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Ostrin LA, Sah RP, Queener HM, Patel NB, Tran R, Shukla D, Mirhajianmoghadam H. Short-Term Myopic Defocus and Choroidal Thickness in Children and Adults. Invest Ophthalmol Vis Sci 2024; 65:22. [PMID: 38597724 PMCID: PMC11008753 DOI: 10.1167/iovs.65.4.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/20/2024] [Indexed: 04/11/2024] Open
Abstract
Purpose Studies report conflicting findings regarding choroidal thickness changes in response to myopic defocus in humans. This study aimed to investigate the choroidal response to myopic defocus in children and adults using automated analysis. Methods Participants (N = 46) were distance-corrected in both eyes and viewed a movie on a screen for 10 minutes. Two optical coherence tomography (OCT) radial scans were collected for each eye, then +3 diopters was added to one eye. Participants continued to watch the movie, OCT scans were repeated every 10 minutes for 50 minutes, and then recovery was assessed at 60 and 70 minutes. Defocus was interrupted for approximately two out of each 10 minutes for OCT imaging. OCT images were analyzed using an automated algorithm and trained neural network implemented in MATLAB to determine choroidal thickness at each time point. Repeated-measures ANOVA was used to assess changes with time in three age groups (6-17, 18-30, and 31-45 years) and by refractive error group (myopic and nonmyopic). Results Choroidal thickness was significantly associated with spherical equivalent refraction, with the myopic group having a thinner choroid than the nonmyopic group (P < 0.001). With imposed myopic defocus, there were no significant changes in choroidal thickness at any time point for any age group and for either refractive error group (P > 0.05 for all). Conclusions Findings demonstrate that, using the described protocol, the choroidal thickness of children and adults does not significantly change in response to short-term, full-field myopic defocus, in contrast to several previously published studies.
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Affiliation(s)
- Lisa A. Ostrin
- University of Houston College of Optometry, Houston, TX, United States
| | - Raman P. Sah
- University of Houston College of Optometry, Houston, TX, United States
| | - Hope M. Queener
- University of Houston College of Optometry, Houston, TX, United States
| | - Nimesh B. Patel
- University of Houston College of Optometry, Houston, TX, United States
| | - Raphaella Tran
- University of Houston College of Optometry, Houston, TX, United States
| | - Divya Shukla
- University of Houston College of Optometry, Houston, TX, United States
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Raphtis VA, Sharma D, Wang S, Kim JY, Jacobson AL, Harman CD, Komáromy AM. Ocular pulse amplitude (OPA) in canine ADAMTS10-open-angle glaucoma ( ADAMTS10-OAG). Front Bioeng Biotechnol 2023; 11:1242166. [PMID: 38130820 PMCID: PMC10733518 DOI: 10.3389/fbioe.2023.1242166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction: The role of ocular rigidity and biomechanics remains incompletely understood in glaucoma, including assessing an individual's sensitivity to intraocular pressure (IOP). In this regard, the clinical assessment of ocular biomechanics represents an important need. The purpose of this study was to determine a possible relationship between the G661R missense mutation in the ADAMTS10 gene and the ocular pulse amplitude (OPA), the difference between diastolic and systolic intraocular pressure (IOP), in a well-established canine model of open-angle glaucoma (OAG). Methods: Animals studied included 39 ADAMTS10-mutant dogs with different stages of OAG and 14 unaffected control male and female dogs between 6 months and 12 years (median: 3.2 years). Dogs were sedated intravenously with butorphanol tartrate and midazolam HCl, and their IOPs were measured with the Icare® Tonovet rebound tonometer. The Reichert Model 30™ Pneumotonometer was used to measure OPA. Central corneal thickness (CCT) was measured via Accutome® PachPen, and A-scan biometry was assessed with DGH Technology Scanmate. All outcome measures of left and right eyes were averaged for each dog. Data analysis was conducted with ANOVA, ANCOVA, and regression models. Results: ADAMTS10-OAG-affected dogs displayed a greater IOP of 23.0 ± 7.0 mmHg (mean ± SD) compared to 15.3 ± 3.6 mmHg in normal dogs (p < 0.0001). Mutant dogs had a significantly lower OPA of 4.1 ± 2.0 mmHg compared to 6.5 ± 2.8 mmHg of normal dogs (p < 0.01). There was no significant age effect, but OPA was correlated with IOP in ADAMTS10-mutant dogs. Conclusion: The lower OPA in ADAMTS10-mutant dogs corresponds to the previously documented weaker and biochemically distinct posterior sclera, but a direct relationship remains to be confirmed. The OPA may be a valuable clinical tool to assess ocular stiffness and an individual's susceptibility to IOP elevation.
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Affiliation(s)
- Vanessa A. Raphtis
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States
| | - Dhruv Sharma
- Center for Statistical Training and Consulting, Michigan State University, East Lansing, MI, United States
| | - Sichao Wang
- Center for Statistical Training and Consulting, Michigan State University, East Lansing, MI, United States
| | - Jae Y. Kim
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States
| | - Amanda L. Jacobson
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States
| | - Christine D. Harman
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States
| | - András M. Komáromy
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States
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Sayah DN, Mazzaferri J, Descovich D, Costantino S, Lesk MR. Ocular rigidity and neuroretinal damage in patients with vasospasticity: a pilot study. Can J Ophthalmol 2023; 58:338-345. [PMID: 35358484 DOI: 10.1016/j.jcjo.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 02/08/2022] [Accepted: 02/12/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Evidence suggests that ocular blood flow dysregulation in patients with vasospasticity could occur in response to biomechanical stimuli, contributing to optic nerve head susceptibility in glaucoma. We evaluate the role of vasospasticity in the association between ocular rigidity (OR) and neuroretinal damage, hypothesizing that low OR correlates with greater glaucoma damage in patients with vasospasticity. DESIGN Cross-sectional study. PARTICIPANTS Patients with open-angle glaucoma (OAG), suspect discs, or no glaucoma. METHODS OR was measured using a noninvasive, validated method developed by our group. Retinal nerve fibre layer (RNFL) and ganglion cell complex thicknesses were acquired using spectral domain optical coherence tomography. Vasospasticity was assessed by a standardized questionnaire that was based on existing validated questionnaires and adapted to our requirements. Atherosclerosis was evaluated based on Broadway and Drance's (1998) cardiovascular disease score. Correlations between OR and structural parameters were assessed in patients with vasospasticity and those with atherosclerosis. RESULTS Of 118 patients with either OAG (n = 67), suspect discs (n = 26), or no glaucoma (n = 25) who were recruited consecutively, 10 were classified as having vasospasticity, and 37 as having atherosclerosis. In the vasospastic group, significant correlations were found between OR and the minimum ganglion cell complex thickness (rs = 0.681, p = 0.030), the average RNFL thickness (rs = 0.745, p = 0.013), and the RNFL in the temporal quadrant (rs = 0.772, p = 0.009), indicating more damage with lower OR. Similar trends were maintained when applying multiple testing correction; however, only the eighth RNFL clock hour corresponding to the inferior-temporal peripapillary region remained significantly correlated with OR in the vasospastic group (p = 0.015). In contrast, no correlation was found in the atherosclerotic group (p > 0.05). CONCLUSIONS The findings of the current pilot study indicate a trend for more neuronal structural damage in less-rigid eyes of patients with vasospasticity, meaning that OR may play a greater role in glaucoma in vasospastic patients than in patients with atherosclerosis. Although these results provide interesting insight into the pathophysiology of OAG, further investigation is needed to confirm our observations.
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Affiliation(s)
- Diane N Sayah
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC; Department of Ophthalmology, Université de Montréal, Montreal, QC
| | | | | | - Santiago Costantino
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC; Department of Ophthalmology, Université de Montréal, Montreal, QC; Centre Universitaire d'Ophtalmologie (CUO), Maisonneuve-Rosemont Hospital, CIUSSS-E, Montreal, QC
| | - Mark R Lesk
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC; Department of Ophthalmology, Université de Montréal, Montreal, QC; Centre Universitaire d'Ophtalmologie (CUO), Maisonneuve-Rosemont Hospital, CIUSSS-E, Montreal, QC.
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4
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Sayah DN, Lesk MR. Ocular Rigidity and Current Therapy. Curr Eye Res 2023; 48:105-113. [PMID: 35763027 DOI: 10.1080/02713683.2022.2093380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Purpose: Ocular rigidity (OR) is an important biomechanical parameter of the eye accounting for the material and geometrical properties of the corneoscleral shell.Methods: This study used a literature search to review the role of ocular rigidity and the application of potential therapies targeting this parameter in glaucoma and myopia.Conclusion: Biomechanical modeling and improved understanding of the biochemistry, and molecular arrangement of sclera and its constituents have yielded important insights. Recent developments, including that of a non-invasive and direct OR measurement method and improved ocular imaging techniques are helping to elucidate the role of OR in healthy and diseased eyes by facilitating large scale and longitudinal clinical studies. Improved understanding of OR at the initial stages of disease processes and its alterations with disease progression will undoubtedly propel research in the field. Furthermore, a better understanding of the determinants of OR is helping to refine novel therapeutic approaches which target and alter the biomechanical properties of the sclera in sight-threatening conditions such as glaucoma and myopia.
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Affiliation(s)
- Diane N Sayah
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Canada.,School of Optometry, Université de Montréal, Montreal, Canada
| | - Mark R Lesk
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Canada.,Department of Ophthalmology, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Centre Universitaire d'ophtalmologie de l'Université de Montréal de l'Hôpital Maisonneuve-Rosemont, CIUSSS-E, Montreal, Canada
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5
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Nakazawa K, Higashide T, Tsuchiya S, Shioya S, Okayama M, Sugiyama K. Association of Ambulatory Blood Pressure and Other Factors With Intraocular Pressure-Related 24-Hour Contact Lens Sensor Profile in Untreated Glaucoma. Transl Vis Sci Technol 2022; 11:18. [PMID: 36223126 PMCID: PMC9583745 DOI: 10.1167/tvst.11.10.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate the association of diurnal blood pressure (BP) and other factors with the intraocular pressure (IOP)–related 24-hour contact lens sensor (CLS) profile of patients with untreated glaucoma. Methods The prospective study included 82 patients with untreated normal-tension glaucoma. CLS measurements and ambulatory BP monitoring were performed simultaneously for 24 hours. The association between the mean arterial pressure (MAP) and CLS profile was examined for the daytime and nocturnal periods using linear regression analysis. The associations between other factors and the CLS profile were also examined. Results Multivariate analysis of data from 63 eligible patients showed that higher average MAPs were significantly associated with larger average nocturnal CLS values (β coefficient = 0.273; P = 0.023); a larger increase in the last CLS value (β coefficient = 0.366; P = 0.003); larger standard deviations (SDs) of CLS values for the daytime, nocturnal, and 24-hour periods (β coefficient = 0.407, 0.293, and 0.375; P < 0.001, P = 0.032 and 0.002, respectively); and higher average ocular pulse frequencies for the daytime, nocturnal, and 24-hour periods (β coefficient = 0.268, 0.380, and 0.403; P = 0.029, 0.002, and 0.001, respectively). Thicker subfoveal choroids and shorter axial length were significantly associated with larger SDs and larger average CLS values, respectively. Smaller anterior chamber volume and lower corneal hysteresis were associated with larger SDs or larger average ocular pulse amplitude. Conclusions Ambulatory BP and several ocular parameters were significantly associated with various parameters of the 24-hour CLS profile. Translational Relevance Ambulatory BP and ocular parameters may be modifiers of the 24-hour IOP-related profile of CLS.
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Affiliation(s)
- Kazuki Nakazawa
- Department of Ophthalmology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan.,Department of Ophthalmology, Hakui General Hospital, Ishikawa, Japan
| | - Tomomi Higashide
- Department of Ophthalmology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Shunsuke Tsuchiya
- Department of Ophthalmology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Satomi Shioya
- Department of Ophthalmology, Noto General Hospital, Ishikawa, Japan
| | - Masahiko Okayama
- Department of Ophthalmology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan.,Department of Ophthalmology, Nanto Municipal Hospital, Toyama, Japan
| | - Kazuhisa Sugiyama
- Department of Ophthalmology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
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Markert JE, Turner DC, Jasien JV, Nyankerh CNA, Samuels BC, Downs JC. Ocular Pulse Amplitude Correlates With Ocular Rigidity at Native IOP Despite the Variability in Intraocular Pulse Volume With Each Heartbeat. Transl Vis Sci Technol 2022; 11:6. [PMID: 36074454 PMCID: PMC9469039 DOI: 10.1167/tvst.11.9.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to assess ocular coat mechanical behavior using controlled ocular microvolumetric injections (MVI) of 15 µL of balanced salt solution (BSS) infused over 1 second into the anterior chamber (AC) via a syringe pump. Methods Intraocular pressure (IOP) was continuously recorded at 200 Hz with a validated implantable IOP telemetry system in 7 eyes of 7 male rhesus macaques (nonhuman primates [NHPs]) during 5 MVIs in a series at native (3 trials), 15 and 20 mm Hg baseline IOPs, repeated in 2 to 5 sessions at least 2 weeks apart. Ocular rigidity coefficients (K) and ocular pulse volume (PV) were calculated for each trial. Data were averaged across sessions within eyes; PV was analyzed with a three-level nested ANOVA, and parameter relationships were analyzed with Pearson Correlation and linear regression. Results After MVI at native baseline IOP of 10.4 ± 1.6 mm Hg, IOP increased by 9.1 ± 2.8 mm Hg (∆IOP) at a 9.6 ± 2.7 mm Hg/s slope, ocular pulse amplitude (OPA) was 0.70 ± 0.13 mm Hg on average; the average K was 0.042 ± 0.010 µL-1 and average PV was 1.16 ± 0.43 µL. PV varied significantly between trials, days, and eyes (P ≤ 0.05). OPA was significantly correlated with K at native IOP: Pearson coefficients ranged from 0.71 to 0.83 (P ≤ 0.05) and R2 ranged from 0.50 to 0.69 (P ≤ 0.05) during the first trial. Conclusions The MVI-driven ∆IOP and slope can be used to assess ocular coat mechanical behavior and measure ocular rigidity. Translational Relevance Importantly, OPA at native IOP is correlated with ocular rigidity despite the significant variability in PV between heartbeats.
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Affiliation(s)
- John E Markert
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Daniel C Turner
- Vision Science Graduate Program, School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jessica V Jasien
- Vision Science Graduate Program, School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Cyril N A Nyankerh
- Vision Science Graduate Program, School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Brian C Samuels
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - J Crawford Downs
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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Kazemi A, Zhou B, Zhang X, Sit AJ. Comparison of Corneal Wave Speed and Ocular Rigidity in Normal and Glaucomatous Eyes. J Glaucoma 2021; 30:932-940. [PMID: 34127628 PMCID: PMC8484019 DOI: 10.1097/ijg.0000000000001901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 06/06/2021] [Indexed: 11/26/2022]
Abstract
PRECIS Ocular biomechanics were compared between treated glaucoma patients and healthy subjects matched for age, intraocular pressure (IOP), and axial length. There was no difference in corneal wave propagation speed, but ocular rigidity was lower in glaucomatous eyes. PURPOSE Ocular biomechanical properties are important in understanding glaucoma pathogenesis but the affected tissues are unclear. In this study, we compared corneal wave speed (a measure of corneal elasticity) and ocular rigidity coefficient between glaucomatous and normal eyes. MATERIALS AND METHODS Twenty glaucomatous eyes from 10 patients and 20 normal eyes from 13 controls, matched for age, IOP, and axial length were included. Ocular rigidity was calculated based on the difference in supine IOP by pneumatonometry with and without a 10-g weight. Corneal wave speed was determined by ultrasound surface wave elastography. A small, 0.1-second harmonic vibration at 100 Hz was generated through the closed eyelids. Wave propagation was captured by an ultrasound transducer, and wave speed was determined from the phase change with distance. Comparisons were performed using generalized estimating equation models. RESULTS There were no significant differences in corneal wave speed between glaucomatous and normal eyes (2.16±0.25 vs. 2.07±0.16 m/s, P=0.17). However, ocular rigidity was significantly lower in glaucomatous eyes (0.0218±0.0033 vs. 0.0252±0.0050/μL, P=0.01). Corneal wave speed was not correlated with age and IOP in either group (P≥0.23) but was correlated with ocular rigidity (R=0.48, P=0.02) and inversely correlated with axial length (R=-0.53, P=0.01) in glaucomatous eyes. CONCLUSION Glaucomatous eyes tend to have lower ocular rigidity than healthy eyes with similar age, IOP, and axial length. However, the lack of a difference in corneal wave speed suggests that corneal tissue may not be significantly affected, and scleral changes likely play a more important role in glaucoma.
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Affiliation(s)
- Arash Kazemi
- Department of Ophthalmology, Mayo Clinic, Rochester, MN, USA
| | - Boran Zhou
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Xiaoming Zhang
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Arthur J. Sit
- Department of Ophthalmology, Mayo Clinic, Rochester, MN, USA
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8
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Ma Y, Moroi SE, Roberts CJ. Non-invasive Clinical Measurement of Ocular Rigidity and Comparison to Biomechanical and Morphological Parameters in Glaucomatous and Healthy Subjects. Front Med (Lausanne) 2021; 8:701997. [PMID: 34291068 PMCID: PMC8287026 DOI: 10.3389/fmed.2021.701997] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/07/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To assess ocular rigidity using dynamic optical coherence tomography (OCT) videos in glaucomatous and healthy subjects, and to evaluate how ocular rigidity correlates with biomechanical and morphological characteristics of the human eye. Methods: Ocular rigidity was calculated using Friedenwald's empirical equation which estimates the change in intraocular pressure (IOP) produced by volumetric changes of the eye due to choroidal pulsations with each heartbeat. High-speed OCT video was utilized to non-invasively measure changes in choroidal volume through time-series analysis. A control-case study design was based on 23 healthy controls and 6 glaucoma cases. Multiple diagnostic modalities were performed during the same visit including Spectralis OCT for nerve head video, Pascal Dynamic Contour Tonometry for IOP and ocular pulse amplitude (OPA) measurement, Corvis ST for measuring dynamic biomechanical response, and Pentacam for morphological characterization. Results: Combining glaucoma and healthy cohorts (n = 29), there were negative correlations between ocular rigidity and axial length (Pearson R = −0.53, p = 0.003), and between ocular rigidity and anterior chamber volume (R = −0.64, p = 0.0002). There was a stronger positive correlation of ocular rigidity and scleral stiffness (i.e., stiffness parameter at the highest concavity [SP-HC]) (R = 0.62, p = 0.0005) compared to ocular rigidity and corneal stiffness (i.e., stiffness parameter at the first applanation [SP-A1]) (R = 0.41, p = 0.033). In addition, there was a positive correlation between ocular rigidity and the static pressure-volume ratio (P/V ratio) (R = 0.72, p < 0.0001). Conclusions: Ocular rigidity was non-invasively assessed using OCT video and OPA in a clinic setting. The significant correlation of ocular rigidity with biomechanical parameters, SP-HC and P/V ratio, demonstrated the validity of the ocular rigidity measurement. Ocular rigidity is driven to a greater extent by scleral stiffness than corneal stiffness. These in vivo methods offer an important approach to investigate the role of ocular biomechanics in glaucoma.
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Affiliation(s)
- Yanhui Ma
- Department of Ophthalmology and Visual Sciences, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Sayoko E Moroi
- Department of Ophthalmology and Visual Sciences, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Cynthia J Roberts
- Department of Ophthalmology and Visual Sciences, The Ohio State University Wexner Medical Center, Columbus, OH, United States.,Department of Biomedical Engineering, The Ohio State University, Columbus, OH, United States
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Sayah DN, Mazzaferri J, Descovich D, Costantino S, Lesk MR. The Association Between Ocular Rigidity and Neuroretinal Damage in Glaucoma. Invest Ophthalmol Vis Sci 2021; 61:11. [PMID: 33151280 PMCID: PMC7671866 DOI: 10.1167/iovs.61.13.11] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Ocular rigidity (OR) is an important biomechanical property, thought to be relevant in the pathophysiology of open-angle glaucoma (OAG). This study aims to evaluate the relationship between OR and neuroretinal damage caused by glaucoma. Methods One hundred eight subjects (22 with healthy eyes, 23 with suspect discs, and 63 with OAG) were included in this study. OR was measured using a noninvasive optical coherence tomography (OCT)-based method developed by our group. We also measured central corneal thickness (CCT), corneal hysteresis (CH), and corneal resistance factor (CRF). Pearson and partial correlations were performed to evaluate the relationship between OR and glaucomatous damage represented by ganglion cell complex (GCC), retinal nerve fiber layer (RNFL) thicknesses, and neuroretinal rim area. Results Significant positive correlations were found between OR and minimum GCC thickness (r = 0.325, P = 0.001), average GCC thickness (r = 0.320, P = 0.002), rim area (r = 0.344, P < 0.001), and RNFL thickness in the superior (r = 0.225, P = 0.023), and inferior (r = 0.281, P = 0.004) quadrants. These correlations were generally greater than those found for CCT, CH, and CRF. Furthermore, no correlation was found between OR and corneal biomechanical parameters. After adjusting for age, sex, and ethnicity, significant correlations were found between OR and minimum and average GCC thickness (r = 0.357, P = 0.001 and r = 0.344, P = 0.001, respectively), rim area (r = 0.327, P = 0.001), average RNFL thickness (r = 0.331, P = 0.001), and RNFL thickness in the superior (r = 0.296, P = 0.003) and inferior (r = 0.317, P = 0.001) quadrants. Conclusions In this study, we found a positive correlation between structural OCT-based parameters and OR, indicating more neuroretinal damage in eyes with lower OR. These findings could provide insight into the pathophysiology of OAG.
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Affiliation(s)
- Diane N Sayah
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada.,Department of Ophthalmology, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Javier Mazzaferri
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada
| | - Denise Descovich
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada
| | - Santiago Costantino
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada.,Department of Ophthalmology, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Centre Universitaire d'ophtalmologie de l'Université de Montréal de l'Hôpital Maisonneuve-Rosemont, CIUSSS-E, Montreal, Quebec, Canada
| | - Mark R Lesk
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada.,Department of Ophthalmology, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Centre Universitaire d'ophtalmologie de l'Université de Montréal de l'Hôpital Maisonneuve-Rosemont, CIUSSS-E, Montreal, Quebec, Canada
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10
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Colakoglu A, Colakoglu IE, Cosar CB. Correlation between corneal thickness, keratometry, age, and differential pressure difference in healthy eyes. Sci Rep 2021; 11:4133. [PMID: 33603061 PMCID: PMC7893151 DOI: 10.1038/s41598-021-83683-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/03/2021] [Indexed: 01/31/2023] Open
Abstract
To determine the use of differential pressure difference (DPD), in air-puff differential tonometry, as a potential biomechanical measure of the cornea and elucidate its relationship with the intraocular pressure (IOP), central corneal thickness, corneal curvature, and age. This study comprised 396 eyes from 198 patients and was conducted at Acibadem University, School of Medicine, Department of Ophthalmology, Istanbul, Turkey. The central corneal curvature and refraction of the eyes were measured using an Auto Kerato-Refractometer (KR-1; Topcon Corporation, Tokyo, Japan). IOP and central corneal thickness were measured using a tono-pachymeter (CT-1P; Topcon Corporation, Tokyo, Japan), wherein two separate readings of IOP were obtained using two different modes: 1-30 and 1-60. The difference between these two readings was recorded as the DPD. The factors affecting the DPD were determined by stepwise multiple linear regression analysis. DPD varied over a dynamic range of - 3.0 to + 5.0 mmHg and was weakly correlated with the central corneal thickness (r = 0.115, p < 0.05). DPD showed no significant correlation with IOP 1-30 (p > 0.05). A weak but statistically significant (p < 0.05) positive correlation of DPD was observed with age (r = 0.123), Kavg (r = 0.102), and the CCT (r = 0.115). There was a significant correlation between DPD and Kavg, CCT, and age. There was no significant correlation between DPD and IOP 1-30. Age-related changes in the corneal ultrastructure may be a plausible explanation for the weak positive association between age and DPD. The proposed method may prove a valid non-invasive tool for the evaluation of corneal biomechanics and introduce DPD in the decision-making of routine clinical practice.
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Affiliation(s)
- Ahmet Colakoglu
- Department of Ophthalmology, Acibadem University School of Medicine, Icerenkoy, 34752, Istanbul, Turkey.
| | | | - Cemile Banu Cosar
- Department of Ophthalmology, Acibadem University School of Medicine, Icerenkoy, 34752, Istanbul, Turkey
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Sayah DN, Szigiato AA, Mazzaferri J, Descovich D, Duval R, Rezende FA, Costantino S, Lesk MR. Correlation of ocular rigidity with intraocular pressure spike after intravitreal injection of bevacizumab in exudative retinal disease. Br J Ophthalmol 2020; 105:392-396. [PMID: 32345604 DOI: 10.1136/bjophthalmol-2019-315595] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 04/03/2020] [Accepted: 04/07/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS To evaluate the non-invasive measurement of ocular rigidity (OR), an important biomechanical property of the eye, as a predictor of intraocular pressure (IOP) elevation after anti-vascular endothelial growth factor (anti-VEGF) intravitreal injection (IVI). METHODS Subjects requiring IVI of anti-VEGF for a pre-existing retinal condition were enrolled in this prospective cross-sectional study. OR was assessed in 18 eyes of 18 participants by measurement of pulsatile choroidal volume change using video-rate optical coherence tomography, and pulsatile IOP change using dynamic contour tonometry. IOP was measured using Tono-Pen XL before and immediately following the injection and was correlated with OR. RESULTS The average increase in IOP following IVI was 19±9 mm Hg, with a range of 7-33 mm Hg. The Spearman correlation coefficient between OR and IOP elevation following IVI was 0.796 (p<0.001), showing higher IOP elevation in more rigid eyes. A regression line was also calculated to predict the IOP spike based on the OR coefficient, such that IOP spike=664.17 mm Hg·µL×OR + 4.59 mm Hg. CONCLUSION This study shows a strong positive correlation between OR and acute IOP elevation following IVI. These findings indicate that the non-invasive measurement of OR could be an effective tool in identifying patients at risk of IOP spikes following IVI.
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Affiliation(s)
- Diane N Sayah
- Ophthalmology, Maisonneuve-Rosemont Hospital Research Centre, Montreal, Quebec, Canada.,Ophthalmology, University of Montreal, Montreal, Quebec, Canada
| | | | - Javier Mazzaferri
- Ophthalmology, Maisonneuve-Rosemont Hospital Research Centre, Montreal, Quebec, Canada
| | - Denise Descovich
- Ophthalmology, Maisonneuve-Rosemont Hospital Research Centre, Montreal, Quebec, Canada
| | - Renaud Duval
- Ophthalmology, Maisonneuve-Rosemont Hospital Research Centre, Montreal, Quebec, Canada.,Ophthalmology, University of Montreal, Montreal, Quebec, Canada
| | - Flavio A Rezende
- Ophthalmology, Maisonneuve-Rosemont Hospital Research Centre, Montreal, Quebec, Canada.,Ophthalmology, University of Montreal, Montreal, Quebec, Canada
| | - Santiago Costantino
- Ophthalmology, Maisonneuve-Rosemont Hospital Research Centre, Montreal, Quebec, Canada.,Ophthalmology, University of Montreal, Montreal, Quebec, Canada
| | - Mark R Lesk
- Ophthalmology, Maisonneuve-Rosemont Hospital Research Centre, Montreal, Quebec, Canada .,Ophthalmology, University of Montreal, Montreal, Quebec, Canada
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Melo GB, Cruz NFSD, Emerson GG, Rezende FA, Meyer CH, Uchiyama S, Carpenter J, Shiroma HF, Farah ME, Maia M, Rodrigues EB. Critical analysis of techniques and materials used in devices, syringes, and needles used for intravitreal injections. Prog Retin Eye Res 2020; 80:100862. [PMID: 32311476 DOI: 10.1016/j.preteyeres.2020.100862] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/23/2020] [Accepted: 04/02/2020] [Indexed: 12/26/2022]
Abstract
Intravitreal injections have become the most commonly performed intraocular treatments worldwide. Because intravitreal injections may induce severe adverse events, such as infectious and noninfectious endophthalmitis, cataract, ocular hypertension, vitreous hemorrhage, or retinal detachment, appropriate awareness of the materials and techniques used are essential to reduce these sight-threatening complications. This review provides insights into the needles, syringes, silicone oil coating, sterilization methods, devices to assist intravitreal injections, scleral piercing techniques using needles, syringe handling, anesthesia, and safety issues related to materials and techniques. It is paramount that physicians be aware of every step involved in intravitreal injections and consider the roles and implications of all materials and techniques used. The ability to understand the theoretical and practical circumstances may definitely lead to state-of-the-art treatments delivered to patients. The most important practical recommendations are: choosing syringes with as little silicone oil as possible, or, preferably, none; avoiding agitation of syringes; awareness that most biologics (e.g., antiangiogenic proteins) are susceptible to changes in molecular properties under some conditions, such as agitation and temperature variation; understanding that improper materials and techniques may lead to complications after intravitreal injections, e.g., inflammation; and recognizing that some devices may contribute to an enhanced, safer, and faster intravitreal injection technique.
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Affiliation(s)
- Gustavo Barreto Melo
- Hospital de Olhos de Sergipe, Rua Campo do Brito, 995, Aracaju, SE, Brazil; Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 806, São Paulo, SP, Brazil.
| | | | | | | | - Carsten H Meyer
- Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 806, São Paulo, SP, Brazil; Department of Ophthalmology, Philipps University of Marburg, Robert-Koch-Strasse 4, Marburg, Germany
| | - Susumu Uchiyama
- Department of Biotechnology, Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Osaka, Japan
| | - John Carpenter
- Department of Pharmaceutical Sciences, University of Colorado, Denver/Aurora, CO, USA
| | - Hélio Francisco Shiroma
- Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 806, São Paulo, SP, Brazil
| | - Michel Eid Farah
- Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 806, São Paulo, SP, Brazil
| | - Maurício Maia
- Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 806, São Paulo, SP, Brazil
| | - Eduardo Büchele Rodrigues
- Department of Ophthalmology, Federal University of São Paulo, Rua Botucatu, 806, São Paulo, SP, Brazil; Department of Ophthalmology, SSM Health Saint Louis University Hospital, Saint Louis University, 1755, S. Grand Boulevard, Saint Louis, MO, USA
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