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Peng Z, Xiang A, He H, Luo Y, Wu S, Luo Y, Yang J, Nie K, Zhong X. Brimonidine as a possible treatment for myopia. BMC Ophthalmol 2024; 24:161. [PMID: 38605375 PMCID: PMC11007938 DOI: 10.1186/s12886-024-03433-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/04/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Myopia is becoming a huge burden on the world's public health systems. The purpose of this study was to explore the effect of brimonidine in the treatment of form-deprivation myopia (FDM) and the relationship between intraocular pressure (IOP) and myopia development. METHODS Monocular form deprivation myopia (FDM) was induced in three-week-old pigmented male guinea pigs. They were treated with 3 different methods of brimonidine administration (eye drops, and subconjunctival or intravitreal injections). Four different concentrations of brimonidine were tested for each method (2µg/µL, 4µg/µL, 20µg/µL, and 40µg/µL). All treatments continued for a period of 21 days. Tonometry, retinoscopy, and A-scan ultrasonography were used to monitor intraocular pressure, refractive error and axial length (AL), respectively. RESULTS Treatment with subconjunctival brimonidine at 40µg/µL, and intravitreal brimonidine at 2µg/µL and 4µg/µL, inhibited the development of FDM. The myopic refraction, excessive axial length, and elevation of IOP were significantly decreased. Brimonidine in eye drops was ineffective. CONCLUSION Brimonidine at appropriate doses significantly reduced the development of FD myopia in guinea pigs. The IOP may change with FD myopia.
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Affiliation(s)
- Zixuan Peng
- Hainan Provincial Key Laboratory of Ophthalmology, Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, No. 19 Xiuhua Road, Xiuying District, 570300, Haikou, Hainan, China
- Hainan Medical University, Haikou, Hainan, China
| | - Aiqun Xiang
- Hainan Provincial Key Laboratory of Ophthalmology, Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, No. 19 Xiuhua Road, Xiuying District, 570300, Haikou, Hainan, China
| | - Hong He
- Hainan Provincial Key Laboratory of Ophthalmology, Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, No. 19 Xiuhua Road, Xiuying District, 570300, Haikou, Hainan, China.
| | - Yaqi Luo
- Hainan Provincial Key Laboratory of Ophthalmology, Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, No. 19 Xiuhua Road, Xiuying District, 570300, Haikou, Hainan, China
- Hainan Medical University, Haikou, Hainan, China
| | - Shunliang Wu
- Hainan Provincial Key Laboratory of Ophthalmology, Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, No. 19 Xiuhua Road, Xiuying District, 570300, Haikou, Hainan, China
- Hainan Medical University, Haikou, Hainan, China
| | - Yanting Luo
- Hainan Provincial Key Laboratory of Ophthalmology, Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, No. 19 Xiuhua Road, Xiuying District, 570300, Haikou, Hainan, China
- Hainan Medical University, Haikou, Hainan, China
| | - Junming Yang
- Hainan Provincial Key Laboratory of Ophthalmology, Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, No. 19 Xiuhua Road, Xiuying District, 570300, Haikou, Hainan, China
- Hainan Medical University, Haikou, Hainan, China
| | - Ke Nie
- Hainan Provincial Key Laboratory of Ophthalmology, Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, No. 19 Xiuhua Road, Xiuying District, 570300, Haikou, Hainan, China
- Hainan Medical University, Haikou, Hainan, China
| | - Xingwu Zhong
- Hainan Provincial Key Laboratory of Ophthalmology, Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, No. 19 Xiuhua Road, Xiuying District, 570300, Haikou, Hainan, China.
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
- Hainan Medical University, Haikou, Hainan, China.
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Lin J, Vasudevan B, Gao TY, Zhou HJ, Ciuffreda KJ, Liang YB, Lin Z. Intraocular Pressure and Myopia Progression, Axial Length Elongation in Rural Chinese Children. Optom Vis Sci 2023; 100:708-714. [PMID: 37639709 DOI: 10.1097/opx.0000000000002065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
SIGNIFICANCE This study reported the relationship between intraocular pressure (IOP) and myopia progression, which helps to understand more comprehensively whether IOP can be an important reference factor to intervene in the progression of myopia. PURPOSE This study aimed to investigate the association between IOP and myopia progression as well as axial length elongation in rural Chinese children. METHODS A total of 598 (598 of 878 [68.1%]) children (6 to 17 years) from the baseline Handan Offspring Myopia Study who completed a 3.5-year follow-up vision examination were included. Ocular examinations at both visits included cycloplegic autorefraction, IOP, and axial length measurements. RESULTS Children with myopia had the highest baseline IOP of the three refractive groups (14.13 ± 1.31, 13.78 ± 1.71, and 13.59 ± 1.64 mmHg in myopes, emmetropes, and hyperopes, respectively, P = .002). However, IOPs showed no significant difference between eyes with or without newly developed myopia (13.63 ± 1.68 vs. 13.89 ± 1.68, P = .16), with or without faster myopia progression (13.75 ± 1.61 vs. 13.86 ± 1.63, P = .46), or with axial length elongation (13.80 ± 1.61 vs. 13.76 ± 1.64, P = .80). The multivariate regression analysis demonstrated that neither baseline refractive error ( β = -0.082, P = .13) nor baseline axial length ( β = -0.156, P = .08) was associated with baseline IOP. CONCLUSIONS Myopic eyes have slightly higher IOP compared with emmetropic and hyperopic eyes, although it was not clinically significant. However, IOP was not found to be associated with either myopia progression or axial length elongation in this cohort sample of rural Chinese children.
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Affiliation(s)
- Jue Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou, Zhejiang, China
| | | | | | - Hong Jia Zhou
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou, Zhejiang, China
| | - Kenneth J Ciuffreda
- Department of Biological and Vision Sciences, SUNY College of Optometry, New York, New York
| | - Yuan Bo Liang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou, Zhejiang, China
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Moghadas Sharif N, Hoseini-Yazdi H, Daneshvar R, Radhakrishnan H, Shoeibi N, Ehsaei A, Collins MJ. Seasonal variations in anterior segment angle parameters in myopes and emmetropes. Clin Exp Optom 2023:1-7. [PMID: 37751623 DOI: 10.1080/08164622.2023.2251478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 04/17/2023] [Indexed: 09/28/2023] Open
Abstract
CLINICAL RELEVANCE Seasonal variations are known to occur in a range of ocular parameters and in conditions including refractive error and glaucoma. It is of clinical importance to know if seasonal changes also occur in anterior segment angle parameters, given that they can influence these conditions. BACKGROUND The study aimed to examine the seasonal variations in anterior segment angle parameters in healthy young adults. METHODS Twenty-three emmetropic participants with a mean age of 26.17 ± 4.43 years and 22 myopic participants with a mean age of 27.27 ± 4.47 years completed four seasons of data collection. Anterior segment angle parameters were measured using swept-source anterior segment optical coherence tomography. Intraocular pressure (IOP) and objective refraction were also measured. Repeated-measures analysis of variance was used to determine the effect of season and refractive error on the various ocular parameters. RESULTS A significant main effect of season was found for the majority of anterior segment angle parameters, including the angle opening distance at 500 and 750 µm from the scleral spur (p = 0.02, p = 0.006, respectively), angle recess area at 500 and 750 µm from the scleral spur (both p = 0.002), and trabecular iris space area at 500 and 750 µm from the scleral (p = 0.02, p = 0.008, respectively). However, measures of anterior chamber depth and trabecular iris angle did not exhibit statistically significant seasonal variations (all p > 0.05). A significant main effect of season was also found for the changes in IOP (p = 0.004) and objective refraction (p < 0.001). There was no season by refractive group interaction for any anterior segment angle parameter or IOP (all p > 0.05). CONCLUSION There is a small but significant seasonal changes in the anterior segment angle parameters, refractive error, and IOP in healthy young adult males, in which the anterior segment angle dimensions are narrower, the IOP is higher, and the refraction is more myopic during winter.
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Affiliation(s)
- Nasrin Moghadas Sharif
- Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Optometry and Visual Science, University of London, London, UK
| | - Hosein Hoseini-Yazdi
- Contact Lens and Visual Optics Laboratory, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Ramin Daneshvar
- Eye Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Ophthalmology, University of Florida, Gainesville, FL, USA
| | | | - Nasser Shoeibi
- Eye Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Asieh Ehsaei
- Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Optometry and Visual Science, University of London, London, UK
| | - Michael J Collins
- Contact Lens and Visual Optics Laboratory, Queensland University of Technology, Brisbane, Queensland, Australia
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Beach KM, Hung LF, Lou L, Ostrin LA. Diurnal Variation and Effects of Dilation and Sedation on Intraocular Pressure in Infant Rhesus Monkeys. Curr Eye Res 2023; 48:289-296. [PMID: 36357337 PMCID: PMC10006333 DOI: 10.1080/02713683.2022.2141782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 10/26/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE Intraocular pressure (IOP) is an important factor in numerous ocular conditions and research areas, including eye growth and myopia. In infant monkeys, IOP is typically measured under anesthesia. This study aimed to establish a method for awake IOP measurement in infant rhesus monkeys, determine diurnal variation, and assess the effects of dilation and sedation. METHODS Awake IOP (iCare TonoVet) was measured every 2 h from 7:30 am to 5:30 pm to assess potential diurnal variations in infant rhesus monkeys (age 3 weeks, n = 11). The following day, and every 2 weeks to age 15 weeks, IOP was measured under three conditions: (1) awake, (2) awake and dilated (tropicamide 0.5%), and (3) sedated (ketamine and acepromazine) and dilated. Intraclass correlation coefficient (ICC) was used to determine intersession repeatability, and repeated measures. ANOVA was used to determine effects of age and condition. RESULTS At age 3 weeks, mean (±SEM) awake IOP was 15.4 ± 0.6 and 15.2 ± 0.7 mmHg for right and left eyes, respectively (p=.59). The ICC between sessions was 0.63[-0.5 to 0.9], with a mean difference of 2.2 ± 0.3 mmHg. Diurnal IOP from 7:30 am to 5:30 pm showed no significant variation (p=.65). From 3 to 15 weeks of age, there was a significant effect of age (p=.01) and condition (p<.001). Across ages, IOP was 17.8 ± 0.7 mmHg while awake and undilated, 18.4 ± 0.2 mmHg awake and dilated, and 11.0 ± 0.3 mmHg after sedation and dilation. CONCLUSIONS Awake IOP measurement was feasible in young rhesus monkeys. No significant diurnal variations in IOP were observed between 7:30 am and 5:30 pm at age 3 weeks. In awake monkeys, IOP was slightly higher after mydriasis and considerably lower after sedation. Findings show that IOP under ketamine/acepromazine anesthesia is significantly different than awake IOP in young rhesus monkeys.
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Affiliation(s)
- Krista M Beach
- University of Houston College of Optometry, Houston, TX, United States
| | - Li-Fang Hung
- University of Houston College of Optometry, Houston, TX, United States
| | - Linjiang Lou
- University of Houston College of Optometry, Houston, TX, United States
| | - Lisa A Ostrin
- University of Houston College of Optometry, Houston, TX, United States
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Lin Z, Wen L, Li D, Moonasar N, Zhai G, Wang Y, Wang FH, Liang YB. Refractive Error in a Chinese Population with Type 2 Diabetes: A Report from the Fushun Diabetic Retinopathy Cohort Study. Ophthalmic Epidemiol 2023; 30:38-45. [PMID: 35188061 DOI: 10.1080/09286586.2022.2031228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To describe the prevalence and risk factors for refractive errors in a northeastern Chinese population with type 2 diabetes. METHODS Subjects (age ≥30 years) from a community-based study, the Fushun Diabetic Retinopathy Cohort Study, were enrolled. All subjects underwent comprehensive ocular examinations, including autorefraction. Myopia, high myopia, and hyperopia were defined as a spherical equivalent (SE) of the right eye <-0.5 diopter (D), <-5.0D, and >0.5D, respectively. Astigmatism was defined as cylinder <-0.5D in a minus cylinder prescription. Anisometropia was defined as a difference of SE >1.0D between two eyes. RESULTS A total of 1929 participants (790 males, 41.0%) were enrolled. The age and gender standardized prevalence of myopia, high myopia, hyperopia, astigmatism, and anisometropia were 43.1% (95% confidence interval [CI]: 40.9%-45.3%), 8.5% (95% CI: 7.3%-9.8%), 21.5% (95% CI: 19.7%-23.4%), 61.0% (95% CI: 58.9%-63.2%), and 17.2% (95% CI: 15.5%-18.9%), respectively. Advancing age was associated with a higher frequency of hyperopia, astigmatism, and anisometropia, as opposed to a lower frequency of myopia. Female (adjusted odds ratio [aOR], 1.27; 95% CI, 1.02-1.57) participants, higher intraocular pressure (aOR, 1.03; 95% CI, 1.00-1.07), and lenticular opacity (aOR, 1.53; 95% CI, 1.20-1.94) were also found to be associated with myopia. Long duration of diabetes (>15 years) was found to be a significant factor for astigmatism (aOR, 1.62; 95% CI, 1.15-2.27) and anisometropia (aOR, 1.87; 95% CI, 1.29-2.71). CONCLUSION Nearly two-thirds of participants with type 2 diabetes had a refractive error. Age is a common factor with different types of refractive errors.
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Affiliation(s)
- Zhong Lin
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Liang Wen
- Fushun Eye Hospital, Fushun, Liaoning Province, China
| | - Dong Li
- Fushun Eye Hospital, Fushun, Liaoning Province, China
| | | | - Gang Zhai
- Fushun Eye Hospital, Fushun, Liaoning Province, China
| | - Yu Wang
- Fushun Eye Hospital, Fushun, Liaoning Province, China
| | - Feng Hua Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Lab, Beijing, China
| | - Yuan Bo Liang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
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B. Sreenivas S, C. M. R, K. R. V, M. R. S, Gopi A. A cross-sectional study of association between ocular pressures and different grades of myopia in young adults. Biomedicine (Taipei) 2022. [DOI: 10.51248/.v42i5.1803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction and Aim: Myopia is one of the most common refractive errors causing visual disability worldwide. Uncorrected refractive error poses a public health challenge especially in young adults who have to spend most of their time in literary works. Intra ocular pressure (IOP) is one of the crucial factors intertwined in the pathophysiology of myopia. Ocular perfusion pressure (OPP) determines ocular blood flow. Studies done on association between IOP and refractive errors are contradictory. There is paucity of literature on relationship between OPP and myopia. Hence this original article aimed to assess the association of IOP and OPP changes with myopia and to analyze the relationship between ocular pressures with severity of myopia.
Materials and Methods: Hundred normal adults in the age group of 18-24 years of either gender were recruited for the present study. Voluntary written and informed consent was sought from all participants and the refractive power of their eyes was noted. They were categorised into three groups based on the severity of myopia. Controls were the emmetropes. All participants were asked to relax for 5-10 minutes and the resting BP and IOP were recorded using sphygmomanometer and rebound tonometer respectively. OPP was calculated.
Results: IOP values were comparatively higher in myopes than emmetropes. A significant reduction in OPP values were observed in moderate myopes.
Conclusion: Myopes have a higher IOP suggesting myopia is one of the major risk factor for ocular hypertension. Low OPP values in moderate myopes indicate reduced ocular perfusion, making the progressive myopes highly susceptible to glaucoma.
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Bai WL, Kang YT, Li SM, Gan JH, Wei SF, Kang MT, Sun YY, Sun MH, Li H, Zhang FJ, Wang NL. Ocular Perfusion Pressure in 7- and 12-Year-Old Chinese Children: The Anyang Childhood Eye Study. Transl Vis Sci Technol 2022; 11:26. [PMID: 36255359 PMCID: PMC9587466 DOI: 10.1167/tvst.11.10.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to report the distribution of mean ocular perfusion pressure (MOPP) and its associated factors in Chinese children. Methods We enrolled 3048 grade 1 students and 2258 grade 7 students of the Anyang Childhood Eye Study in central China. Systolic and diastolic blood pressure (SBP and DBP) were recorded with a digital automatic sphygmomanometer. Intraocular pressure (IOP) was assessed by a non-contact tonometer. MOPP was calculated as 2/3 × (DBP + 1/3[SBP – DBP]) - IOP. Risk factors for myopia were obtained through a questionnaire survey. Results The MOPP was 33.83 ± 6.37 mm Hg (mean ± SD) in grade 1, which was lower than 36.99 ± 6.80 mm Hg in grade 7 (P < 0.001). Compared with myopic eyes, non-myopic eyes had higher MOPP in grade 7 (37.72 ± 6.72 mm Hg versus 36.58 ± 6.57 mm Hg, P < 0.001) and in grade 1 (33.88 ± 6.29 mm Hg versus 33.12 ± 7.03 mm Hg, P = 0.12). Multivariable analysis showed that higher MOPP was associated with less myopia (P < 0.001), higher body mass index (BMI; P < 0.001), thinner central corneal thickness (P < 0.001), less time on near work (P < 0.001), and more time on sleeping (P = 0.04). Conclusions MOPP was higher in children of older age, with higher BMI, less time on near work, and more time on sleeping, and was higher in eyes with less myopia. Translational Relevance We found that MOPP might be an indicator for the detection of myopia development.
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Affiliation(s)
- Wei-Ling Bai
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Yu-Ting Kang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Shi-Ming Li
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Jia-He Gan
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Shi-Fei Wei
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Meng-Tian Kang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Yun-Yun Sun
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Ming-Hao Sun
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - He Li
- Anyang Eye Hospital, Henan Province, Anyang, China
| | - Feng-Ju Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Ning-Li Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
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Lin F, Wang Y, Liu Y, Qu X, Zhou X. The Influence of 0.5% Tropicamide on Anterior Segment Parameters With CASIA2 in Emmetropic, Myopic, and Hyperopic Eyes. Front Physiol 2022; 13:957097. [PMID: 35903064 PMCID: PMC9315225 DOI: 10.3389/fphys.2022.957097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 06/23/2022] [Indexed: 11/25/2022] Open
Abstract
Aim: To evaluate the effects of 0.5% tropicamide on anterior segment parameters with the CASIA2 imaging device in emmetropic, myopic, and hyperopic eyes. Methods: In this prospective study, a total of 125 subjects (34 emmetropic subjects, 57 myopic subjects, and 34 hyperopic subjects) at the Shanghai Eye and ENT Hospital of Fudan University were recruited from June 2021 to September 2021. The 0.5% tropicamide solution was used once every 5 min a total of 5 times for cycloplegia. The anterior segment parameters were recorded by CASIA2 before and after cycloplegia. Changes in anterior segment parameters were compared among the three refractive groups. Results: Crystalline lens rise (CLR) and crystalline lens thickness (CLT) significantly decreased in all three refractive groups after cycloplegia (all p < 0.01). The anterior radius of lens (ARL) and anterior chamber depth (ACD) significantly increased in all three refractive groups after cycloplegia (all p < 0.01). Posterior radius of lens (PRL) significantly increased in hyperopic eyes after cycloplegia (p < 0.01) while it remained unchanged in emmetropic eyes and myopic eyes. Central corneal thickness (CCT), anterior chamber width (ACW), lens decentration (LD), and lens tilt (LT) remained unchanged after cycloplegia in all three refractive groups (all p > 0.05). Changes in CLR, CLT, ARL, PRL, and ACD in hyperopic eyes were greater than those in emmetropic eyes and myopic eyes (all p < 0.05). Conclusion: Apart from various changes in anterior segment parameters after application by 0.5% tropicamide in all three refractive groups, significant changes in CLR, CLT, ARL, PRL, and ACD in hyperopic eyes should be noted for proper clinical interpretation.
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Affiliation(s)
- Feng Lin
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Yuliang Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Yujia Liu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Xiaomei Qu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
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Wang P, Song Y, Lin F, Wang Z, Gao X, Cheng W, Chen M, Peng Y, Liu Y, Zhang X, Chen S. Comparison of Non-contact Tonometry and Goldmann Applanation Tonometry Measurements in Non-pathologic High Myopia. Front Med (Lausanne) 2022; 9:819715. [PMID: 35308502 PMCID: PMC8927768 DOI: 10.3389/fmed.2022.819715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/10/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeTo compare intraocular pressure (IOP) values obtained using Goldmann applanation tonometry (IOPGAT) and non-contact tonometry (IOPNCT) in a non-pathologic high myopia population.MethodsA total of 720 eyes from 720 Chinese adults with non-pathologic high myopia were enrolled in this cross-sectional study. Demographic and ocular characteristics, including axial length, refractive error, central corneal thickness (CCT), and corneal curvature (CC) were recorded. Each patient was successively treated with IOPNCT and IOPGAT. Univariate and multivariable linear regression analyses were conducted to detect factors associated with IOPNCT and IOPGAT, as well as the measurement difference between the two devices (IOPNCT−GAT).ResultsIn this non-pathologic high myopia population, the mean IOPNCT and IOPGAT values were 17.60 ± 2.76 mmHg and 13.85 ± 2.43 mmHg, respectively. The IOP measurements of the two devices were significantly correlated (r = 0.681, P < 0.001), however, IOPNCT overestimated IOPGAT with a mean difference of 3.75 mmHg (95% confidence interval: 3.60–3.91 mmHg). In multivariate regression, IOPNCT was significantly associated with body mass index (standardized β = 0.075, p = 0.033), systolic blood pressure (SBP) (standardized β = 0.170, p < 0.001), and CCT (standardized β = 0.526, p < 0.001). As for IOPGAT, only SBP (standardized β = 0.162, p < 0.001), CCT (standardized β = 0.259, p < 0.001), and CC (standardized β = 0.156, p < 0.001) were significantly correlated. The mean IOPNCT−GAT difference increased with younger age (standardized β = −0.134, p < 0.001), higher body mass index (standardized β = 0.091, p = 0.009), higher SBP (standardized β = 0.074, p = 0.027), thicker CCT (standardized β = 0.506, p < 0.001), and lower IOPGAT (standardized β = −0.409, p < 0.001).ConclusionIn the non-pathologic high myopia population, IOPNCT overestimated IOPGAT at 3.75 ± 2.10 mmHg. This study suggests that the difference between the values obtained by the two devices, and their respective influencing factors, should be considered in the clinical evaluation and management of highly myopic populations.
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Ha A, Baek SU, Kim JS, Jeoung JW, Park KH, Kim YK. Association of progressive optic disc tilt with development of retinal nerve fibre layer defect in children with large cup-to-disc ratio. Br J Ophthalmol 2022; 107:869-875. [PMID: 35017160 DOI: 10.1136/bjophthalmol-2021-320029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 12/17/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS Whereas myopic optic disc deformation has been posited as a risk factor for glaucomatous damage, longitudinal studies evaluating their association have been sparse. We investigated whether the optic nerve head (ONH)'s morphological alteration during myopia progression play any role in development of retinal nerve fibre layer defect (RNFLD) in children with a large vertical cup-to-disc ratio (vCDR). METHODS Sixty-five normotensive eyes of 65 children aged under 8 years with (1) vCDR ≥0.5 but no additional signs of glaucoma and (2) who could be tracked at young adulthood (18-28 years) were included. Children's spherical equivalent (SE), intraocular pressure, vCDR and optic disc tilt ratio were recorded. Rare events logistic regression analysis was employed to identify factors associated with RNFLD-development risk. RESULTS The study group's mean age was 5.4±1.3 years, its average vCDR was 0.62±0.07, and the average SE was -0.3±1.4 dioptres ((D), range -3.15 to 2.75D) at the baseline. After an average follow-up of 16.1±3.0 years, the mean vCDR was 0.64±0.09, and the mean SE, -3.2±2.2D (range -7.25 to 0.00 D). Among the 65 eyes, 12 (18.5%) developed RNFLD. A greater SE change (OR=1.737, p=0.016) and a greater increase in tilt ratio (OR=2.364, p=0.002) were both significantly associated with higher RNFLD-development risk. CONCLUSION In this cohort of Korean children with large vCDR, progressive optic disc tilt in the course of myopia progression was associated with higher RNFLD-development risk. This finding suggests that morphological alterations in the ONH during axial elongation might represent an underlying susceptibility to glaucomatous damage in large-vCDR children.
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Affiliation(s)
- Ahnul Ha
- Ophthalmology, Jeju National University Hospital, Jeju-si, Jeju-do, Korea (the Republic of).,Ophthalmology, Jeju National University, Jeju-si, Jeju-do, South Korea
| | - Sung Uk Baek
- Department of Ophthalmology, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, Korea (the Republic of)
| | - Jin-Soo Kim
- Ophthalmology, Chungnam National University Sejong Hospital, Sejong, Korea (the Republic of)
| | - Jin Wook Jeoung
- Ophthalmology, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
| | - Ki Ho Park
- Ophthalmology, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of).,Ophthalmology, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| | - Young Kook Kim
- Ophthalmology, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of) .,Ophthalmology, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
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11
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Janssens R, van Rijn LJ, Eggink CA, Jansonius NM, Janssen SF. Ultrasound biomicroscopy of the anterior segment in patients with primary congenital glaucoma: a review of the literature. Acta Ophthalmol 2021; 100:605-613. [PMID: 34939345 DOI: 10.1111/aos.15082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 12/07/2021] [Indexed: 01/25/2023]
Abstract
PURPOSE Primary congenital glaucoma (PCG) is a form of childhood glaucoma caused by maldevelopment of the anterior chamber. Disease severity differs greatly amongst patients. Ultrasound biomicroscopy (UBM) is a non-invasive technique that can visualize the anterior segment in infants in vivo. The purpose of this narrative review is to make an overview of the UBM data in PCG and study the applicability of UBM in characterizing the disease. METHODS An online search was performed on PubMed in December 2020. After a critical appraisal of the included articles, study and patient characteristics were summarized. The UBM measurements of the anterior segment in PCG of the different studies were analysed. RESULTS Six studies were included in this review. All were cross-sectional prospective studies. A total of 221 PCG eyes were examined. PCG eyes showed a larger trabecular iris angle, decreased iris thickness, narrower or absent Schlemm's canal and an increased zonular length compared to controls. Abnormal tissue membrane covering the trabecular meshwork and abnormal insertion of the iris and ciliary process were frequently found. The success rate of glaucoma surgery depended on the severity of anterior segment malformations found with UBM. CONCLUSION Malformations of the anterior segment in PCG can be demonstrated by UBM in vivo. This imaging can help to characterize disease severity and might support surgical treatment decisions.
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Affiliation(s)
- Robin Janssens
- Department of Ophthalmology Amsterdam University Medical Center location VUmc Amsterdam The Netherlands
| | - Laurentius J. van Rijn
- Department of Ophthalmology Amsterdam University Medical Center location VUmc Amsterdam The Netherlands
- Department of Ophthalmology OLVG Hospital Amsterdam The Netherlands
| | - Cathrien A. Eggink
- Department of Ophthalmology Radboud University Medical Center Nijmegen The Netherlands
| | - Nomdo M. Jansonius
- Department of Ophthalmology University Medical Center Groningen Groningen The Netherlands
| | - Sarah F. Janssen
- Department of Ophthalmology Amsterdam University Medical Center location VUmc Amsterdam The Netherlands
- Department of Ophthalmology Dijklander Hospital Hoorn The Netherlands
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12
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Yang Y, Wu J, Wu D, Wei Q, Zhong T, Yang J, Yang X, Zeng M, Zhong X. Intravitreal brimonidine inhibits form-deprivation myopia in guinea pigs. EYE AND VISION 2021; 8:27. [PMID: 34256866 PMCID: PMC8278638 DOI: 10.1186/s40662-021-00248-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 05/24/2021] [Indexed: 11/15/2022]
Abstract
Background The use of ocular hypotensive drugs has been reported to attenuate myopia progression. This study explores whether brimonidine can slow myopia progression in the guinea pig form-deprivation (FD) model. Methods Three-week-old pigmented male guinea pigs (Cavia porcellus) underwent monocular FD and were treated with 3 different methods of brimonidine administration (eye drops, subconjunctival or intravitreal injections). Four different concentrations of brimonidine were tested for intravitreal injection (2 μg/μL, 4 μg/μL, 20 μg/μL, 40 μg/μL). All treatments continued for a period of 21 days. Tonometry, retinoscopy, and A-scan ultrasonography were used to monitor intraocular pressure (IOP), refractive error and axial length (AL), respectively. On day 21, guinea pigs were sacrificed for RNA sequencing (RNA-seq) to screen for associated transcriptomic changes. Results The myopia model was successfully established in FD animals (control eye vs. FD eye, respectively: refraction at day 20, 0.97 ± 0.18 D vs. − 0.13 ± 0.38 D, F = 6.921, P = 0.02; AL difference between day 0 and day 21, 0.29 ± 0.04 mm vs. 0.45 ± 0.03 mm, F = 11.655, P = 0.004). Among the 3 different brimonidine administration methods, intravitreal injection was the most effective in slowing myopia progression, and 4 μg/μL was the most effective among the four different concentrations of brimonidine intravitreal injection tested. The AL and the refraction of the brimonidine intravitreal injection group was significantly shorter or more hyperopic than those of other 2 groups. Four μg/μL produced the smallest difference in AL and spherical equivalent difference values. FD treatment significantly increased the IOP. IOP was significantly lower at 1 day after intravitreal injections which was the lowest in FD eye of intravitreal injection of brimonidine. At day 21, gene expression analyses using RNA-seq showed upregulation of Col1a1 and Mmp2 expression levels by intravitreal brimonidine. Conclusions Among the 3 different administration methods, intravitreal injection of brimonidine was the most effective in slowing myopia progression in the FD guinea pig model. Intravitreal brimonidine at 4 μg/μL significantly reduced the development of FD myopia in guinea pigs. Expression levels of the Col1a1 and Mmp2 genes were significantly increased in the retinal tissues of the FD-Inj-Br group. Supplementary Information The online version contains supplementary material available at 10.1186/s40662-021-00248-0.
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13
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Wang P, Chen S, Liu Y, Lin F, Song Y, Li T, Aung T, Zhang X. Lowering Intraocular Pressure: A Potential Approach for Controlling High Myopia Progression. Invest Ophthalmol Vis Sci 2021; 62:17. [PMID: 34787640 PMCID: PMC8606873 DOI: 10.1167/iovs.62.14.17] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
High myopia is among the most common causes of vision impairment, and it is mainly characterized by abnormal elongation of the axial length, leading to pathologic changes in the ocular structures. Owing to the close relationship between high myopia and glaucoma, the association between intraocular pressure (IOP) and high myopia progression has garnered attention. However, whether lowering IOP can retard the progression of high myopia is unclear. On reviewing previous studies, we suggest that lowering IOP plays a role in progressive axial length elongation in high myopia, particularly in pathologic myopia, wherein the sclera is more remodeled. Based on the responses of the ocular layers, we further proposed the potential mechanisms. For the sclera, lowering the IOP could inhibit the activation of scleral fibroblasts and then reduce scleral remodeling, and a decrease in the scleral distending force would retard the ocular expansion like a balloon. For the choroid, lowering IOP results in an increase in choroidal blood perfusion, thereby reducing scleral hypoxia and slowing down scleral remodeling. The final effect of these pathways is slowing axial elongation and the development of scleral staphyloma. Further animal and clinical studies regarding high myopia with varied degree of IOP and the changes of choroid and sclera during IOP fluctuation in high myopia are needed to verify the role of IOP in the pathogenesis and progression of high myopia. It is hoped that this may lead to the development of a prospective treatment option to prevent and control high myopia progression.
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Affiliation(s)
- Peiyuan Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Shida Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yaoming Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Fengbin Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yunhe Song
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Tuozhang Li
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Tin Aung
- Singapore National Eye Center, National University of Singapore, Singapore
| | - Xiulan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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14
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Zhou Q, Gao TY, Fan SJ, Peng Y, Li L, Lin Z, Han W, Lin HS, Wang NL, Liang YB. Intraocular Pressure, Age, and Central Corneal Thickness in a Healthy Chinese Children Population: The Handan Offspring Myopia Study. Ophthalmic Epidemiol 2021; 29:499-506. [PMID: 34542011 DOI: 10.1080/09286586.2021.1966806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To assess the distribution and factors related to intraocular pressure (IOP) in a Chinese children population in Northern China. METHODS 1,238 offspring aged 6 to 18 years, residing in six villages, were recruited for this current study, the Handan Offspring Myopia Study. Participants underwent an interviewer-administered questionnaire and a complete ocular examination, including standardized measurement of IOP with Perkins applanation tonometry. RESULTS 1,648 eyes of 828 children were included in the analysis. The mean IOP was 13.9 ± 1.6 mmHg. The mean IOP for the study population increased from 13.0 ± 1.5 mmHg for those 6 to 7 years of age to 14.2 ± 1.4 mmHg for those 15 years of age or older (P < .001). The mean central corneal thickness (CCT) was 548.7 ± 32.1 μm, and had no difference among different age groups and gender. In univariate regression analysis, age (0.12 mmHg per 1 year old), height (0.09 mmHg per 5 cm), weight (0.02 mmHg per kg), body mass index (0.07 mmHg per 1 m/kg2), systolic blood pressure (0.06 mmHg per 5 mmHg), CCT (0.06 mmHg per 5 μm), and SE (-0.11 mmHg per 1 D) were correlated with IOP. In multivariate regression analysis, higher IOP was only associated with older ages (p = .002) and thicker CCT (p = .001). CONCLUSION The mean IOP in healthy rural Chinese children aged 6-18 years is about 14 mmHg, which is lower than in adults in the same locality. The mean IOP is slightly increasing with age during childhood, which is opposite to the result among adults. Age and CCT are the major independent factors associated with IOP.
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Affiliation(s)
- Qiang Zhou
- Department Of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Tie Ying Gao
- Department of Ophthalmology, Handan Eye Hospital, Handan, Hebei Province, China
| | - Su Jie Fan
- Department of Ophthalmology, Handan Eye Hospital, Handan, Hebei Province, China
| | - Yi Peng
- Beijing Ophthalmology & Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Lei Li
- Department of Ophthalmology, Handan Eye Hospital, Handan, Hebei Province, China
| | - Zhong Lin
- Department ofGlaucoma, The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wei Han
- Department of Ophthalmology, Handan Eye Hospital, Handan, Hebei Province, China
| | - Hai Shuang Lin
- Department ofGlaucoma, The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ning Li Wang
- Beijing Ophthalmology & Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yuan Bo Liang
- Department ofGlaucoma, The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,Glaucoma Institute, Wenzhou Medical University, Wenzhou, Zhejiang, China
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15
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Mcmonnies CW. An examination of the baropathic nature of axial myopia. Clin Exp Optom 2021; 97:116-24. [DOI: 10.1111/cxo.12101] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 04/17/2013] [Accepted: 05/05/2013] [Indexed: 11/29/2022] Open
Affiliation(s)
- Charles W Mcmonnies
- School of Optometry and Vision Science, University of New South Wales, Kensington, New South Wales, Australia,
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16
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Gupta S, Singh A, Mahalingam K, Selvan H, Gupta P, Pandey S, Somarajan BI, Gupta V. Myopia and glaucoma progression among patients with juvenile onset open angle glaucoma: A retrospective follow up study. Ophthalmic Physiol Opt 2021; 41:475-485. [DOI: 10.1111/opo.12805] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/01/2021] [Indexed: 01/09/2023]
Affiliation(s)
- Shikha Gupta
- Glaucoma Services Dr Rajendra Prasad Centre for Ophthalmic Sciences All India Institute of Medical Sciences New Delhi India
| | - Abhishek Singh
- Glaucoma Services Dr Rajendra Prasad Centre for Ophthalmic Sciences All India Institute of Medical Sciences New Delhi India
| | - Karthikeyan Mahalingam
- Glaucoma Services Dr Rajendra Prasad Centre for Ophthalmic Sciences All India Institute of Medical Sciences New Delhi India
| | - Harathy Selvan
- Glaucoma Services Dr Rajendra Prasad Centre for Ophthalmic Sciences All India Institute of Medical Sciences New Delhi India
| | - Prasad Gupta
- Glaucoma Services Dr Rajendra Prasad Centre for Ophthalmic Sciences All India Institute of Medical Sciences New Delhi India
| | - Shivam Pandey
- Department of Biostatistics All India Institute of Medical Sciences New Delhi India
| | - Bindu I Somarajan
- Glaucoma Services Dr Rajendra Prasad Centre for Ophthalmic Sciences All India Institute of Medical Sciences New Delhi India
| | - Viney Gupta
- Glaucoma Services Dr Rajendra Prasad Centre for Ophthalmic Sciences All India Institute of Medical Sciences New Delhi India
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17
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Teberik K, Eski MT, Ankarali H. Comparison of central corneal thickness and intraocular pressure measured with two different tono/pachymeter devices in non-glaucomatouse children. Eur J Ophthalmol 2021; 31:3010-3017. [PMID: 33525899 DOI: 10.1177/1120672121991492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The goal of this research is to compare the intraocular pressure (IOP) and the mean central corneal thickness (CCT) values obtained from the measurements with Nidek NT-530P and Canon TX-20P devices with the values obtained by ultrasound pachymetry (UP) and Goldmann applanation tonometry (GAT) in children. METHODS This prospective study was conducted with 119 healthy children. The measurements were repeated three times for each eye. The intraclass correlation coefficient (ICC) was used to assess the correlation between the measurements obtained from different devices. The Bland-Altman plot was used to analyze the agreement between two different devices graphically. The measurements were taken in the same order in all subjects: TX-20P, NT-530P, UP, and GAT. RESULTS The mean age of the children was 10.1 ± 3.2 (6-17) years. The mean CCT values for the eyes were 568.90 and 569.68 (TX-20P), 571.44 and 566.37 (NT-530P), 564.77 and 564.67 μm UP, (right and left, respectively). The highest correspondence observed for CCT was between UP and NT-530P devices (ICC, 0.982, the left eye). The mean IOP measurements for Canon TX-20P, NT-530P, and GAT were 16.5 ± 3.2, 16.3 ± 3.2, and 16.8 ± 3.6 mmHg for the right eyes, respectively, while those for the left eyes were 16.6 ± 3.1, 16.2 ± 3.3, and 16.8 ± 3.7 mmHg. The highest correspondence was noted between measurements obtained using GAT and Nidek NT-530P devices (ICC, 0.945, in the left eye). CONCLUSION Tono/pachymetry devices in the healthy children are provides significant agreements with the gold standard methods for IOP and CCT measurements.Clinical Trial Registration number: 2016-94.
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Affiliation(s)
- Kuddusi Teberik
- Department of Ophthalmology, Düzce University Medical School, Düzce, Turkey
| | | | - Handan Ankarali
- Biostatistics and Medical Informatics Department, İstanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey
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18
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Wang WY, Chen C, Chang J, Chien L, Shih YF, Lin LLK, Pang CP, Wang IJ. Pharmacotherapeutic candidates for myopia: A review. Biomed Pharmacother 2021; 133:111092. [PMID: 33378986 DOI: 10.1016/j.biopha.2020.111092] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/24/2020] [Accepted: 11/28/2020] [Indexed: 01/11/2023] Open
Abstract
This review provides insights into the mechanism underlying the pathogenesis of myopia and potential targets for clinical intervention. Although the etiology of myopia involves both environmental and genetic factors, recent evidence has suggested that the prevalence and severity of myopia appears to be affected more by environmental factors. Current pharmacotherapeutics are aimed at inhibiting environmentally induced changes in visual input and subsequent changes in signaling pathways during myopia pathogenesis and progression. Recent studies on animal models of myopia have revealed specific molecules potentially involved in the regulation of eye development. Among them, the dopamine receptor plays a critical role in controlling myopia. Subsequent studies have reported pharmacotherapeutic treatments to control myopia progression. In particular, atropine treatment yielded favorable outcomes and has been extensively used; however, current studies are aimed at optimizing its efficacy and confirming its safety. Furthermore, future studies are required to assess the efficacy of combinatorial use of low-dose atropine and contact lenses or orthokeratology.
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Affiliation(s)
- Wen-Yi Wang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Camille Chen
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Justine Chang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Lillian Chien
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yung-Feng Shih
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Luke L K Lin
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Hong Kong Eye Hospital, 147K Argyle Street, KLN, Hong Kong, China.
| | - I-Jong Wang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Biomedical Sciences, School of Medicine, China Medical University, Taichung, Taiwan.
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19
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Pileggi C, Papadopoli R, De Sarro C, Nobile CGA, Pavia M. Obesity, Blood Pressure, and Intraocular Pressure: A Cross-Sectional Study in Italian Children. Obes Facts 2021; 14:169-177. [PMID: 33794545 PMCID: PMC8138192 DOI: 10.1159/000514096] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 12/23/2020] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Several studies in the adult population have shown that obesity is an independent risk factor for elevated intraocular pressure (IOP), whereas data in the paediatric population are sparse and controversial. The purpose of the present study is to investigate the relationship between body mass index (BMI), blood pressure (BP), and IOP in healthy school children. METHODS The survey was conducted among a random sample of 8-year-old Italian students. Data were collected on their health status and behaviours related to obesity (physical activity, food and drinking habits, etc.). Physical examinations, conducted at school, included measurements of height, weight, BP, and IOP. RESULTS Five hundred and seventy-six subjects were recruited (92.8% response rate); 42.4% were overweight or obese, 58.9% consumed inadequate daily servings of fruit and vegetables, and 87.5% were involved in sedentary activities. Elevated BP/hypertension (HTN) affected 3.6% and high IOP was revealed in 12.5% of the children. In the multivariate analysis, elevated BP/HTN was the only significant determinant of ocular HTN (OR 5.36, 95% CI 1.95-14.73, p = 0.001). CONCLUSIONS Our results show that high IOP affects 12.5% of 8-year-old school children and appears to be associated with high BP related to a high BMI.
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Affiliation(s)
- Claudia Pileggi
- Department of Health Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - Rosa Papadopoli
- Department of Health Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - Caterina De Sarro
- Department of Health Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | | | - Maria Pavia
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
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20
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Dong L, Li YF, Wu HT, Di Kou H, Lan YJ, Wang YX, Jonas JB, Wei WB. Lens-induced myopization and intraocular pressure in young guinea pigs. BMC Ophthalmol 2020; 20:343. [PMID: 32842961 PMCID: PMC7446117 DOI: 10.1186/s12886-020-01610-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/14/2020] [Indexed: 11/29/2022] Open
Abstract
Background Intraocular pressure (IOP) is an important physiological measure of the eye and is associated with some ocular disorders. We aimed to assess the influence of topical beta blocker-induced IOP reduction on lens-induced axial elongation in young guinea pigs. Methods The experimental study included 20 pigmented guinea pigs (age: 2–3 weeks). Myopia was induced in the right eyes for 5 weeks with − 10 diopter lenses. The right eyes additionally received either one drop of carteolol 2% (study group, n = 10) or one drop of artificial tears daily (control group, n = 10), while the contralateral eyes of all animals remained untouched. The outcome parameter was axial elongation during the follow-up period. The mean of all IOP measurements taken during the study was referred to as mean IOP. Results Greater axial elongation was associated with a shorter axial length at baseline (P < 0.001; standardized regression coefficient beta: − 0.54) and lens-induced myopization (P < 0.001; beta: 0.55). In the multivariable model, axial elongation was not significantly correlated with the IOP at study end (P = 0.59), the mean IOP during the study period (P = 0.12), the mean of all IOP measurements (P = 0.17), the difference between the IOP at study end and baseline IOP (P = 0.38), the difference between the mean IOP during the study period and the baseline IOP (P = 0.11), or the application of carteolol eye drops versus artificial tears eye drops (P = 0.07). The univariate analysis of the relationships between axial elongation and the IOP parameters yielded similar results. The inter-eye difference between the right eye and the left eye in axial elongation was significantly associated with the inter-eye difference in baseline axial length (P = 0.001; beta:-0.67) but not significantly correlated with the inter-eye difference in any of the IOP-related parameters (all P > 0.25). Conclusions In young guinea pigs with or without lens-induced axial elongation, neither the physiological IOP nor the IOP reduced by carteolol, a topical beta-blocker, was associated with the magnitude of axial elongation. These results suggest that IOP, regardless of whether it is influenced by carteolol, does not play a major role in axial elongation in young guinea pigs.
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Affiliation(s)
- Li Dong
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Lane, Beijing, 100730, China
| | - Yi Fan Li
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Lane, Beijing, 100730, China
| | - Hao Tian Wu
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Lane, Beijing, 100730, China
| | - Hai Di Kou
- Optometry Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yin Jun Lan
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Lane, Beijing, 100730, China
| | - Ya Xing Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Ophthalmology & Visual Science Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - Wen Bin Wei
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Lane, Beijing, 100730, China.
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21
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Jean YK, Kam D, Gayer S, Palte HD, Stein ALS. Regional Anesthesia for Pediatric Ophthalmic Surgery: A Review of the Literature. Anesth Analg 2020; 130:1351-1363. [PMID: 30676353 DOI: 10.1213/ane.0000000000004012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Ophthalmic pediatric regional anesthesia has been widely described, but infrequently used. This review summarizes the available evidence supporting the use of conduction anesthesia in pediatric ophthalmic surgery. Key anatomic differences in axial length, intraocular pressure, and available orbital space between young children and adults impact conduct of ophthalmic regional anesthesia. The eye is near adult size at birth and completes its growth rapidly while the orbit does not. This results in significantly diminished extraocular orbital volumes for local anesthetic deposition. Needle-based blocks are categorized by relation of the needle to the extraocular muscle cone (ie, intraconal or extraconal) and in the cannula-based block, by description of the potential space deep to the Tenon capsule. In children, blocks are placed after induction of anesthesia by a pediatric anesthesiologist or ophthalmologist, via anatomic landmarks or under ultrasonography. Ocular conduction anesthesia confers several advantages for eye surgery including analgesia, akinesia, ablation of the oculocardiac reflex, and reduction of postoperative nausea and vomiting. Short (16 mm), blunt-tip needles are preferred because of altered globe-to-orbit ratios in children. Soft-tip cannulae of varying length have been demonstrated as safe in sub-Tenon blockade. Ultrasound technology facilitates direct, real-time visualization of needle position and local anesthetic spread and reduces inadvertent intraconal needle placement. The developing eye is vulnerable to thermal and mechanical insults, so ocular-rated transducers are mandated. The adjuvant hyaluronidase improves ocular akinesia, decreases local anesthetic dosage requirements, and improves initial block success; meanwhile, dexmedetomidine increases local anesthetic potency and prolongs duration of analgesia without an increase in adverse events. Intraconal blockade is a relative contraindication in neonates and infants, retinoblastoma surgery, and in the presence of posterior staphylomas and buphthalmos. Specific considerations include pertinent pediatric ophthalmologic topics, block placement in the syndromic child, and potential adverse effects associated with each technique. Recommendations based on our experience at a busy academic ophthalmologic tertiary referral center are provided.
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Affiliation(s)
- Yuel-Kai Jean
- From the Department of Anesthesiology, Perioperative Medicine and Pain Management, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, Florida
| | - David Kam
- From the Department of Anesthesiology, Perioperative Medicine and Pain Management, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, Florida
| | - Steven Gayer
- Department of Anesthesiology, Perioperative Medicine and Pain Management, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami Health System, Miami, Florida
| | - Howard D Palte
- Department of Anesthesiology, Perioperative Medicine and Pain Management, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami Health System, Miami, Florida
| | - Alecia L S Stein
- Department of Anesthesiology, Perioperative Medicine and Pain Management, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami Health System, Miami, Florida
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Masoumpour MB, Nowroozzadeh MH, Talebnejad MR, Mahdaviazad H, Khalili MR, Keshtkar M, Mohammadi E, Tajbakhsh Z. Distribution of intraocular pressure in healthy Iranian children: the Shiraz Pediatric Eye Study. J AAPOS 2020; 24:155.e1-155.e6. [PMID: 32522705 DOI: 10.1016/j.jaapos.2018.07.358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 06/13/2018] [Accepted: 07/04/2018] [Indexed: 10/24/2022]
Abstract
PURPOSE To describe the mean and normal range of intraocular pressure (IOP) and its associations in healthy Iranian school children using the noncontact tonometer. METHODS In this cross-sectional study as part of the Shiraz Pediatric Eye Study, a stratified random sampling was performed among elementary school children of Shiraz, Iran. Basic demographics and socioeconomic status of households, past medical history, drug history, and eye health history were collected for each eligible student. Children underwent complete ophthalmic examination. Axial length, corneal curvature, and anterior chamber depth were measured using the IOL-Master 500. RESULTS Of 2,001 eligible children, 1,901 (95.0%; 3,802 eyes) with a mean age of 9.1 ± 1.6 years (standard deviation; range, 6-12 years) had reliable IOP. The mean spherical equivalent refraction was 0.5 ± 1.3 D for the right eye and 0.6 ± 1.2 D for the left eye. Mean IOP in the right eye was 15.1 ± 2.5 mm Hg (median, 15.0; range, 8.0-27.0 mm Hg); in the left eye, 15.2 ± 2.5 mm Hg (median, 15.0; range, 9.0-28.0 mm Hg). In multiple regression analyses, the mean IOP was significantly lower among asthmatic children compared to normal participants (P = 0.007). The measured IOP was significantly higher in myopic participants than hyperopic patients (P = 0.003). CONCLUSIONS This study provides a useful normative IOP database using the noncontact tonometer for healthy Iranian school children.
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Affiliation(s)
| | - M Hossein Nowroozzadeh
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | | | - Hamideh Mahdaviazad
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Khalili
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Keshtkar
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elham Mohammadi
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Tajbakhsh
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Zhang JR, Wang JH, Lin HZ, Lee YC. Anterior Chamber Angles in Different Types of Mucopolysaccharidoses. Am J Ophthalmol 2020; 212:175-184. [PMID: 31945334 DOI: 10.1016/j.ajo.2020.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 12/16/2019] [Accepted: 01/03/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE To evaluate the anterior chamber angle status and estimate the intraocular pressure (IOP) in patients with mucopolysaccharidoses (MPSs) type I, II, IV, and VI. DESIGN Prospective cross-sectional study. METHODS This study enrolled 27 consecutive MPS patients (8 patients with MPS I, 4 patients with MPS II, 9 patients with MPS IV, and 6 patients with MPS VI) and 20 normal control subjects. Anterior chamber angle status was evaluated by swept-source optical coherence tomography and IOP was estimated by the new-generation tonometer Corvis ST. RESULTS Twelve eyes (6 patients) of 15 eyes (8 patients) with MPS I had narrow angles or peripheral iridocorneal touches together with elevated IOP (80%). Six eyes (3 patients) of 8 eyes (4 patients) with MPS II had plateau iris configuration, but all 8 eyes had normal IOP. All 18 eyes (9 patients) with MPS IV had normal angle structures, but 8 eyes (4 patients) had elevated IOP (44.4%). Nine eyes (5 patients) of 11 eyes (6 patients) with MPS VI had shallow but not closed angles (81.8%). Among these 9 eyes, 5 eyes had elevated IOP, and 4 of these 5 eyes had IOP >30 mm Hg. The trabecular iris angles of MPS types I, II, and VI were smaller than those of MPS type IV and of the control subjects. The angle recess areas of MPS types I and VI were smaller than those of MPS type IV and of the control subjects. CONCLUSIONS MPS type I patients are prone to have glaucoma with narrow or closed angles; MPS type II patients tend to have plateau iris; MPS type IV patients are vulnerable to open-angle glaucoma; MPS type VI patients have narrow angles not as close as those of MPS type I. MPS types I, IV, and VI had higher IOP estimates than the control subjects, but only MPS I and IV had higher corrected IOP estimates than the control subjects. The ordinary IOP estimates in MPS VI patients may be falsely high because of clouded corneas and increased corneal rigidity. Swept-source optical coherence tomography helps ophthalmologist investigate the angle structure and the pathophysiology of glaucoma caused by MPS.
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Affiliation(s)
- Jia-Rong Zhang
- Department of Ophthalmology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Jen-Hung Wang
- Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Hong-Zin Lin
- Department of Ophthalmology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
| | - Yuan-Chieh Lee
- Department of Ophthalmology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan; Department of Ophthalmology and Visual Science, Tzu Chi University, Hualien, Taiwan.
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24
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Mocan MC, Machen L, Jang I, Cao D. The Relationship Between Optic Nerve Cup-to-Disc Ratio and Retinal Nerve Fiber Layer Thickness in Suspected Pediatric Glaucoma. J Pediatr Ophthalmol Strabismus 2020; 57:90-96. [PMID: 32203592 DOI: 10.3928/01913913-20200117-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/03/2019] [Indexed: 12/27/2022]
Abstract
PURPOSE To evaluate the relationship between optic nerve cup-to-disc ratio and peripapillary retinal nerve fiber layer (RNFL) thickness in suspected pediatric glaucoma with large cup-to-disc ratios. METHODS This was a retrospective study undertaken at a single academic institution. Eighty-six eyes of 43 patients who presented with large (≥ 0.5) cup-to-disc ratios in both eyes and without elevated intraocular pressure were evaluated using spectral-domain optical coherence tomography. Global and sectoral peripapillary RNFL thickness measurements, Bruch's membrane opening size, refractive error in spherical equivalents, and intraocular pressure levels were recorded for all patients. Cup-to-disc ratios were manually derived using digital fundus images (D-cup-to-disc ratio). Parameters were compared between gender or race by t tests or analysis of variance. The differences in the relationship among the clinical parameters between two eyes were assessed using generalized estimation equation modeling followed by Pearson's correlation analysis. RESULTS Forty-three patients (25 boys and 18 girls) with a mean age of 9.3 ± 2.7 years (range: 5 to 15 years) were included. The mean global peripapillary RNFL thickness and the D-cup-to-disc ratio of study eyes were 99.0 ± 9.2 µm and 0.66 ± 0.03, respectively. The peripapillary RNFL thickness was found to be correlated with refractive error (r = 0.404; P = .008) and Bruch's membrane opening size (r = 0.410; P = .008) but not with cup-to-disc ratios (r = 0.029; P = .858) or patient age (r = -0.044; P = .797). CONCLUSIONS In patients with suspected pediatric glaucoma who present with large cup-to-disc ratios, RNFL thickness does not correlate with the degree of optic nerve cupping. Myopic refractive errors and Bruch's membrane opening size need to be taken into consideration to prevent misinterpretation of peripapillary RNFL measurements. [J Pediatr Ophthalmol Strabismus. 2020;57(2):90-96.].
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High Myopia and Its Associated Factors in JPHC-NEXT Eye Study: A Cross-Sectional Observational Study. J Clin Med 2019; 8:jcm8111788. [PMID: 31731571 PMCID: PMC6912595 DOI: 10.3390/jcm8111788] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 10/22/2019] [Indexed: 11/30/2022] Open
Abstract
The increasing prevalence of high myopia has been noted. We investigated the epidemiological characteristics and the related factors of high myopia in a Japanese adult population. Japan Public Health Center-Based Prospective Study for the Next Generation (JPHC-NEXT) Eye Study was performed in Chikusei-city, a rural area in mid-east Japan, between 2013 and 2015. A cross-sectional observational analysis was conducted to investigate prevalence and related factors of high myopia. A total of 6101 participants aged ≥40 years without a history of ocular surgeries was included. High myopia was defined as a spherical equivalent refraction of ≤−6.00 diopters according to the American Academy of Ophthalmology. Potential high myopia-related factors included intraocular pressure (IOP), corneal structure, corneal endothelial cell density, age, height, body mass index, heart rate, blood pressure, biochemical profile, and current history of systemic and ocular disorders. The odds ratios of high myopia were estimated using the logistic regression models adjusted for the associated factors. The prevalence of high myopia was 3.8% in males and 5.9% in females with a significant difference. Age was inversely associated, IOP was positively associated, and none of other factors were associated with high myopia in both sexes. In conclusion, only age and IOP were associated with high myopia in this community-based sample.
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26
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Tan NYQ, Sng CCA, Jonas JB, Wong TY, Jansonius NM, Ang M. Glaucoma in myopia: diagnostic dilemmas. Br J Ophthalmol 2019; 103:1347-1355. [DOI: 10.1136/bjophthalmol-2018-313530] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 12/27/2018] [Accepted: 04/03/2019] [Indexed: 11/03/2022]
Abstract
Myopic eyes have an increased risk of glaucoma. However, glaucomatous changes in a myopic eye are often difficult to detect. Classic structural and functional investigations to diagnose glaucoma may be confounded by myopia. Here, we identify some of the common pitfalls in interpreting these structural parameters, and the possible solutions that could be taken to overcome them. For instance, in myopic eyes, we discuss the limitations and potential sources of error when using neuroretinal rim parameters, and retinal nerve fibre layer and ganglion cell-inner plexiform layer thickness measurements. In addition, we also review new developments and potential adjuncts in structural imaging such as the assessment of the retinal nerve fibre layer texture, and the examination of the microcirculation of the optic nerve head using optical coherence tomography angiography. For the functional assessment of glaucoma, we discuss perimetric strategies that may aid in detecting characteristic visual field defects in myopic glaucoma. Ultimately, the evaluation of glaucoma in myopia requires a multimodal approach, to allow correlation between structural and functional assessments. This review provides overview on how to navigate this diagnostic dilemma.
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27
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Carr BJ, Mihara K, Ramachandran R, Saifeddine M, Nathanson NM, Stell WK, Hollenberg MD. Myopia-Inhibiting Concentrations of Muscarinic Receptor Antagonists Block Activation of Alpha2A-Adrenoceptors In Vitro. Invest Ophthalmol Vis Sci 2019; 59:2778-2791. [PMID: 29860464 DOI: 10.1167/iovs.17-22562] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Myopia is a refractive disorder that degrades vision. It can be treated with atropine, a muscarinic acetylcholine receptor (mAChR) antagonist, but the mechanism is unknown. Atropine may block α-adrenoceptors at concentrations ≥0.1 mM, and another potent myopia-inhibiting ligand, mamba toxin-3 (MT3), binds equally well to human mAChR M4 and α1A- and α2A-adrenoceptors. We hypothesized that mAChR antagonists could inhibit myopia via α2A-adrenoceptors, rather than mAChR M4. Methods Human mAChR M4 (M4), chicken mAChR M4 (cM4), or human α2A-adrenergic receptor (hADRA2A) clones were cotransfected with CRE/promoter-luciferase (CRE-Luc; agonist-induced luminescence) and Renilla luciferase (RLuc; normalizing control) into human cells. Inhibition of normalized agonist-induced luminescence by antagonists (ATR: atropine; MT3; HIM: himbacine; PRZ: pirenzepine; TRP: tropicamide; OXY: oxyphenonium; QNB: 3-quinuclidinyl benzilate; DIC: dicyclomine; MEP: mepenzolate) was measured using the Dual-Glo Luciferase Assay System. Results Relative inhibitory potencies of mAChR antagonists at mAChR M4/cM4, from most to least potent, were QNB > OXY ≥ ATR > MEP > HIM > DIC > PRZ > TRP. MT3 was 56× less potent at cM4 than at M4. Relative potencies of mAChR antagonists at hADRA2A, from most to least potent, were MT3 > HIM > ATR > OXY > PRZ > TRP > QNB > MEP; DIC did not antagonize. Conclusions Muscarinic antagonists block hADRA2A signaling at concentrations comparable to those used to inhibit chick myopia (≥0.1 mM) in vivo. Relative potencies at hADRA2A, but not M4/cM4, correlate with reported abilities to inhibit chick form-deprivation myopia. mAChR antagonists might inhibit myopia via α2-adrenoceptors, instead of through the mAChR M4/cM4 receptor subtype.
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Affiliation(s)
- Brittany J Carr
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Inflammation Research Network-Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Neuroscience, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Koichiro Mihara
- Inflammation Research Network-Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Rithwik Ramachandran
- Inflammation Research Network-Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Physiology and Pharmacology, Western University, London, Ontario, Canada
| | - Mahmoud Saifeddine
- Inflammation Research Network-Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Neil M Nathanson
- Department of Pharmacology, University of Washington, Seattle, Washington, United States
| | - William K Stell
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Cell Biology and Anatomy, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Morley D Hollenberg
- Inflammation Research Network-Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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28
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El-Nimri NW, Wildsoet CF. Effects of Topical Latanoprost on Intraocular Pressure and Myopia Progression in Young Guinea Pigs. Invest Ophthalmol Vis Sci 2019; 59:2644-2651. [PMID: 29847673 PMCID: PMC5973826 DOI: 10.1167/iovs.17-22890] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine whether latanoprost, a prostaglandin analog proven to be very effective in reducing intraocular pressure (IOP) in humans, can also slow myopia progression in the guinea pig form deprivation (FD) model. Methods Two-week-old pigmented guinea pigs underwent monocular FD and daily topical latanoprost (0.005%, n = 10) or artificial tears (control, n = 10) starting 1 week after the initiation of FD, with all treatments continuing for a further 9 weeks. Tonometry, retinoscopy, and high-frequency A-scan ultrasonography were used to monitor IOP, refractive error, and ocular axial dimensions, respectively. Results Latanoprost significantly reduced IOP and slowed myopia progression. Mean interocular IOP differences (±SEM) recorded at baseline and week 10 were -0.30 ± 0.51 and 1.80 ± 1.16 mm Hg (P = 0.525) for the control group and 0.07 ± 0.35 and -5.17 ± 0.96 mm Hg (P < 0.001) for the latanoprost group. Equivalent interocular differences for optical axial length at baseline and week 10 were 0.00 ± 0.015 and 0.29 ± 0.04 mm (P < 0.001; control) and 0.02 ± 0.02 and 0.06 ± 0.02 mm (P = 0.202; latanoprost), and for refractive error were +0.025 ± 0.36 and -8.2 ± 0.71 diopter (D) (P < 0.001; control), and -0.15 ± 0.35 and -2.25 ± 0.54 D (P = 0.03; latanoprost). Conclusions In the FD guinea pig model, latanoprost significantly reduces the development of myopia. Although further investigations into underlying mechanisms are needed, the results open the exciting possibility of a new line of myopia control therapy.
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Affiliation(s)
- Nevin W El-Nimri
- School of Optometry and Vision Science Program, University of California Berkeley, Berkeley, California, United States
| | - Christine F Wildsoet
- School of Optometry and Vision Science Program, University of California Berkeley, Berkeley, California, United States
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Li SM, Iribarren R, Li H, Kang MT, Liu L, Wei SF, Stell WK, Martin G, Wang N. Intraocular pressure and myopia progression in Chinese children: the Anyang Childhood Eye Study. Br J Ophthalmol 2018; 103:349-354. [PMID: 29858181 DOI: 10.1136/bjophthalmol-2017-311831] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 04/29/2018] [Indexed: 12/30/2022]
Abstract
PURPOSE To explore the relationship between intraocular pressure (IOP) at baseline and myopia progression in Chinese children from the Anyang Childhood Eye Study. DESIGN Prospective school-based cohort study. METHODS A total of 1558 grade 7 students completed the entire 2-year study. Ocular biometry, cycloplegic refractions and pneumotonometry were performed. Three years of follow-up have been completed for the children aged 12 years. The refractive groups and the tertiles of IOP were assessed by analysis of variance, to look for differences in mean values of spherical equivalent and IOP, respectively. RESULTS The children's mean baseline IOP was 15.87±3.42 mm Hg. Mean IOP was significantly higher in girls by 0.57 mm Hg (p=0.024). In the whole sample, there was a mean change in spherical equivalent of -1.05 D over 2 years. The baseline IOP was 15.69 mm Hg in those progressing 1 D or more vs 16.09 mm Hg for those progressing <1 D (p=0.022). In the myopic group, myopes progressing >1 D had mean IOP of 15.94 vs 16.42 mm Hg for those myopes progressing 1 D or less (p=0.024). CONCLUSIONS In this sample of Chinese children, myopia progression over 2 years was inversely related to IOP, suggesting that IOP had essentially no relationship with myopia progression in school children. The lower IOP in progressing myopic eyes may indicate more compliant sclerae.
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Affiliation(s)
- Shi-Ming Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, , Beijing, China
| | - Rafael Iribarren
- Laboratory of Ocular Investigations, Dpt. of Patology, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - He Li
- Anyang Eye Hospital, Henan Province, Anyang, China
| | - Meng-Tian Kang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, , Beijing, China
| | - Luoru Liu
- Anyang Eye Hospital, Henan Province, Anyang, China
| | - Shi-Fei Wei
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, , Beijing, China
| | - William K Stell
- Department of Cell Biology and Anatomy, and Department of Surgery; Hotchkiss Brain Institute, and Alberta Children's Hospital Research Institute; Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Gabriel Martin
- Research Consultant, Reichert Inc, Bufalo, New York City, New York, USA
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, , Beijing, China
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30
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Sabel BA, Wang J, Cárdenas-Morales L, Faiq M, Heim C. Mental stress as consequence and cause of vision loss: the dawn of psychosomatic ophthalmology for preventive and personalized medicine. EPMA J 2018; 9:133-160. [PMID: 29896314 PMCID: PMC5972137 DOI: 10.1007/s13167-018-0136-8] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 04/18/2018] [Indexed: 12/14/2022]
Abstract
The loss of vision after damage to the retina, optic nerve, or brain has often grave consequences in everyday life such as problems with recognizing faces, reading, or mobility. Because vision loss is considered to be irreversible and often progressive, patients experience continuous mental stress due to worries, anxiety, or fear with secondary consequences such as depression and social isolation. While prolonged mental stress is clearly a consequence of vision loss, it may also aggravate the situation. In fact, continuous stress and elevated cortisol levels negatively impact the eye and brain due to autonomous nervous system (sympathetic) imbalance and vascular dysregulation; hence stress may also be one of the major causes of visual system diseases such as glaucoma and optic neuropathy. Although stress is a known risk factor, its causal role in the development or progression of certain visual system disorders is not widely appreciated. This review of the literature discusses the relationship of stress and ophthalmological diseases. We conclude that stress is both consequence and cause of vision loss. This creates a vicious cycle of a downward spiral, in which initial vision loss creates stress which further accelerates vision loss, creating even more stress and so forth. This new psychosomatic perspective has several implications for clinical practice. Firstly, stress reduction and relaxation techniques (e.g., meditation, autogenic training, stress management training, and psychotherapy to learn to cope) should be recommended not only as complementary to traditional treatments of vision loss but possibly as preventive means to reduce progression of vision loss. Secondly, doctors should try their best to inculcate positivity and optimism in their patients while giving them the information the patients are entitled to, especially regarding the important value of stress reduction. In this way, the vicious cycle could be interrupted. More clinical studies are now needed to confirm the causal role of stress in different low vision diseases to evaluate the efficacy of different anti-stress therapies for preventing progression and improving vision recovery and restoration in randomized trials as a foundation of psychosomatic ophthalmology.
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Affiliation(s)
- Bernhard A. Sabel
- Institute of Medical Psychology, Medical Faculty, Otto von Guericke University of Magdeburg, Magdeburg, Germany
| | - Jiaqi Wang
- Institute of Medical Psychology, Medical Faculty, Otto von Guericke University of Magdeburg, Magdeburg, Germany
| | - Lizbeth Cárdenas-Morales
- Institute of Medical Psychology, Medical Faculty, Otto von Guericke University of Magdeburg, Magdeburg, Germany
| | - Muneeb Faiq
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029 India
- Department of Ophthalmology, NYU Langone Health, New York University School of Medicine, New York, NY USA
| | - Christine Heim
- Berlin Institute of Health (BIH), Institute of Medical Psychology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA USA
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31
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Alaghband P, Beltran-Agulló L, Galvis EA, Overby DR, Lim KS. Effect of phacoemulsification on facility of outflow. Br J Ophthalmol 2018; 102:1520-1526. [PMID: 29654113 PMCID: PMC6241621 DOI: 10.1136/bjophthalmol-2017-311548] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/15/2018] [Accepted: 01/19/2018] [Indexed: 11/24/2022]
Abstract
Purpose Phacoemulsification has been shown to reduce intraocular pressure (IOP). The mechanism of action is thought to be via increased trabecular outflow facility. However, studies on the relationship between phacoemulsification and outflow facility have been inconsistent. This study intended to examine the change in electronic Schiotz tonographic outflow facility (TOF) and IOP measurements following phacoemulsification. Methods Patients who were due to undergo a standard clear corneal incision phacoemulsification with intraocular lens (IOL) implantation, at St Thomas’ Hospital, were invited to participate in this study. IOP was measured using Goldmann’s applanation tonometer, and TOF was measured by electronic Schiotz tonography at baseline and at 3, 6 and 12 months postoperatively. Results Forty-one patients were recruited. Tonography data for 27 patients were reliable and available at all time points. Eleven cases had primary open angle glaucoma and cataract, while 16 patients had cataract only. Mean IOP reduced at every time point postoperatively significantly compared with baseline. TOF improved significantly after cataract extraction at all time points (baseline of 0.14±0.06 vs 0.18±0.09 at 3 months, P=0.02 and 0.20±0.09 at 6 months, P=0.003, 0.17±0.07 µL/min mmHg at 12 months, P=0.04). Five contralateral eyes of patients with cataracts only who did not have any intraocular surgery during the follow-up period were used as comparison. Their IOP and TOF did not change significantly at any postoperative visits. Conclusion This is the first study using electronic Schiotz tonography with documented anterior chamber depth and gonioscopy after modern cataract surgery (CS) with phacoemulsification and IOL implantation. We demonstrated that phacoemulsification increases TOF and this fully accounts for the IOP reduction following CS. ISTCRN registration number ISRCTN04247738.
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Affiliation(s)
- Pouya Alaghband
- Ophthalmology, St Thomas' Hospital, London, UK.,Academic ophthalmology, King's College London, London, UK
| | - Laura Beltran-Agulló
- Ophthalmology, St Thomas' Hospital, London, UK.,Ophthalmology, Institut Català de la Retina, Barcelona, Spain
| | | | - Darryl R Overby
- Department of Bioengineering, Imperial College London, London, UK
| | - Kin Sheng Lim
- Ophthalmology, St Thomas' Hospital, London, UK.,Academic ophthalmology, King's College London, London, UK
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Hashemi H, Khabazkhoob M, Nabovati P, Yazdani N, Ostadimoghaddam H, Shiralivand E, Derakhshan A, Yekta A. Distribution of IOP measured with an air puff tonometer in a young population. J Curr Ophthalmol 2018; 30:35-41. [PMID: 29564406 PMCID: PMC5859631 DOI: 10.1016/j.joco.2016.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 11/06/2016] [Accepted: 11/06/2016] [Indexed: 11/25/2022] Open
Abstract
Purpose To determine the normal range of intraocular pressure (IOP) in the young and its association with certain corneal parameters using a non-contact device. Methods Subjects were selected from students of Mashhad University of Medical Sciences through stratified sampling. All participants had visual acuity testing, corneal imaging, a comprehensive slit-lamp examination by an ophthalmologist, and IOP measurement using a non-contact air-puff tonometer. Results Of the 1280 invitees, 1073 (83.8%) participated, and 1027 were eligible. Mean IOP was 16.38 mmHg [95% confidence interval (CI): 16.22–16.53] in the total sample, 16.14 mmHg (95% CI: 15.84–16.45) in men, and 16.48 mmHg (95% CI: 16.31–16.66) in women. There was a significant IOP difference between myopes and emmetropes (P = 0.031). Based on the multiple linear regression model, IOP associated directly with age and central corneal thickness (CCT), and inversely with corneal diameter, spherical equivalent (SE), and keratoconus. Based on standardized coefficients of the regression model, CCT and SE had the strongest association with IOP. Conclusions In the present study, we demonstrated the IOP distribution in a young population using a non-contact method. CCT and SE were strongly associated with IOP.
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Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Payam Nabovati
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Negareh Yazdani
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Ostadimoghaddam
- Refractive Errors Research Center, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Shiralivand
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Akbar Derakhshan
- Khatam-al-Anbia Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - AbbasAli Yekta
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
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Liu Y, Wang Y, Lv H, Jiang X, Zhang M, Li X. α-adrenergic agonist brimonidine control of experimentally induced myopia in guinea pigs: A pilot study. Mol Vis 2017; 23:785-798. [PMID: 29204068 PMCID: PMC5693025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 11/13/2017] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To investigate the efficacy of α-adrenergic agonist brimonidine either alone or combined with pirenzepine for inhibiting progressing myopia in guinea pig lens-myopia-induced models. METHODS Thirty-six guinea pigs were randomly divided into six groups: Group A received 2% pirenzepine, Group B received 0.2% brimonidine, Group C received 0.1% brimonidine, Group D received 2% pirenzepine + 0.2% brimonidine, Group E received 2% pirenzepine + 0.1% brimonidine, and Group F received the medium. Myopia was induced in the right eyes of all guinea pigs using polymethyl methacrylate (PMMA) lenses for 3 weeks. Eye drops were administered accordingly. Intraocular pressure was measured every day. Refractive error and axial length measurements were performed once a week. The enucleated eyeballs were removed for hematoxylin and eosin (H&E) and Van Gieson (VG) staining at the end of the study. RESULTS The lens-induced myopia model was established after 3 weeks. Treatment with 0.1% brimonidine alone and 0.2% brimonidine alone was capable of inhibiting progressing myopia, as shown by the better refractive error (p=0.024; p=0.006) and shorter axial length (p=0.005; p=0.0017). Treatment with 0.1% brimonidine and 0.2% brimonidine combined with 2% pirenzepine was also effective in suppressing progressing refractive error (p=0.016; p=0.0006) and axial length (p=0.017; p=0.0004). The thickness of the sclera was kept stable in all groups except group F; the sclera was much thinner in the lens-induced myopia eyes compared to the control eyes. CONCLUSIONS Treatment with 0.1% brimonidine alone and 0.2% brimonidine alone, as well as combined with 2% pirenzepine, was effective in inhibiting progressing myopia. The result indicates that intraocular pressure elevation is possibly a promising mechanism and potential treatment for progressing myopia.
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Abstract
PURPOSE To study the central corneal thickness (CCT) in eyes with microcornea and aphakia and without glaucoma, compare it with normal controls, and correlate it with the measured intraocular pressure (IOP). METHODS The study was conducted on 62 eyes of 31 aphakic children with microcornea. Controls (20 children) were selected from age-matched children presenting for routine refraction. Detailed anterior-segment and fundus examinations were conducted. The CCT and the axial length were measured. Medical records of the study patients were reviewed for the stability of the ocular parameters over time to exclude glaucoma. RESULTS The mean±SD age of the study patients and controls were 4.0 (±3.1, 1.0 to 12.0) and 3.1 (±2.7, 0.6 to 12.0) years, respectively. The mean±SD CCT, the corneal diameter, the measured IOP, the cup/disc ratio, and the axial length of the study patients and the controls were 667.01±72.90 μm, 8.9±0.8 mm, 10.9±5.7 mm Hg, 0.1±0.1, 20.35±2.90 mm and 545.22±28.14 μm, 11.7±0.5 mm, 5.3±1.8 mm Hg, 0.1±0.1, and N/A, respectively. The difference between the study eyes and the controls in the CCT and the measured IOP was statistically significant (P<0.05). CONCLUSIONS Aphakic eyes with microcornea have thicker CCTs and greater measured IOPs than normal eyes. Hence, the measurement of CCT is recommended in the assessment of aphakic eyes with microcornea for possible glaucoma. The measured IOP, although a reliable parameter, in isolation does not provide a diagnosis of glaucoma and must be viewed in conjunction with other patient findings, such as the cup/disc ratio, the progression of which over time must be considered for a more solid diagnosis.
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Li S, Li SM, Wang XL, Kang MT, Liu LR, Li H, Wei SF, Ran AR, Zhan S, Thomas R, Wang N. Distribution and associations of intraocular pressure in 7- and 12-year-old Chinese children: The Anyang Childhood Eye Study. PLoS One 2017; 12:e0181922. [PMID: 28817606 PMCID: PMC5560658 DOI: 10.1371/journal.pone.0181922] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 06/30/2017] [Indexed: 11/18/2022] Open
Abstract
Purpose To report the intraocular pressure (IOP) and its association with myopia and other factors in 7 and 12-year-old Chinese children. Methods All children participating in the Anyang Childhood Eye Study underwent non-contact tonometry as well as measurement of central corneal thickness (CCT), axial length, cycloplegic auto-refraction, blood pressure, height and weight. A questionnaire was used to collect other relevant information. Univariable and multivariable analysis were performed to determine the associations of IOP. Results A total of 2760 7-year-old children (95.4%) and 2198 12-year-old children (97.0%) were included. The mean IOP was 13.5±3.1 mmHg in the younger cohort and 15.8±3.5 mmHg in older children (P<0.0001). On multivariable analysis, higher IOP in the younger cohort was associated with female gender (standardized regression coefficient [SRC], 0.11, P<0.0001), increasing central corneal thickness (SRC, 0.39, P<0.0001), myopia (SRC, 0.05, P = 0.03), deep anterior chamber (SRC, 0.07, P<0.01), smaller waist (SRC, 0.07, P<0.01) and increasing mean arterial pressure (SRC, 0.13, P<0.0001). In the older cohort, higher IOP was again associated with female gender (SRC, 0.16, P<0.0001), increasing central corneal thickness (SRC, 0.43, P<0.0001), deep anterior chamber (SRC, 0.09, P<0.01), higher body mass index (SRC, 0.07, P = 0.04) and with increasing mean arterial pressure (SRC, 0.09, P = 0.01), age at which reading commenced (SRC, 0.10, P<0.01) and birth method (SRC, 0.09, P = 0.01), but not with myopia (SRC, 0.09, P = 0.20). Conclusion In Chinese children, higher IOP was associated with female gender, older age, thicker central cornea, deeper anterior chamber and higher mean arterial pressure. Higher body mass index, younger age at commencement of reading and being born of a caesarean section was also associated with higher IOP in adolescence.
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Affiliation(s)
- Shuning Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China
| | - Shi-Ming Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China
- * E-mail: (NLW); (SML)
| | - Xiao-lei Wang
- Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Meng-Tian Kang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China
| | - Luo-Ru Liu
- Anyang Eye Hospital, Anyang, Henan, China
| | - He Li
- Anyang Eye Hospital, Anyang, Henan, China
| | - Shi-Fei Wei
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China
| | - An-Ran Ran
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China
| | - Siyan Zhan
- Department of Epidemiology and Health Statistics, Peking University School of Public Health, Beijing, China
| | - Ravi Thomas
- Queensland Eye Institute, Brisbane, Australia
- University of Queensland, Brisbane, Australia
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China
- * E-mail: (NLW); (SML)
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Hashemi H, Khabazkhoob M, Emamian MH, Shariati M, Yekta A, Fotouhi A. Distribution of intraocular pressure and its determinants in an Iranian adult population. Int J Ophthalmol 2016; 9:1207-14. [PMID: 27588277 DOI: 10.18240/ijo.2016.08.19] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Accepted: 04/14/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To determine the distribution of intraocular pressure (IOP) and its determinants in an Iranian population. METHODS In a cross-sectional survey, random cluster sampling was conducted from the 40-64 years old population of Shahroud, in the north of Iran. All participants had optometry and ophthalmic exams. IOP was determined using the Goldmann tonometry method and biometric components were measured. RESULTS Of the 6311 people selected for the study, 5190 (82.2%) participated. The mean age of the participants was 50.9±6.2y and 58.7% of them were female. Mean IOP was 12.87±2.27 mm Hg. In this study 0.3% of the participants had an IOP higher than 21 mm Hg. The multiple linear regression model revealed that sex (Coef=-0.30; 95% CI: -0.43 to -0.17), diabetes (Coef=0.43; 95% CI: 0.19 to 0.67), high systolic blood pressure (Coef=0.02; 95% CI: 0.01 to 0.02), high body mass index (BMI) (Coef=0.03; 95% CI: 0.01 to 0.04), higher education (Coef=0.02, 95% CI: 0.01 to 0.04), thicker central corneal thickness (Coef=0.01; 95% CI: 0.01 to 0.02), and myopic shift in spherical equivalent (Coef=-0.14; 95% CI: -0.18 to -0.10) significantly correlated with high IOP. CONCLUSION The IOP in this 40-64 years old population is low overall. In the north of Iran, average IOP is statistically significantly correlated with female sex, diabetes, higher BMI, systolic blood pressure, higher education, thicker cornea, and myopic refractive error.
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Affiliation(s)
- Hassan Hashemi
- Ophthalmic Epidemiology, Noor Research Center, Noor Eye Hospital, Tehran 1968653163, Iran; Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran 1968653163, Iran
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran 1634858433, Iran
| | - Mohammad Hassan Emamian
- Health Related Social and Behavioral Sciences Research Center, Shahroud University of Medical Sciences, Shahroud 3614773947, Iran
| | - Mohammad Shariati
- Department of Community Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran 1417613181, Iran
| | - Abbasali Yekta
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad 9183896858, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran 1417613181, Iran
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Lee CY, Sun CC, Lin YF, Lin KK. Effects of topical atropine on intraocular pressure and myopia progression: a prospective comparative study. BMC Ophthalmol 2016; 16:114. [PMID: 27435576 PMCID: PMC4950753 DOI: 10.1186/s12886-016-0297-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 07/13/2016] [Indexed: 11/19/2022] Open
Abstract
Background Myopia-related maculopathy is one of the leading causes of blindness in the world. The prevalence of myopia has been reported as high as 90 % in some Asian countries. Therefore, controlling myopia progression is an urgent public issue. The purpose of this study is to evaluate the effects of topical atropine with different concentrations on intraocular pressure measurements and myopia progression in school-aged children in Taiwan. Methods Fifty-six myopic children were divided into three groups: 32 children were treated with 0.125 % atropine eyedrop; 12 of them were treated with 0.25 % atropine eye drop and another 12 served as a control group. IOP, auto-refractor and manifest refraction were measured at baseline and every 3 months following treatment for one year. Results There were no significant differences for the mean age, gender and baseline IOPs among the three groups. During the follow up period, no significant IOP difference was found among three groups. The change between final and baseline mean IOPs also revealed no significant differences: 0.54 mmHg, −1.28 mmHg, −0.33 mmHg for the 0.125 % atropine, 0.25 % atropine and control groups. The baseline mean spherical equivalent similarly did not differ significantly among groups but the control group showed a significant myopic progression compared to the 0.125 % atropine group 6 months after treatment, and persisted for one year. The change between final and baseline mean spherical equivalents were −0.05 D, 0 D, −1.05 D for the 0.125 % atropine, 0.25 % atropine and control groups, with both atropine-treated groups showing significant myopic retardation compared to the control group. Conclusions Topical use of low concentration atropine for one year does not induce ocular hypertension and is effective for retarding myopic progression. However, further large scale studies with longer follow up period is necessary to validate the long term safety and efficacy. Trial registration ISRCTN33002849, 2016/01/19, retrospectively registered.
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Affiliation(s)
- Chia-Yi Lee
- Department of Medicine, Chang Gung University, College of Medicine, 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 33302, Taiwan
| | - Chi-Chin Sun
- Department of Ophthalmology, Keelung Chang Gung Memorial Hospital, 222, Maijin Road, Keelung, 20402, Taiwan. .,Department of Chinese Medicine, Chang Gung University, 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 33302, Taiwan.
| | - Yi-Fang Lin
- Department of Ophthalmology, Keelung Chang Gung Memorial Hospital, 222, Maijin Road, Keelung, 20402, Taiwan
| | - Ken-Kuo Lin
- Department of Ophthalmology, Linkou Chang Gung Memorial Hospital, 5 Fuxing Street, Guishan District, Taoyuan, 33305, Taiwan
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McMonnies CW. An examination of the relation between intraocular pressure, fundal stretching and myopic pathology. Clin Exp Optom 2016; 99:113-9. [PMID: 26840631 DOI: 10.1111/cxo.12302] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 04/07/2015] [Accepted: 04/14/2015] [Indexed: 11/28/2022] Open
Abstract
Pathological myopia is one of the leading causes of visual impairment worldwide. Myopic development and progression is biomechanical and dominated by axial elongation. This clinical perspective examines some of the stretch-related fundal changes, which are associated with axial elongation and myopic pathology. The biomechanics of stretching of the fundus appears to depend on genetically and/or visual experience-based scleral changes, which reduce its thickness and elastic modulus so that it becomes more susceptible to the distending forces of intraocular pressure. These changes include reduced collagen synthesis, altered collagen fibres, tissue loss, altered proteoglycans and increased matrix metalloproteinase activity. Such changes are associated with reduced scleral rigidity and related increased potential to stretch in response to intraocular pressure. As axial elongation progresses, the sclera appears likely to continue to reduce in thickness and in its capacity to resist intraocular pressure, especially when pressure becomes elevated. Tessellation, lacquer cracks, myopic crescents, staphylomata, chorioretinal atrophy and retinal detachment are examined within a model for stretching of the fundus. Age, refractive error and axial length, for example, are associated with increased pathological progression. Myopic pathological progression can become dominated by vascular changes and include a greater risk of loss of acuity and blindness. Measures to control myopic pathology, which successfully slow or prevent stretching of the fundus, appear to be key factors in reducing or even avoiding permanent visual loss associated with this condition. For example, limiting axial elongation and related myopic fundus pathology by inhibiting changes which reduce the elastic modulus of scleral tissue is a desirable outcome from interventions to control myopia. Similarly, reducing exposure to the distending stress of elevated intraocular pressure appears to be a desirable form of intervention to control myopia, especially if myopic pathology can be reduced or prevented.
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Affiliation(s)
- Charles W McMonnies
- School of Optometry and Vision Science, University of New South Wales, Kensington, Australia
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Intraocular Pressure Changes during Accommodation in Progressing Myopes, Stable Myopes and Emmetropes. PLoS One 2015; 10:e0141839. [PMID: 26517725 PMCID: PMC4627769 DOI: 10.1371/journal.pone.0141839] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 10/13/2015] [Indexed: 11/19/2022] Open
Abstract
Purpose To investigate the changes of intraocular pressure (IOP) induced by 3-diopter (3 D) accommodation in progressing myopes, stable myopes and emmetropes. Design Cross-sectional study. Participants 318 subjects including 270 myopes and 48 emmetropes. Methods 195 progressing myopes, 75 stable myopes and 48 emmetropes participated in this study. All subjects had their IOP measured using iCare rebound tonometer while accommodative stimuli of 0 D and 3 D were presented. Main Outcome Measures IOP values without accommodation and with 3 D accommodation were measured in all subjects. Baseline IOPs and IOP changes were compared within and between groups. Results There was no significant difference in IOPs between progressing myopes, stable myopes and emmetropes when no accommodation was induced (17.47±3.46, 16.62±2.98 and 16.80±3.62 respectively, p>0.05). IOP experienced an insignificantly slight decrease after 3 D accommodation in three groups (mean change -0.19±2.16, -0.03±1.68 and -0.39±2.65 respectively, p>0.05). Subgroup analysis showed in progressing myopic group, IOP of children (<18 years old) declined with accommodation while IOP of adults (≥18 years) increased, and the difference was statistically significant (p = 0.008). However, after excluding the age factor, accommodation induced IOP changes of high progressing myopes (≤-6 D), low, moderate and non-myopes (>-6 D) was not significantly different after Bonferroni correction (p = 0.838). Conclusions Although no difference was detected between the baseline IOPs and accommodation induced IOP changes in progressing myopes, stable myopes and emmetropes, this study found accommodation could cause transient IOP elevation in adult progressing myopes.
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Öner V, Taş M, Özkaya E, Oruç Y. Effect of pathological myopia on biomechanical properties: a study by ocular response analyzer. Int J Ophthalmol 2015; 8:365-8. [PMID: 25938057 DOI: 10.3980/j.issn.2222-3959.2015.02.27] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 07/23/2014] [Indexed: 12/13/2022] Open
Abstract
AIM To evaluate the ocular response analyzer (ORA) measurements of patients with pathological myopia in comparison with those of emmetropic control subjects, and to investigate the correlation between these ORA measurements and spherical equivalent (SE). METHODS Measurements of 53 eyes of 53 subjects with pathological myopia (SE>-6.00 D) were compared with those of 60 eyes of 60 emmetropic controls. Corneal hysteresis (CH), corneal resistance factor (CRF), noncontact tonometer intraocular pressure (IOPg), and corneal-compensated IOP (IOPcc) were obtained for each subject. The refractive error value was determined as SE via a cycloplegic refraction test. RESULTS The mean age was 54.1±18.9y (ranging from 5 to 88) in the pathological myopic group and 56.2±19.0y (ranging from 6 to 89) in the control group. There were no significant differences between the groups concerning age and sex. CH and CRF were significantly lower in the pathological myopic group than in the control group (P<0.001, P=0.005, respectively). IOPcc and IOPg were significantly higher in the pathological myopic group than in the control group (P<0.001, P=0.009, respectively). There were significantly positive correlations between CH and SE (r=0.565, P<0.001) and between CRF and SE (r=0.364, P=0.007). There were significantly negative correlations between IOPcc and SE (r=-0.432, P=0.001) and between IOPg and SE (r=-0.401, P=0.003). CONCLUSION The present study displayed that pathological myopia affected biomechanical properties measured by ORA. The results of corneal biomechanical properties measured by ORA may need to be appreciated by taking refraction into account. Further, pathological myopia might be related with the increased IOP.
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Affiliation(s)
- Veysi Öner
- Department of Ophthalmology, Recep Tayyip Erdoğan University Medical School, Rize 53100, Turkey
| | - Mehmet Taş
- Department of Ophthalmology, Malatya State Hospital, Malatya 44000, Turkey
| | - Erdal Özkaya
- Department of Ophthalmology, Malatya State Hospital, Malatya 44000, Turkey
| | - Yavuz Oruç
- Department of Ophthalmology, Recep Tayyip Erdoğan University Education and Research Hospital, Rize 53100, Turkey
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Hussein TR, Shalaby SM, Elbakary MA, Elseht RM, Gad RE. Ultrasound biomicroscopy as a diagnostic tool in infants with primary congenital glaucoma. Clin Ophthalmol 2014; 8:1725-30. [PMID: 25228789 PMCID: PMC4161531 DOI: 10.2147/opth.s66682] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose Studying the role of ultrasound biomicroscopy (UBM) in detection of anterior segment changes in infants with primary congenital glaucoma (PCG). Methods Cross-sectional study that included 25 eyes of 15 patients suffering from PCG and a control group of 15 eyes of ten age- and sex-matched participants. Diagnosis of PCG was based on clinical data (intraocular pressure, corneal diameter, fundus examination and amplitude-modulation scan measurement of axial length). UBM examination was done for all participants for measurement of central corneal thickness, anterior chamber depth, lens thickness, iris thickness (measured 2 mm from the iris root and again at the thickest point near the pupil), zonular length, posterior chamber depth, and angle of anterior chamber. Qualitative evaluation was done for abnormal angle membranes, iris insertion level, and ciliary processes position and configuration. Results Mean age ± standard deviation was 10.32±3.59 months in the study group and 14.54±5.9 months in the control group. The central corneal thickness, anterior chamber depth, zonular length, and angle of anterior chamber were significantly larger in the study group than in the control group, with mean values 700±190 μm, 3.55±0.32 mm, 1.02±0.15 mm, and 58.47°±5.57°, respectively. The posterior chamber depth had a mean of 0.33±0.06 mm, which was significantly smaller than that of the control group. In the study group, the mean iris thickness 2 mm from the iris root was 0.32±0.04 mm, the mean iris thickness at the thickest point near the pupil was 0.38±0.08 mm, and the mean lens thickness was 3.32±0.18 mm. These three parameters were smaller than the control group but the difference was insignificant. Loss of normal iris configuration was detected in all eyes of the study group. Anterior iris insertion was detected in 56% of the eyes in the study group, and abnormal angle membrane was found in 12%. Conclusion UBM is a useful tool for detection of anterior segment changes in PCG, which is helpful especially in cases with opaque cornea or cases with borderline clinical findings.
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Affiliation(s)
| | | | | | | | - Rania E Gad
- Faculty of Medicine, Tanta University, Tanta, Egypt
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Yan L, Huibin L, Xuemin L. Accommodation-induced intraocular pressure changes in progressing myopes and emmetropes. Eye (Lond) 2014; 28:1334-40. [PMID: 25190534 DOI: 10.1038/eye.2014.208] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Accepted: 07/17/2014] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To investigate the changes of intraocular pressure (IOP) and anterior eye segment biometric parameters under different accommodative statuses in progressing myopes and emmetropes. METHODS Forty-six progressing myopes and 40 emmetropes participated in this study. All the subjects had their IOP and anterior eye segment biometric parameters (including corneal thickness, anterior chamber depth, anterior chamber angle width, and lens thickness) measured using iCare rebound tonometer and VisanteTM anterior segment-optical coherence tomography while accommodative stimuli of 0, 3, and 6D were presented. RESULTS There was no significant difference in IOP between progressing myopes and emmetropes when no accommodation was induced (16.22±4.11 vs 17.01±3.72, respectively, t=-0.93, P>0.05). However, IOP significantly increased with accommodation in progressing myopes (mean change +1.02±2.07 mm Hg from 0D to 6D, F=5.35, P<0.01), but remained unchanged (mean change -0.76±3.22 mm Hg from 0D to 6D, F=1.46, P>0.05) in emmetropes. Meanwhile, we found that their anterior chamber depth decreased (P<0.01), anterior chamber angle narrowed (P<0.01), and lens thickened (P<0.01) significantly with accommodation, both in progressing myopes and emmetropes. CONCLUSIONS Although no difference was detected between the IOPs of progressing myopes and emmetropes without accommodation, accommodation could induce transient IOP elevation in progressing myopes. Simultaneously, we found that their anterior chamber depth decreased, anterior chamber angle narrowed, and lens thickened with accommodation. Although emmetropes showed the similar anterior eye segment structure changes, their IOPs did not increase with accommodation. Our study indicated that IOP elevation with accommodation in progressing myopes might be related to myopia progression.
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Affiliation(s)
- L Yan
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - L Huibin
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - L Xuemin
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
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Correlation analysis between central corneal thickness and intraocular pressure in juveniles in Northern China: the Jinan city eye study. PLoS One 2014; 9:e104842. [PMID: 25148520 PMCID: PMC4141688 DOI: 10.1371/journal.pone.0104842] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 07/15/2014] [Indexed: 12/27/2022] Open
Abstract
Purpose To determine the distributions and relation of central corneal thickness (CCT) and intraocular pressure (IOP) by NT-530P in Chinese juveniles, and the effect of gender, age, height, weight and refractive errors on the CTT and IOP. Methods CCT and IOP of 982 eyes in 514 juveniles aged from 7 to 18 years were measured with NT-530P. Multi-linear regression and ANOVA analysis were used to analyze the relation of CCT and IOP, and the effect of gender, age, height, weight, refractive condition on CCT and IOP respectively. Results The mean CCT and IOP were 554.19±35.46 µm and 15.31±2.57 mmHg. There were significant correlations between the CCT and IOP values. Linear regression analysis revealed a positive correlation between CCT and IOP (r = 0.44, P<0.05). Linear regression equation: IOP = −2.35+0.032CCT, which means the IOP will increase 0.32 mm Hg for every 10-µm increase in CCT. The mean of Corrected IOP (CIOP) was 15.32±2.38 mmHg and had no relation with CCT. There was a negative correlation between refraction degree and CCT (P<0.05), but no correlation between refraction degree and IOP. Multi-linear regression model revealed that the height, weight, age and gender have no effect on the distribution of CCT and IOP respectively. Conclusions There is a 0.32 mmHg increase in IOP for every 10-µm increase in CCT. The height, weight, age and gender has no effect on the distribution of CCT and IOP. CCT will become thinner with myopia diopters increases in juveniles. The measurement of CCT is helpful in evaluating the actual IOP correctly.
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Refractive error change and its association with ocular and general parameters in junior high school students in Taiwan. Jpn J Ophthalmol 2014; 58:375-80. [PMID: 24882398 DOI: 10.1007/s10384-014-0328-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Accepted: 04/28/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE To assess the relationships between refractive error and ocular and general parameters in Taiwanese junior high school students and to identify the predictive factors associated with the changes in refractive error. METHODS This was a prospective, school-based study. A total of 687 students (357 boys and 330 girls) from a municipal junior high school in Taipei were enrolled. The students' refractive status, intraocular pressure, and ocular parameters were measured first in 2010 and again 1 year later. Data were analyzed using multiple linear regression models and generalized estimating equations (GEEs). RESULTS Significant differences were found between the baseline (2010) and 1-year follow-up (2011) mean anterior chamber depths, mean axial lengths, and mean horizontal and vertical corneal refractive powers. GEE models revealed that vertical and horizontal corneal refractive powers, axial length, and anterior chamber depth were significantly associated with refractive error change. CONCLUSIONS Students with a longer axial length, steeper corneal radius, and shallower anterior chamber depth had an increased risk of myopic refractive errors.
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Cheng HC, Hsieh YT. The effect of low-concentration atropine combined with auricular acupoint stimulation in myopia control. Complement Ther Med 2014; 22:449-55. [PMID: 24906584 DOI: 10.1016/j.ctim.2014.03.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 02/09/2014] [Accepted: 03/13/2014] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES To compare the effect of myopia control between patients treated with low-concentration atropine eye drops combined with auricular acupoint stimulation and those treated with atropine alone. DESIGN AND SETTINGS Single-blinded randomized controlled clinical trial in a regional teaching hospital. INTERVENTIONS The patients received either topical 0.125% atropine nightly plus auricular acupoint stimulation (0.125A + ACU group) or topical 0.125% atropine alone nightly (0.125A group). MAIN OUTCOME MEASURES The changes in spherical equivalent (SE), axial length (AL), anterior chamber depth (ACD), and intraocular pressure (IOP) per year were compared between the two groups. RESULTS Seventy-three of 110 total patients (66.4%) completed at least 6 months of follow-up. Patients in the 0.125A + ACU group had less myopic progression and AL elongation (-0.41 diopter and 0.24 mm/year) than those in the 0.125A group (-0.66 diopter and 0.32 mm/year) (mean follow-up 14.7 months, p < 0.0001 and p = 0.02, respectively). The ACD increased more in the 0.125A + ACU group than in the 0.125A group (0.076 mm vs. 0.023 mm/year, p = 0.0004). IOP decreased more in the 0.125A + ACU group than in the 0.125A group (-1.01 mmHg vs. -0.13 mmHg/year, p = 0.007). A decrease of 1 mmHg of IOP correlated with a decrease of myopic progression of 0.021 diopter/year (p = 0.006). CONCLUSIONS Patients treated with 0.125% atropine eye drops plus auricular acupoint stimulation had less myopic progression, less axial length elongation, more anterior chamber deepening, and greater IOP reductions than those treated with 0.125% atropine alone. Auricular acupoint stimulation in combination with low-concentration topical atropine was beneficial for myopia control.
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Affiliation(s)
- Han-Chih Cheng
- Department of Ophthalmology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
| | - Yi-Ting Hsieh
- Department of Ophthalmology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan; Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
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cAMP level modulates scleral collagen remodeling, a critical step in the development of myopia. PLoS One 2013; 8:e71441. [PMID: 23951163 PMCID: PMC3741144 DOI: 10.1371/journal.pone.0071441] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 06/28/2013] [Indexed: 11/19/2022] Open
Abstract
The development of myopia is associated with decreased ocular scleral collagen synthesis in humans and animal models. Collagen synthesis is, in part, under the influence of cyclic adenosine monophosphate (cAMP). We investigated the associations between cAMP, myopia development in guinea pigs, and collagen synthesis by human scleral fibroblasts (HSFs). Form-deprived myopia (FDM) was induced by unilateral masking of guinea pig eyes. Scleral cAMP levels increased selectively in the FDM eyes and returned to normal levels after unmasking and recovery. Unilateral subconjunctival treatment with the adenylyl cyclase (AC) activator forskolin resulted in a myopic shift accompanied by reduced collagen mRNA levels, but it did not affect retinal electroretinograms. The AC inhibitor SQ22536 attenuated the progression of FDM. Moreover, forskolin inhibited collagen mRNA levels and collagen secretion by HSFs. The inhibition was reversed by SQ22536. These results demonstrate a critical role of cAMP in control of myopia development. Selective regulation of cAMP to control scleral collagen synthesis may be a novel therapeutic strategy for preventing and treating myopia.
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Abstract
PURPOSE To describe intraocular pressure (IOP) and central corneal thickness (CCT) in ethnically diverse, myopic young adults enrolled in COMET (the Correction of Myopia Evaluation Trial) and their association with ocular and demographic factors. METHODS IOP (Goldmann tonometry), CCT (handheld pachymetry), refractive error (cycloplegic autorefraction), and ocular components (A-scan ultrasonography) were measured in 385 of the original 469 subjects (mean age = 20.3 ± 1.3 years). Summary statistics for descriptive analysis, Pearson correlation coefficients, and linear regression models to formally test the association of IOP and CCT with other covariates were used. RESULTS Mean IOP was 15.1 ± 0.1 mm Hg and differed by ethnicity and CCT but did not vary by gender, magnitude of myopia, or vitreous chamber depth (VCD). Adjusting for CCT, IOP in black participants was 1.8 mm Hg higher than in Hispanics (p = 0.0001) and 0.8 mm Hg higher than in whites (p = 0.03). Mean CCT was 562.4 ± 1.8 μm and differed by ethnicity, VCD, and IOP after adjusting for covariates. Blacks had thinner corneas than Asians, whites, and Hispanics, with adjusted differences of 15.4, 11.8, and 15.3 μm (p = 0.03, < 0.01 and < 0.01), respectively. Eyes with shorter VCD (<17.8 mm) had 8.0-μm thinner CCT (p = 0.03). CCT did not vary by gender or magnitude of myopia. Overall, a modest positive correlation (r = 0.25, P < 0.0001) was found between IOP and CCT, which varied by ethnicity in Asians (r = 0.47; p = 0.008), blacks (r = 0.29; p = 0.002), and whites (r = 0.24; p = 0.002). CONCLUSIONS Myopic, black young adults had higher IOP and thinner corneas relative to other ethnic groups, suggesting that evaluation of these parameters during routine examination of these individuals should begin at a young age. Their thinner CCT should also be considered in evaluations for refractive surgery.
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Razeghinejad MR, Banifatemi M. Ocular biometry in angle closure. J Ophthalmic Vis Res 2013; 8:17-24. [PMID: 23825708 PMCID: PMC3691973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 06/23/2012] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To compare ocular biometric parameters in primary angle closure suspects (PACS), primary angle closure glaucoma (PACG) and acute primary angle closure (APAC). METHODS This cross-sectional study was performed on 113 patients including 33 cases of PACS, 45 patients with PACG and 35 subjects with APAC. Central corneal thickness (CCT), axial length (AL), anterior chamber depth (ACD) and lens thickness (LT) were measured with an ultrasonic biometer. Lens-axial length factor (LAF), relative lens position, corrected ACD (CACD) and corrected lens position were calculated. The parameters were measured bilaterally but only data from the right eyes were compared. In the APAC group, biometric parameters were also compared between affected and unaffected fellow eyes. Logistic regression analysis was performed to identify risk factors. RESULTS No statistically significant difference was observed in biometric parameters between PACS and PACG eyes, or between affected and fellow eyes in the APAC group (P>0.05 for all comparisons). However, eyes with APAC had thicker cornea (P=0.001), thicker lens (P<0.0001), shallower ACD (P=0.009), shallower CACD (P=0.003) and larger LAF (P<0.0001). Based on ROC curve analysis, lower ACD, and larger LT, LAF and CCT values were associated with APAC. In the APAC group, LAF (P<0.0001) and CCT (P=0.001) were significant risk factors. CONCLUSION This study revealed no significant difference in biometric characteristics in eyes with PACS and PACG. However, larger LAF and CCT were predictive of APAC.
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Affiliation(s)
- Mohammad Reza Razeghinejad
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Correspondence to: Mohammad Reza Razeghinejad, MD. Professor of Ophthalmology, Department of Ophthalmology, Khalili Hospital, Shiraz 71936-16641, Iran; Tel: +98 711 629 17179, Fax: +98 711 647 1479;
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Abstract
PURPOSE The ethnically diverse Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study cohort provides a unique opportunity to explore associations among intraocular pressure (IOP), ethnicity, and refractive error while adjusting for potential confounding variables. METHODS Mixed linear models were used to examine the effect of age, refractive error (cycloplegic auto-refraction), ethnicity, sex, and measurement protocol on IOP (Tono-pen) in 3777 children, aged 6 to 14 years at their first CLEERE visit (1995-2009). Children who became myopic during follow-up were used to examine the relationship between time since myopia onset and IOP. Clinically meaningful differences in IOP were preset at >2 mm Hg. RESULTS IOP differed among refractive error categories with higher IOP in children with low/moderate myopia than those with high hyperopia (differences <1 mm Hg). There was a statistically significant relationship between age and IOP that depended on ethnicity (interaction p < 0.0001) and measurement protocol (interaction p < 0.0001). The relationship between sex and IOP depended on measurement protocol (interaction p = 0.0004). For children who became myopic during follow-up, the adjusted mean IOP showed a significant decline for only Asian (p = 0.024) and white children (p = 0.004). As with other statistically significant results, these changes in mean adjusted IOPs from 2 years before to 2 years after myopia onset were <2 mm Hg. CONCLUSIONS Small but significant differences in IOP by refractive error category were found in this ethnically diverse cohort of children. Relationships between IOP and age, ethnicity, sex, and measurement protocol were complicated by significant interactions between these parameters. Longitudinal analysis of children before and after myopia onset showed changes in IOP over time that varied by ethnicity. Higher IOPs before and at myopia onset were not present in all ethnic groups, with differences before and after onset too small to suggest a role for IOP in the onset of myopia.
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Atkinson MJ, Tally S, Heichel CW, Kozak I, Leich J, Levack A. A qualitative investigation of visual tasks with which to assess distance-specific visual function. Qual Life Res 2012; 22:437-53. [DOI: 10.1007/s11136-012-0154-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2012] [Indexed: 10/28/2022]
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