vitreous cavity. Measurements were obtained through blood-pressure transducers connected to 21-gauge catheters. A third cannula was inserted into the anterior chamber to increase the IOP; when the cannula was connected to the water column, the pressure increased rapidly from 0 to 180 mmHg. Changes were registered every 5 seconds during the first minute. Statistical analysis was performed using the Wilcoxon signed-rank test. P ≤ 0.05 was considered significant. RESULTS Before the IOP was increased, the median basal IOP value was 18 mmHg in the anterior chamber and 23 mmHg in the vitreous cavity (P > 0.05). Sixty seconds after the end of the experiment, the median IOP value was 135 mmHg (range 122-145) in the anterior chamber and 55 mmHg (range 16-68) in the vitreous cavity (P < 0.01). CONCLUSION Cannulation of the anterior chamber measures the actual IOP; however, the IOP measured by cannulation in the vitreous cavity using the same catheter diameter was different, possibly because of the viscosity of the vitreous. The viscosity of the vitreous probably makes the cannulation method of IOP evaluation in the vitreous cavity inaccurate.
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Moreno-Montañés J, Gosende I, Caire J, García-Granero M. Comparation of the new rebound tonometer IOPen and the Goldmann tonometer, and their relationship to corneal properties. Eye (Lond) 2010; 25:50-6. [DOI: 10.1038/eye.2010.137] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Cone FE, Gelman SE, Son JL, Pease ME, Quigley HA. Differential susceptibility to experimental glaucoma among 3 mouse strains using bead and viscoelastic injection. Exp Eye Res 2010; 91:415-24. [PMID: 20599961 DOI: 10.1016/j.exer.2010.06.018] [Citation(s) in RCA: 130] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Revised: 06/17/2010] [Accepted: 06/18/2010] [Indexed: 12/20/2022]
Abstract
The purpose of this experiment was to test the susceptibility to retinal ganglion cell (RGC) axon loss and RGC layer cell loss from experimental glaucoma among 3 mouse strains, and between younger and older mice. We obstructed the mouse aqueous outflow channels by injecting 2 microL of 6 mum diameter, polystyrene beads followed by 3 microL of viscoelastic solution into the anterior chamber with a glass micropipette. We evaluated intraocular pressure (IOP) and damage to RGC as measured by optic nerve axon counts and RGC layer neuron counts in 3 strains of young mice (2 month old C57BL/6, DBA/2J, and CD1) and 10 month C57BL/6 mice. Bead and viscoelastic injection produced IOP elevation at >or=1 time point in 94.1% of eyes (112/119), with mean IOP difference from fellow eyes of 4.4 +/- 3.0 mmHg. By 6-12 weeks, injected eyes were 10.8% longer and 7.6% wider (p < 0.0001). Young DBA/2J and C57BL/6 eyes increased axial length significantly more than young CD1 or older C57BL/6 (all p <or= 0.02). RGC layer and axon loss was greatest in CD1 mice, significantly more than the other groups (p from 0.04 to <0.0001). Young C57BL/6 eyes elongated more and lost more RGC layer cells than older C57BL/6 mice (p = 0.02 and 0.01, respectively). With this mouse glaucoma model, there was differential susceptibility to ocular elongation and RGC layer and axon damage among mouse strains and by age. Factors that determine sensitivity to RGC injury can be studied using transgenic mouse strains with inducible models.
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Harazny J, Scholz M, Buder T, Lausen B, Kremers J. Electrophysiological deficits in the retina of the DBA/2J mouse. Doc Ophthalmol 2009; 119:181-97. [PMID: 19760280 DOI: 10.1007/s10633-009-9194-5] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2009] [Accepted: 08/24/2009] [Indexed: 12/14/2022]
Abstract
The DBA/2J (D2J) is a genetic mouse model for glaucomatous neurodegeneration because the animals develop anatomical and functional retinal deficits that partially can be correlated with elevated intraocular pressure (IOP). The IOP starts to increase at an age of about 6 months as a result of morphological changes within the anterior eye segment, e.g., pigment dispersion and iris synechiae. The purpose of the present study was to investigate how ERG responses change in individuals at different ages in D2J mice and to compare these changes with normal aging effects in pigmented C57/B6 (B6) mice. IOP was measured in awake, non-sedated D2J and B6 mice with a rebound tonometer. At ages between 2-3 and 10 months, scotopic flash ERGs were measured five times with about 2 months' intervals. In addition, light adapted flicker ERGs were recorded. Our data show that the D2J shows lower flicker ERG responses than the B6 mice already at an age of 2-3 months. Dark adapted flash ERG responses are not decreased at this age. In both mouse strains the ERG responses decrease as a function of age, but there is a stronger decrease in the D2J mice. The data of flicker ERGs suggest the presence of early functional deficits in the D2J retina that possibly have a post-receptoral origin. The scotopic flash ERG reveals a functional deficit that occurs at a later stage and that possibly is IOP dependent. But, the deficits appear at an age at which the IOP is still lower than in the B6 mouse, indicating that other factors play an additional role.
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Vaajanen A, Mervaala E, Oksala O, Vapaatalo H. Is There a Relationship Between Blood Pressure and Intraocular Pressure? An Experimental Study in Hypertensive Rats. Curr Eye Res 2009; 33:325-32. [DOI: 10.1080/02713680802011679] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Morrison JC, Jia L, Cepurna W, Guo Y, Johnson E. Reliability and sensitivity of the TonoLab rebound tonometer in awake Brown Norway rats. Invest Ophthalmol Vis Sci 2009; 50:2802-8. [PMID: 19324849 DOI: 10.1167/iovs.08-2465] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To compare the sensitivity of the TonoLab rebound tonometer with the Tono-Pen in awake Brown Norway rats and to compare their ability to predict optic nerve damage induced by experimental IOP elevation. METHODS TonoLab and Tono-Pen tonometers were calibrated in cannulated rat eyes connected to a pressure transducer. The TonoLab was used in awake animals housed in standard lighting to measure IOP during light and dark phases. Both instruments were used to monitor chronically elevated IOP produced by episcleral vein injection of hypertonic saline. Measured IOPs were correlated with quantified optic nerve damage in injected eyes. RESULTS Although they were lower than transducer and Tono-Pen measurements at all levels, TonoLab readings showed an excellent linear fit with transducer readings from 20 to 80 mm Hg (R(2) = 0.99) in cannulated eyes. In awake animals housed in standard lighting, the TonoLab documented significantly higher pressures during the dark phase (27.9 +/- 1.7 mm Hg) than during the light phase (16.7 +/- 2.3 mm Hg). With elevated IOP, correlation between TonoLab and Tono-Pen readings (R(2) = 0.86, P < 0.0001) was similar to that in cannulated eyes. Although both instruments provided measurements that correlated well with optic nerve injury grade, only the Tono-Pen documented significant IOP elevation in eyes with the least amount of injury (P < 0.05). CONCLUSIONS The TonoLab is sensitive enough to be used in awake Brown Norway rats, though instrument fluctuation may limit its ability to identify significant pressure elevations in eyes with minimal optic nerve damage.
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Affiliation(s)
- John C Morrison
- Kenneth C Swan Ocular Neurobiology Laboratory, Casey Eye Institute, Oregon Health and Science University, Portland, Oregon 97239-4146, USA.
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Abstract
Rats are becoming an increasingly popular model system for understanding mechanisms of optic nerve injury in primary open-angle glaucoma (POAG). Although the anatomy of the rat optic nerve head (ONH) is different from the human, the ultrastructural relationships between astrocytes and axons are quite similar, making it likely that cellular processes of axonal damage in these models will be relevant to human glaucoma. All of these models rely on elevating intraocular pressure (IOP), a major risk factor for glaucoma. Methods that produce increased resistance to aqueous humor outflow at the anterior chamber angle, specifically hypertonic saline injection of aqueous outflow pathways and laser treatment of the limbal tissues, appear to produce a specific regional pattern of injury that may have a particular relevance to understanding regional injury in human glaucoma. Because increased pressure fluctuations are a characteristic of such models and the rodent ONH appears to have high susceptibility to elevated IOP, special instrumentation and measurement techniques are required to document pressure exposure in these eyes and understand the pressure levels that the eyes and the optic nerve are exposed to. With these techniques, it is possible to obtain an excellent correlation between pressure and the extent of nerve damage. Continued use of these models will lead to a better understanding of cellular mechanisms of pressure-induced optic nerve damage and POAG.
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Affiliation(s)
- John C Morrison
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA.
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Ohashi M, Aihara M, Saeki T, Araie M. Efficacy of TonoLab in detecting physiological and pharmacological changes in rat intraocular pressure: comparison of TonoPen and microneedle manometry. Jpn J Ophthalmol 2008; 52:399-403. [PMID: 18991042 DOI: 10.1007/s10384-008-0532-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Accepted: 04/23/2008] [Indexed: 12/01/2022]
Abstract
PURPOSE To assess the efficacy of two noninvasive tonometers, TonoLab and TonoPen-XL, in detecting physiological or pharmacological changes of intraocular pressure (IOP) in rat eyes, by comparing them with the microneedle method. METHODS Sprague Dawley rats, bred under a 12-h light-and-dark cycle, were used. Under systemic anesthesia, eyes were cannulated by a microneedle connected to a transducer and a water reservoir. Variable intracameral pressure was attained by changing the reservoir height, and the resulting tonometer readings were compared. Then, the daytime and nighttime IOP, and the effect at 2 h after latanoprost instillation, were measured with the three devices. RESULTS TonoLab and TonoPen-XL readings (y) were strongly correlated with microneedle tonometer readings (x) (y=0.96x-4.3, r2=0.985, and y=0.48x+3.9, r2=0.985, respectively), but TonoPen-XL readings were only half those of the microneedle tonometer. Nocturnal elevation of IOP was significant both with TonoLab and with the microneedle tonometer (P<0.001), but not with TonoPen-XL. Latanoprost significantly elevated IOP by 3.0+/-2.1 with TonoLab and by 1.1+/-1.1 mmHg with the microneedle tonometer (P<0.05), but not with TonoPen-XL. CONCLUSION TonoLab provides readings similar to those of a microneedle tonometer, and diurnal variations and drug effects were detectable. TonoLab promises to be a noninvasive and useful method for physiological and pharmacological studies in rat eyes.
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Affiliation(s)
- Masaaki Ohashi
- Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan
| | - Makoto Aihara
- Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan. .,Department of Ophthalmology, University of Tokyo School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Tadashiro Saeki
- Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan
| | - Makoto Araie
- Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan
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Affiliation(s)
- Christoph Kniestedt
- Department of Ophthalmology, University Hospital Zurich (USZ), Zurich, Switzerland
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Abstract
OBJECTIVE-To report values for tear production, central corneal touch threshold (CTT), and intraocular pressure (IOP) in healthy guinea pigs and determine results of aerobic bacterial culture and cytologic examination of conjunctival swab specimens. DESIGN-Cross-sectional study. ANIMALS-31 Healthy guinea pigs (62 eyes) of various ages and breeds. PROCEDURES-Tear production was measured by the phenol red thread tear test (PRT) and Schirmer tear test (STT) before and after topical anesthetic application, CTT was measured with an esthesiometer, and IOP was measured by applanation tonometry. RESULTS-Combining data from all eyes, mean +/- SD PRT values before and after topical anesthetic administration were 21.26 +/- 4.19 mm/15 s and 22.47 +/- 3.31 mm/15 s, respectively, and mean IOP was 18.27 +/- 4.55 mm Hg. Median STT values before and after topical anesthetic administration were 3 mm/min (range, 0 to 12 mm/min) and 4 mm/min (range, 0 to 11 mm/min), respectively, and median CTT was 2.0 cm (range, 0.5 to 3.0 cm). Values did not differ between eyes for any test, but significant differences were identified for PRT values between males and females and between values obtained before and after topical anesthetic administration. Common bacterial isolates included Corynebacterium spp, Streptococcus spp, and Staphylococcus spp. Cytologic examination of conjunctival swab specimens revealed mainly basal epithelial cells; lymphocytes were common. CONCLUSIONS AND CLINICAL RELEVANCE-Results provided information on values for PRT, STT, CTT, and IOP in healthy guinea pigs and on expected findings for aerobic bacterial culture and cytologic examination of conjunctival swab specimens.
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Affiliation(s)
- Martin E Coster
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
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Johnson TV, Fan S, Toris CB. Rebound tonometry in conscious, conditioned mice avoids the acute and profound effects of anesthesia on intraocular pressure. J Ocul Pharmacol Ther 2008; 24:175-85. [PMID: 18355131 DOI: 10.1089/jop.2007.0114] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS The aims of this study were to evaluate the accuracy, repeatability, and safety of multiple intraocular pressure (IOP) measurements by a commercially available rebound tonometer in conscious, conditioned mice, and to characterize the acute and profound effects of anesthesia on IOP in mice. METHODS To test the accuracy of the tonometer, IOPs of CD-1 mice under ketamine/xylazine anesthesia were experimentally set and monitored with a water manometer/transducer system following transcorneal cannulation while simultaneously performing tonometry. The long- and short-term repeatability of the tonometer was tested in conscious, restrained mice, as measurements were taken once-daily in the afternoon for 4 consecutive days. On day 5, IOPs were measured in the same mice once every 4 min for 32 min. On 2 separate days, mice were administered ketamine/xylazine or 2,2,2-tribromoethanol anesthesia, in a crossover design, and IOPs were measured once every 2 min for 32 min. Rebound tonometry was performed in conscious mice before and 1 hour after 1 drop of timolol maleate (10 microL of 0.5%) application to 1 eye. RESULTS IOP measurements by rebound tonometry correlated well with manometry for pressures between 8 and 38 mmHg (y = 0.98x - 0.32, R(2) = 0.94; P < 0.001). The average tonometric IOP was invariant over 4 days (range, 11.7-13.2 mmHg). IOPs dropped significantly ( P < or = 0.05) within 6 min (ketamine/xylazine) or 10 min (2,2,2-tribromoethanol) postadministration of anesthesia but not with conscious restraint. Timolol significantly (P < 0.001) lowered IOP from 12.8 +/- 0.3 (mean +/- standard error of the mean) to 10.1 +/- 0.6 mmHg, as measured by the tonometer. CONCLUSIONS Rebound tonometry can be used to obtain accurate IOP measurements in conscious, restrained mice while avoiding the rapid and profound ocular hypotensive effects of general anesthesia. Small changes in IOP with an aqueous-flow suppressant are readily detectable with conscious restraint that may be missed with chemical restraint.
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Affiliation(s)
- Thomas V Johnson
- Department of Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, NE 68198-5840, USA
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Jeong MB, Kim YJ, Yi NY, Park SA, Kim WT, Kim SE, Chae JM, Kim JT, Lee H, Seo KM. Comparison of the rebound tonometer (TonoVet) with the applanation tonometer (TonoPen XL) in normal Eurasian Eagle owls (Bubo bubo). Vet Ophthalmol 2007; 10:376-9. [PMID: 17970999 DOI: 10.1111/j.1463-5224.2007.00573.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine the feasibility and accuracy of a handheld rebound tonometer, TonoVet, and to compare the intraocular pressure (IOP) readings of the TonoVet with those of an applanation tonometer, TonoPen XL, in normal Eurasian Eagle owls. ANIMALS STUDIED Ten clinically normal Eurasian Eagle owls (20 eyes). PROCEDURES Complete ocular examinations, using slit-lamp biomicroscopy and indirect ophthalmoscopy, were conducted on each raptor. The IOP was measured bilaterally using a rebound tonometer followed by a topical anesthetic agent after 1 min. The TonoPen XL tonometer was applied in both eyes 30 s following topical anesthesia. RESULTS The mean +/- SD IOP obtained by rebound tonometer was 10.45 +/- 1.64 mmHg (range 7-14 mmHg), and by applanation tonometer was 9.35 +/- 1.81 mmHg (range 6-12 mmHg). There was a significant difference (P = 0.001) in the IOP obtained from both tonometers. The linear regression equation describing the relationship between both devices was y = 0.669x + 4.194 (x = TonoPen XL and y = TonoVet). The determination coefficient (r(2)) was r(2) = 0.550. CONCLUSIONS The results suggest that readings from the rebound tonometer significantly overestimated those from the applanation tonometer and that the rebound tonometer was tolerated well because of the rapid and minimal stress-inducing method of tonometry in the Eurasian Eagle owls, even without topical anesthesia. Further studies comparing TonoVet with manometric measurements may be necessary to employ rebound tonometer for routine clinical use in Eurasian Eagle owls.
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Affiliation(s)
- Man-Bok Jeong
- Department of Veterinary Surgery and Ophthalmology, College of Veterinary Medicine, Seoul National University, San 56-1, Sillim 9-dong, Gwanak-gu, Seoul 151-742, Korea
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Prashar A, Guggenheim JA, Erichsen JT, Hocking PM, Morgan JE. Measurement of intraocular pressure (IOP) in chickens using a rebound tonometer: quantitative evaluation of variance due to position inaccuracies. Exp Eye Res 2007; 85:563-71. [PMID: 17719031 DOI: 10.1016/j.exer.2007.07.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2007] [Revised: 06/12/2007] [Accepted: 07/06/2007] [Indexed: 11/13/2022]
Abstract
Intraocular pressure (IOP), an important risk factor for glaucoma, is a continuous trait determined by a complex set of genetic and environmental factors that are largely unknown. Genetic studies in laboratory animals may facilitate the identification of genes that affect IOP. We examined the use of the rebound tonometer for measuring IOP in non-anaesthetised birds, along with the device's robustness to alignment errors. Calibration curves were obtained by measuring the IOP of cannulated chicken eyes with the rebound tonometer over a range of pressures. To simulate different types of alignment errors that might be expected with measurement of IOP in alert chickens, for some calibrations the tonometer was positioned (1) at various distances from the cornea, (2) laterally displaced from the visual axis, or (3) angled away from the visual axis. In vivo measurements were taken on three-week-old alert chickens from a layer line, a broiler line, and a layer-broiler "advanced intercross line" (AIL) designed to facilitate QTL mapping. The rebound tonometer showed excellent linearity (R2=0.95-0.99) during calibration, as well as robustness to variation in the probe-to-cornea distance over the range 3-5mm and to lateral displacement over the range 0-2mm. However, the tonometer appeared less robust to off-axis misalignment over the range 0-20 degrees (P<0.05). Also, the slope of calibration curves sometimes differed between eyes (P<0.001), presumably reflecting differences in ocular structure. The IOP measured in non-anaesthetised three-week-old AIL chickens was 17.51+/-0.13 mmHg (mean+/-S.E.; N=105 birds). IOP was significantly associated with corneal thickness (P<0.05) and body weight (P<0.001) in a regression model. Replicate measurements were necessary in order to gauge IOP accurately in individual birds; a series of seven tonometry sessions over a 12-h period during the light phase of the light/dark cycle permitted IOP to be measured with a 95% CI of +/-0.7 mmHg. IOP did not differ significantly between the broiler and layer chicken lines which served as the progenitor lines for the AIL. In conclusion, the rebound tonometer permits rapid estimation of IOP in chickens and is well tolerated. The small alignment errors that are expected when taking measurements in non-anaesthetised animals are unlikely to affect accuracy. Since high IOP is a major risk factor for glaucoma, identifying QTL controlling IOP may offer future health benefits. However, our preliminary findings highlight several obstacles to mapping such QTL using the chicken advanced intercross line evaluated here.
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Affiliation(s)
- A Prashar
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, Wales, UK
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Abstract
PURPOSE To establish the intraobserver and interobserver reliability of the rebound tonometer (RBT) in healthy schoolchildren and to test patient tolerance in an unanesthetized eye. SUBJECTS AND METHODS To examine the reproducibility of the RBT, 2 experienced ophthalmologists undertook 3 consecutive intraocular pressure (IOP) measurements with the RBT without an anesthetic in 304 eyes of 152 healthy schoolchildren. Any pain or discomfort experienced by the children was recorded. Intraobserver and interobserver reliabilities were established by calculating correlation coefficients (r). RESULTS Of the 152 patients, 78 (51.3%) were males and 74 (48.7%) were females. The mean patient age was 11.2+/-2.6 years (range: 7 to 15 y). Mean IOP values obtained by examiners 1 and 2 were 16.48+/-2.82 mm Hg and 17.27+/-3.27 mm Hg for the right eyes and 17.15+/-3.36 mm Hg and 17.06+/-3.21 mm Hg for the left eyes. Intraobserver correlation coefficients for examiner 1 were 0.970 for the right eyes and 0.974 for the left eyes. For examiner 2, intraobserver correlation coefficients were 0.963 for the right eyes and 0.970 for the left eyes. The interobserver correlation coefficients were 0.798 for the right eyes and 0.858 for the left eyes (all P<0.0001). With the RBT, 98.6% of the subjects felt no pain and/or discomfort. CONCLUSIONS Measurement of IOP with the RBT is a highly reproducible method in schoolchildren showing high intraobserver and interobserver correlation and it seems to be very comfortable when performing IOP measurements in schoolchildren without an anesthetic.
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Affiliation(s)
- Afsun Sahin
- Department of Ophthalmology, Eskisehir Osmangazi University Hospital, Eskisehir, Meselik, Turkey
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Abstract
PURPOSE The Icare dynamic tonometer (impact or Rebound tonometry) is a new tonometer based on making a moving object collide with an eye and on monitoring the motion parameters of this object following contact. The purpose of this study was to assess intra- and interobserver variability of IOP measurements with the Icare and their correlations with Goldmann applanation tonometry (GAT) and central corneal thickness (CCT). MATERIAL AND METHODS A prospective study including three groups of patients: group 1 (50 normal subjects), group 2 (50 patients with OHT or POAG and GAT IOP>22 mmHg), and group 3 (38 glaucomatous patients with GAT IOP< or =22 mmHg). In group 1, three consecutive IOP measurements were taken by three distinct observers with Icare followed by three GAT measurements by the same clinician. In group 2, the same procedure was followed from patients 1 to 25 and the reverse sequence from patients 25 to 50 after a 10-min break. In group 3, only one clinician took three GAT measurements followed by three Icare measurements after a 10-min break to exclude a tonographic effect in eyes with statistically normal-range IOPs. RESULTS : In group 1, intraobserver variability was about 6% for each observer (NS). There was no learning curve effect. The interobserver variation coefficient was 6.4%. Icare overestimated IOP compared to GAT (mean difference, 1.5-2.2 mmHg) (p<0.001). Icare IOP was 23.4 mmHg for observer 1 when GAT was 22 mmHg (95% individual CI, 18-28.9 mmHg). In group 2, intraobserver variation coefficients of the IOP ranged from 5% to 5.4% (NS). Icare overestimated IOP by mean 0.84 mmHg compared with GAT. In group 3, mean IOP was not different between Icare and GAT. Icare IOP of 20.7 mmHg corresponded to a value of 22 mmHg using GAT. In this group, correlations between CCT and IOP measurements were higher for Icare than for GAT (p=0.062). CONCLUSION Icare measures IOP in an unanesthetized sitting patient in a very brief time. Patient's minimal cooperation is needed. As long as the device is correctly positioned, the learning curve is short. Icare gives reproducible IOP measurements. Intra- and interobserver variability of IOP measurements are close to those of GAT. Icare overestimates IOP measurements an average 1.5 mmHg compared with GAT. Whatever the IOP level, Icare IOP measurements are well correlated with GAT. To a greater extent than for GAT, the reliability of IOP measurements is influenced by CCT. This tonometer can be used as a screening device for ocular hypertension as long as CCT measurements can be taken.
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Affiliation(s)
- M Detry-Morel
- Cliniques Universitaires St Luc, UCL, Bruxelles, Belgique.
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