Significant Increase In Intraocular Pressure Research Articles

Intraocular Pressure Measurements in Standing, Sitting, Prone, and Supine Positions.

In this study, intraocular pressure (IOP) was measured in sitting, supine, prone, and standing (ST) positions and again five minutes after standing (ST-5) utilizing a Tono-Pen AVIA in 124 eyes of 62 healthy subjects with ages ranging from 21 to 59 years (mean 30 ± 10 years). In each subject, the average IOP of both eyes was used for the statistical evaluation. The mean IOP difference between the ST and sitting positions was -0.13 ± 1.63 mmHg (p = 0.548); between ST-5 and sitting, it was 0.53 ± 1.24 mmHg (p = 0.001); between supine and sitting, it was 1.30 ± 1.48 mmHg (p < 0.001); between ST and supine, it was -1.43 ± 1.74 mmHg (p < 0.001); between ST-5 and supine, it was -0.77 ± 1.59 mmHg (p < 0.001); between prone and supine, it was 2.24 ± 1.92 mmHg (p < 0.001); between ST and ST-5, it was -0.67 ± 1.84 mmHg (range: -7.5 to 5 mmHg) (p = 0.007); between prone and ST, it was 3.46 ± 2.01 mmHg (p < 0.001); between ST-5 and prone, it was -2.46 ± 1.67 mmHg (p < 0.001); and between sitting and prone, it was -3.22 ± 1.56 mmHg (p < 0.001). The results show a significant IOP increase in the ST-5 position, suggesting that such measurements need to be performed in an attempt to explain the progression of glaucoma in apparently normal-tension patients.

Understanding the Ocular Hypertension Model in Mice Induced by Dexamethasone-21-Acetate – Implications for Glaucoma Research

Purpose This study aimed to assess the effectiveness of monocular and bilateral injections of Dexamethasone-21-acetate (Dex-21-Ac) into the murine fornix twice a week as a glucocorticoid-induced ocular hypertension model and investigated potential systemic side effects. Methods Dex-21-Ac was administered twice weekly in three groups: bilateral injections, monocular injections, and a control group receiving the vehicle solution bilateral. After 21 days, enucleated eyes were examined using immunocytochemistry (ICC), and organ histology was performed. Results All groups receiving Dex-21-Ac injections had a significant increase in intraocular pressure (IOP). Monocular injections also resulted in a significant increase in IOP in the fellow eye. The Dex-21-Ac-treated groups showed a bilateral increase in IOP of approximately 8 mmHg, accompanied by elevated expression of alpha smooth muscle actin and fibronectin in the anterior chamber angle. There were no significant changes in weight progression. Hepatic steatosis was observed in all Dex-21-Ac-treated animals, and some suffered from residual neuromuscular blockade under fentanyl anesthesia. Conclusion Bilateral injections of Dex-21-Ac twice a week lead to a significant increase in daytime IOP and fibrotic changes in the trabecular meshwork. Unilateral application has a significant impact on the fellow eye. Local dexamethasone leads to notable systemic effects independent of changes in animal weight. Considering liver damage and associated influence on metabolization, hepatically eliminated injection anesthetics may lead to overdosing and are not recommended. They should be replaced by inhalation anesthesia.

A Prospective, Randomized, Controlled Clinical Investigation Comparing the Efficacy and Safety of Sodium Hyaluronate-Based Ophthalmical Viscosurgical Devices FIDIAL PLUS and IAL®-F in Cataract Surgery.

Purpose: To protect the corneal endothelium, various ophthalmical viscoelastic devices (OVDs) are used during cataract surgery. In this study, we compared two sodium hyaluronate-based OVD, the bacteria-derived FIDIAL PLUS OVD (test) with the animal-derived IAL®-F OVD (reference) during the surgical procedure. Methods: Fifty patients with bilateral cataract participated in the study: 50 eyes randomly received FIDIAL PLUS and 50 eyes received IAL®-F (ratio 1:1). Noninferior efficacy of FIDIAL PLUS compared with reference OVD (first objective) was evaluated using a paired t-test comparing the mean percent loss of corneal endothelial cells (CECs) with FIDIAL PLUS against the mean percent loss with IAL®-F. Corneal endothelial protection during cataract surgery with FIDIAL PLUS without significant (≥30 mmHg) postoperative intraocular pressure (IOP) increase (main secondary objective) was assessed using a repeated measures logistic model comparing the incidence of significant postoperative IOP elevation between the two groups. Safety, tolerability, and efficacy were also evaluated by assessing secondary endpoints before and after surgery. Results: FIDIAL PLUS showed a statistically noninferior efficacy compared with IAL®-F; there was no significant increase in IOP in either group or different trends of the secondary endpoints were observed between the OVD groups. The safety profile was similar in both OVD groups and no adverse device effects were reported. Conclusions: This study demonstrates the equivalent efficacy, tolerability, and safety of the bacteria-derived FIDIAL PLUS compared with the animal-derived IAL®-F, confirming the clinical value of this product.

Psychological Stress and Intraocular Pressure in Glaucoma: A Randomized Controlled Trial

To evaluate the intraocular pressure (IOP) behavior after applying a standardized protocol to induce psychological stress in primary open-angle glaucoma (POAG) patients. Randomized controlled trial. A total of 39 POAG patients were included: 18 in the stress group and 21 in the control group. Patients were randomized to undergo the Trier Social Stress Test (TSST) or to be included in the control group. All participants were submitted to a modified diurnal tension curve (DTC) 1 to 4 weeks before randomization, with 3 IOP measurements performed between 8:00 AM and 2:00 PM. We evaluated the response to the TSST by measuring the levels of salivary cortisol, salivary amylase, IOP, mean arterial pressure and heart rate before, immediately after, and 40 minutes after the TSST. The State Trait Anxiety Inventory (STAI) was applied to evaluate the levels of anxiety at the same time intervals. Changes in IOP (mmHg), salivary cortisol and amylase, heart rate, mean arterial pressure and STAI scores. At baseline, there were no significant differences between the groups regarding age (P=0.661), gender (P=0.669), salivary cortisol (P=0.104) and mean DTC IOP for the right (P=0.439) and left (P=0.576) eyes. We observed a significant mean IOP increase of 3.8 mmHg (right eye, P<0.001) and 4.1mmHg (left eye, P<0.001) when we compared IOP measurements obtained during the DTC and immediately after TSST. Salivary cortisol (5.9 nmol/L, P=0.004), salivary amylase (323,388 UL, P=0.004), mean arterial pressure (10.1mmHg, P<0.001) and heart rate (12.9bpm, P<0.001) also increased significantly after the TSST. In addition, 61.1% (11 out of 18) of the patients in the TSST group showed an IOP increase greater than 4 mmHg following the test. The STAI-state score significantly increased after the TSST compared to baseline (P<0.001) and decreased from post-stress to the recovery period (P<0.001). POAG patients present significant elevations of IOP, salivary cortisol and amylase, mean arterial pressure, heart rate and STAI scores after psychological stress induced by the TSST.

The effect of cycloplegia on intraocular pressure with and without adjusting for central corneal thickness in patients with diabetes mellitus

PurposeTo assess and compare the effects of cycloplegia using 0.5% tropicamide and 1% tropicamide on intraocular pressure (IOP) in patients with diabetes mellitus, with and without considering adjustments for central corneal thickness (CCT). MethodsA total of 98 eyes of 98 patients with open angles were included. Patients were randomly assigned to receive either 0.5% tropicamide (49 eyes) or 1% tropicamide (49 eyes). IOP was measured by Goldmann applanation tonometry. Pupillary diameter and CCT were measured by a Pentacam HR (Oculus Optikgeräte GmbH, Wetzlar, Germany) before and 30 min after tropicamide administration. ResultsThe mean IOP change was 0.12 ± 1.71 mmHg in the 0.5% tropicamide group and 0.25 ± 1.70 mmHg in the 1% tropicamide group. These two values were not significantly different, even after adjusting IOP for CCT using all formulae (P > 0.05). Without adjustment, the mean post-dilation IOP was similar to the mean pre-dilation IOP in both groups (P > 0.5), and none of the patients experienced an IOP increase of 5 mmHg or more. With adjustment, the mean IOP increased significantly after administration of 0.5% tropicamide, as determined by the Ehlers formula (P = 0.02). Similarly, the mean IOP increased significantly after administration of 1% tropicamide, as determined by the Ehlers formula (P = 0.008), the Doughty formula (P = 0.03), and the Kohlhaas formula (P = 0.04). In each study group, a single patient encountered an increase in IOP ≥5 mmHg when IOP adjustment was performed using the Ehlers formula. ConclusionCycloplegia with 0.5% and 1% tropicamide leads to similar mean changes in IOP in patients with diabetes. However, the statistical significance of the change and the occurrence of the significant increases in IOP, as determined by a predefined cut-off point, are dependent upon the method used to adjust the IOP.

Clinical outcomes of a modified ophthalmic viscosurgical device-free implantable collamer lens implantation.

To investigate the efficacy and safety of a modified dual-incision ophthalmic viscosurgical device-free (OVD-free) method for implantable collamer lens (ICL) implantation in high myopic eyes. A total of 68 participants were enrolled in this prospective randomized clinical trial, including 33 in the OVD-free group and 35 in the standard group. Operation time and intraocular pressure (IOP) at 2 hours postoperatively were recorded. Visual acuity, refractive power, IOP, corneal endothelium parameters, and anterior segment parameters were assessed at 1 day, 1 week, 1 month, 3 months, and 6 months postoperatively. Postoperative subjective visual quality at 3 months was recorded through a Quality of Vision (QoV) questionnaire. No significant differences in visual acuity, refractive outcomes, and corneal endothelial parameters were found, while the operation time was significantly shorter in the OVD-free group. Both groups showed a significant increase in IOP at 2 hours after surgery, but the increase in the OVD-free group was significantly smaller than that in the standard group. In addition, the frequency of ring-shaped dysphotopsia in the OVD-free group (15.15%) was significantly lower than that in the standard group (40%), and the severity and annoyance of this symptom were also significantly lower in the OVD-free group. The modified OVD-free ICL implantation is a safe, effective, and predictable method for myopia correction, which could be a better choice for short surgery time, better subjective visual perception, and low occurrence of IOP elevation.

Safety and Effectiveness of Intravitreal Brolucizumab Injection in Combination With Sub-Tenon's Capsule Triamcinolone Acetonide Injection for Polypoidal Choroidal Vasculopathy During the Loading Phase.

This study evaluated the safety and effectiveness of combining intravitreal brolucizumab injection with sub-tenon's capsule triamcinolone acetonide injection (STTA) during the loading phase for polypoidal choroidal vasculopathy (PCV). In this retrospective observational study, untreated patients with PCV receiving intravitreal brolucizumab injections with STTA during loading at Saitama Medical University Hospital's Eye Center from May 2021 to June 2022 were analyzed. Complete regression rates of polypoidal lesions were assessed using indocyanine green angiography 12 weeks post-treatment initiation. Nineteen patients (19 eyes) participated. Best-corrected visual acuity significantly improved at eight weeks compared to baseline. No significant intraocular pressure increases occurred throughout the loading phase, while central foveal and choroidal thickness significantly reduced at 4, 8, and 12 weeks. Subretinal fluid was present in all patients before treatment, rapidly resolving post-intravitreal brolucizumab injections and STTA, with residual rates of 36.8% (seven eyes) and 5.3% (one eye) at four and 12 weeks, respectively. Intraocular inflammation did not occur during the loading phase, and the complete regression rate of polypoidal lesions was 89.5% (17 eyes). Combining intravitreal brolucizumab injection with STTA during the loading phase may be one treatment option for PCV management.

Impact of positive airway pressure therapy on intraocular pressure in obstructive sleep apnea: A systematic review.

Positive airway pressure (PAP) therapy has been reported to have variable effect on intraocular pressure (IOP) in patients with obstructive sleep apnea (OSA) . The objective of this review is to present a qualitative assessment of available literature on impact of PAP on IOP in patients of OSA.Method: Online databases were searched for relevant articles up to September 2023. It included randomized control trial (RCT), prospective observational study, case control study, cross-sectional study, published abstract having relevant information. The comparator group consisted of OSA patients not receiving the PAP therapy or the pre-PAP IOP. Studies reporting change in IOP immediately after PAP use, at 1 month and at 1 year of PAP use were included. For quality assessment Cochrane Risk of Bias tool version 2 and NIH study quality assessment tool for Before-After (Pre-Post) Studies with No Control Group was used.Result: In this systematic review of ten clinical studies with 191 patients of OSA, use of continuous positive airway pressure (CPAP) therapy led to an immediate increase in IOP but it was not significantly different from non-CPAP users. One month and 1 year of CPAP use led to a significant increase in IOP from the baseline value. The available albeit limited evidence suggests that CPAP use, particularly at higher pressures, is linked to an elevation in IOP. However, high quality evidence from well-designed RCTs is needed to confirm or refute this findings.

Effect of anti-VEGF on retinal blood flow in diabetic mice using laser speckle flowgraphy.

To assess intra- (repeatability) and inter-observer (reproducibility) variability of laser speckle flowgraphy (LSFG) for retinal blood flow (RBF) measurement in 20 eyes of wild type (C57BL/6J) mice and effect of intravitreal Aflibercept on RBF in optic nerve head (ONH) region of 10 eyes of Ins2 (Akita) diabetic mice. 'Mean blur rate (MBR)' was measured for all quadrants of tissue area (MT), vessel (MV) and total area (MA) of ONH region. Changes in MT were analysed at each timepoint. Repeatability was evaluated by measuring MBR variability without changing mouse head position, and reproducibility after resetting mouse head position by another operator. Coefficient of repeatability (CR) through Bland-Altman plot method coefficient of variation (COV) and Intraclass correlation coefficient (ICC) was calculated. Intravitreal Aflibercept (1 μg) was administered to Akita eyes and intraocular pressure (IOP) was measured using a tonometer at baseline, day 7, 14, 21 and 28 post-injection. Hurvich and Tsai's criterion was used. Coefficient of repeatability values of repeatability and reproducibility for all quadrants were within limits of agreement. Reliability was excellent (ICC 0.98-0.99) and reproducibility was moderate to excellent (ICC 0.64-0.96). There was a non-significant IOP increase in all Akita eyes at Day 28 (p > 0.05), and significant increase in MT in all quadrants at Day 21 and superior, inferior and temporal quadrants at Day 28 (p < 0.05). Laser speckle flowgraphy demonstrates excellent repeatability and moderate to excellent reproducibility in measuring RBF. Intravitreal Aflibercept injection results in a significant increase in MT up to 28 days post-injection without significant increase in IOP.

Secondary Neovascular Glaucoma in the Course of Diabetes in a Kidney Transplant Recipient: Case Report and Review of the Literature

The increase in intraocular pressure during hemodialysis challenges nephrologists and ophthalmologists. It most often affects patients with previously diagnosed glaucoma and is particularly dangerous in the setting of diabetic retinopathy. Hypoperfusion and hypoxia of the retina may occur, leading to pathologic neovascularization in the retina and the anterior chamber angle. Changes in the filtration angle block the outflow of aqueous humor and cause secondary glaucoma. A special type of glaucoma is neovascular glaucoma, developing among others in patients with diabetic retinopathy. This study describes a patient with secondary neovascular glaucoma in whom a significant increase in intraocular pressure was observed during hemodialysis, not responding to the applied topical treatment. The patient experienced severe pain, and her cornea was constantly injured by paracentesis. Ultimately, secondary glaucoma led to a significant decrease in vision in both eyes. The patient was enrolled on a transplant waiting list and transplanted with priority. The patient experienced some urologic and infectious complications, although 7 months after transplantation, her creatinine concentration was 1.2 mg/dL, and the ocular disease was stabilized. The intraocular pressure decreased, but there were still values above the norm, which required periodic injections of anti-vascular endothelial growth factor into the vitreous chamber and 5-fluorouracil injections under the conjunctiva. Patients with diabetes and secondary neovascular glaucoma on dialysis constitute an extremely difficult therapeutic problem and require the involvement of several specialists. Successful kidney transplantation, besides ameliorating general clinical conditions, may increase the chance of successful ophthalmologic treatment.

Long-term observation of V4c implantable collamer lenses implantation for moderate to extreme high myopia correction: five years follow-up.

This study aims to assess the long term effectiveness, safety, predictability and stability of V4c implantable collamer lenses (ICL) for correction of moderate to extreme high myopia. We reviewed 125 eyes from 64 patients who implanted V4c ICL at the Refractive Surgery Center of West China Hospital in Chengdu, China, between May 2015 and January 2017. The median spherical equivalent was -11.50 D (interquartile range [IQR]: -13.00 to -9.00 D). We followed up with the patients over five years and evaluated several parameters, including uncorrected visual acuity (UDVA), corrected visual acuity (CDVA), axial length, refractive error, endothelial cell density (ECD), intraocular pressure (IOP), white-to-white distance (WTW), and vault. We performed a correlation analysis to explore the potential impacts on vault following implantation. The median safety index (postoperative CDVA/preoperative CDVA) during the last follow-up was 1.00 (interquartile range [IQR]: 1.00-1.20), and the efficacy indices (postoperative UDVA/preoperative CDVA) were 1.20 (IQR: 1.00-1.25), 1.20 (IQR: 1.00-1.33), and 0.8 (IQR: 0.65-1.00) at postoperative 1 week, 1 month, and 5 years, respectively. At the five-year mark, 16% of the eyes were within ±0.50 D of expected correction, and 73% were within ±2.00 D. No significant difference in ECD was observed between pre-operative and post-operative measurements. Compared to baseline, we observed a significant increase in IOP at the one-week follow-up, which decreased significantly at the one-month visit. Furthermore, we identified ICL size and spherical equivalent (SE) as independent variables in a multiple linear regression model that accurately predicted the five-year vault after surgery. In conclusion, V4c ICL implantation is an effective and safe treatment for moderate to extreme high myopia with good predictability and stability over the long-term.

Effect of silicone oil versus gas tamponade on macular layer microstructure after pars plana vitrectomy for macula on rhegmatogenous retinal detachment

PurposeTo analyze structural changes in the macular retinal layers and sub-foveal choroidal thickness (SFCT) in eyes after macula-on rhegmatogenous retinal detachment (RRD) repair by pars plana vitrectomy with either silicone oil (SO) or gas tamponade, and the effect of these changes on visual acuity.Patients and methodsRetrospective study which included 26 eyes in the SO Group and 32 in the Gas Group. Optical coherence tomography (OCT) scans of the affected eyes were obtained before surgery, and 3 months after PPV in the Gas Group, and during silicone oil in situ and 3 months after SO removal, in the SO Group. Qualitative assessment of photoreceptor layer and foveal contour, along with quantitative assessment of macular retinal thickness and SFCT was performed. Postoperative OCT macular microstructural changes were recorded and correlated to corrected distance visual acuity (CDVA). Intraocular pressure (IOP) was measured preoperative and at 3 months post operative.ResultsThere was a 2-line loss (from 20/28 preoperatively to 20/40 at final follow-up) of CDVA in the SO Group (p=0.051), while there was no statistically significant change in CDVA in the Gas Group (p=0.786). There was no significant correlation between CDVA loss and duration of silicon tamponade (r=-0.031, p=0.893). There was a statistically significant increase in IOP from its baseline to final follow-up of 0.7 mmHg in the SO Group (p=0.023) while there was no statistically significant change in IOP in the Gas Group. During silicone oil tamponade, there was approximately 11% and 5% of retinal and sub-foveal choroidal thinning respectively, which was moderately resolved following silicone oil removal. 20% (5/24) of eyes in the SO Group had qualitative flattening of foveal contour during SO tamponade that resolved after SO removal.ConclusionThinning of the macula was noticed after macula-on RRD repair with SO tamponade. Such thinning was only partially reversible after the removal of SO.

Dexamethasone Implant under a Proactive Treatment Regimen in a Clinical Setting: The ProDEX Study

To assess the effectiveness of switching intravitreal dexamethasone implants (DEX-implant) from pro re nata (PRN) treatment regimen to a proactive regimen in patients with macular edema of diverse etiologies. An observational, retrospective, uncontrolled, multicenter, national case series. Eighty-one eyes from 68 patients treated between October 2015 and June 2023 were included. This study included consecutive eyes treated with DEX-implant who were switched from a PRN regimen to a proactive regimen for diabetic macular edema (DME), retinal vein occlusion (RVO), noninfectious uveitis macular edema (UME; including postsurgical macular edema), and radiation maculopathy (RM). The main outcome measures were change in the best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) at each visit. According to the etiology, DME represented 49.4% of eyes, UME 24.3%, RVO 21.0%, and RM 6.2%. The mean (standard deviation [SD]) duration of follow-up under the PRN and proactive regimens was 20.6 (13.3) and 14.2 (10.3) months, respectively. Switching from a PRN to a proactive regimen significantly improved mean (SD) BCVA by 3.7 (12.9) ETDRS letters (P= 0.01) with a mean (SD) decrease in CMT of 108.0 (151.4) μm (P< 0.001). The proportion of visits with significant anatomic recurrence (> 50 μm) also decreased from 40.1% to 6.0% after switching to a proactive regimen (P < 0.001). The number of DEX-implant injections significantly increased during the proactive treatment period (P < 0.001), but the change in the number of visits was not significantly different (P= 0.2). The proactive treatment period was not associated with a significant increase in IOP (P= 0.6). Switching to a proactive regimen in patients already treated with DEX-implant seems to significantly improve BCVA and CMT while maintaining stable IOP. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

The Effect of Esophagogastroduodenoscopy on Intraocular Pressure.

Esophagogastroduodenoscopy (EGD) is an endoscopic examination of the upper gastrointestinal tract that requires insufflation with gas, leading to intra-abdominal hypertension (IAH). There is evidence suggesting that IAH positively correlates with intracranial pressure (ICP) and possibly with intraocular pressure (IOP). The aim of this study was to examine the effect of a routine screening EGD on the IOP. In this observational study, 25 patients were recruited; 15 males with a mean age of 50 ± 18 years and 10 females with a mean age of 45 ± 14 years. EGD was conducted under sedation in 21 subjects. Both eyes' IOP measurements were performed using Tonopen Avia in the sitting and left lateral decubitus positions before sedation and the start of EGD, and subsequently in the left lateral decubitus position when the endoscope reached the duodenum (D2) and at the end of the procedure. The final measurement was performed in the sitting position 10 min after the end of the procedure. The mean IOP in the sitting position was 15.16 ± 2.27 mmHg, and in the left lateral decubitus position, 15.68 ± 2.82 mmHg. When the gastroscope entered the D2, it was 21.84 ± 6.55 mmHg, at the end of the procedure, 15.80 ± 3.25 mmHg, and 10 min later, 13.12 ± 3.63 mmHg. There was a statistically significant IOP increase when the gastroscope entered the duodenum (p < 0.01). At the end of the gastroscopy, the IOP significantly decreased compared to the one registered when the gastroscope entered the D2 (p < 0.001) and it became similar to the values measured before the EGD, in the same left lateral decubitus position (p > 0.05). Significant changes in IOP were observed during the EGD. IOP fluctuations during EGD should be taken into account, especially in patients that need repeated EGDs during their life or in patients with glaucoma. Further studies are needed to better understand the short-effect and long-effect influence of an IOP increase in these patients.

Comparing the effects of intraocular pressure and tear production measurements in horses in two different environments: Horse stable and medical barn.

To date, there are no studies on the impact of two distinct environments-one familiar to the horse and another unfamiliar-on intraocular pressure (IOP) and tear production. To compare the measured IOP and tear production values in horses between a horse stable and a medical barn. Cross-over. Thirty healthy male Arabian horses, aged 6.88 ± 3.34 years were used. IOP and tear production measurements were assessed in both the horse stable and the medical barn, with a paired Student's t-test and Bland-Altman analysis conducted for comparison and agreement, respectively. A significant increase in IOP was observed in the medical barn (34.2 ± 6.8 mmHg) compared with the horse stable (29.5 ± 7.2 mmHg, p = 0.02). However, no statistically significant difference in tear production was found between horse stable (22.1 ± 2.8 mm/min) and medical barn (23.6 ± 3.4 mm/min) (p = 0.09). The standard error of the slope was 0.36 for the IOP measured in the medical barn, indicating a difference of -4.7 mmHg compared with the IOP measured in the horse stable (p = 0.02). The bias was fitted to y = -7.9350 + 0.1003x. The standard error of the slope was 0.39 for the tear production measured in the medical barn, indicating a difference of -1.5 mm/min compared with the tear production measured in the horse stable (p = 0.09). The bias was fitted to y = 6.1530 + -0.3367x. The absence of horses with ocular disorders and an assessment of the potential impact of transportation. A notable increase in IOP was observed in the medical barn compared with the horse stable, while tear production exhibited no significant variance between the two environments. The Bland-Altman analysis highlighted a discrepancy in IOP measurements in the horse stable, emphasising the potential influence of the environment on ocular parameters in horses.

Intraocular pressure increase after Nd:YAG laser capsulotomy and anterior segment optical coherence tomography analysis.

This study is to determine whether post-procedure intraocular pressure (IOP) increase is associated with the anterior chamber angle in cases of Neodymium: yttrium-aluminum garnet (Nd: YAG) laser capsulotomy. The study included 51 eyes with posterior capsule opacification. Initial IOP values of the patients were compared with IOP values without intraocular pressure-lowering administration at the end of the 1st hour, 1st day, 3rd day, and 7th day after Nd:YAG laser capsulotomy. The anterior segment angle configuration was evaluated using anterior segment optical coherence tomography analysis without dilatation before the procedure. The anterior chamber angle (ACA) and angle opening distances of 500 and 750 μm (AOD500 and AOD750) in the nasal and temporal quadrants were examined. The mean pre-laser IOP value only increased significantly at 1st hour post-laser (13.02 ± 3.02 mmHg vs 14.16 ± 4.07 mmHg, p = 0.016). In eyes with ACA below 40° in both the nasal and temporal quadrants, mean IOP increased significantly at 1st hour post-laser (p = 0.025 and p = 0.032, respectively), while it was not significant in eyes with ACA above 40° (p > 0.05). No correlation was found between ACA, AOD500, and AOD750 values and IOP changes at the first hour (p > 0.05). Except for the first hour after Nd:YAG laser capsulotomy, no significant increase in IOP was observed. This elevation was higher in eyes with ACA less than 40°. In patients with a narrow ACA, first-hour follow-up may be beneficial in terms of susceptibility to increased IOP.

Comparison of RCI001 and corticosteroid on the effects on intraocular pressure in mice.

RCI001, a novel therapeutic candidate for the treatment of ocular inflammatory diseases, have demonstrated remarkable anti-inflammatory and antioxidant effects in various ocular experimental models. This study was to evaluate the effects of RCI001 on intraocular pressure (IOP) and compare them with those of corticosteroids in experimental mouse models. Experimental mice were randomly divided into naïve, phosphate-buffered saline (PBS), 0.1% dexamethasone (DEX-1), and 1% RCI001 (RCI) groups, and each reagent was pipetted into the right eye of the mouse at 10 μL thrice daily for 5 weeks. In addition, 20 μL of 0.1% dexamethasone was injected subconjunctivally into the right eye once weekly for 5 weeks in the DEX-2 group. The IOP was measured under anesthesia at baseline and twice weekly for 5 weeks. The △IOP (%) was defined as the change in IOP from baseline [△IOP (%) = (IOPweek5-IOPbaseline)/IOPbaseline × 100%]. The anterior segments were clinically and histologically examined. There was no significant increase in IOP and △IOP (%) [values by week 3 (day 21) in any of the groups]. However, IOP and △IOP (%) in the DEX-2 group tended to increase slightly after day 10 compared with baseline. Compared with baseline IOP values, the DEX-1 group showed a statistically significant increase in IOP at weeks 4 and 5, and the DEX-2 group at week 5. The △IOP (%) of the DEX-1 and DEX-2 groups (%) at week 5 were 38.2% ± 5.8% and 38.4 ± 4.6%, respectively. However, the IOP in the RCI group did not increase significantly until week 5. The RCI group did not show notable corneal changes, such as epithelial defects or stromal opacities, at week 5. In addition, hematoxylin and eosin (H&E) staining of corneas in the RCI group revealed healthy corneal epithelial, stromal, and endothelial integrity. Long-term use of RCI001 did not induce significant IOP elevation or ocular surface changes, whereas topical corticosteroids significantly increased the IOP. Therefore, RCI001 may be an effective anti-inflammatory agent with a low risk of drug-induced IOP elevation.

Intraocular Pressure Variations in Postural Changes: Comparison between Obese and Non-Obese Controls.

Comparing intraocular pressure (IOP) changes (ΔIOP) between obese subjects and non-obese controls in relation to different positions: standing, sitting, supine. the IOP was measured in both obese patients and non-obese controls groups with Tono-Pen AVIA in different positions following this sequence: after 5 min (5') in the standing position, sitting, supine, supine after 5 min (supine 5') and immediately after standing. ΔIOP values obtained comparing all positions were, therefore, evaluated. 92 eyes of 46 obese subjects aged between 18 and 59 years (mean 38.07 ± 11.51 years) and of a Body Mass Index (BMI) between 31.84 and 60.65 (mean 41.84 ± 7.05) were evaluated. A total of 48 eyes of 24 non-obese controls aged between 23 and 55 (mean 35.21 ± 11.96 years) and of a BMI between 18.20 and 26.79 (mean 21.04 ± 2.36) were also recruited. In obese subjects, there were statistically significant differences between the IOP in the supine position and the supine positions 5' with all other IOP measurements (p < 0.05). There were statistically significant differences between ΔIOP in both supine positions and prolonged standing positions obtained by obese subjects and non-obese controls (p < 0.05). In obese subjects, there is a statistically significant increase in IOP in the supine positions that is significantly greater than the non-obese population. BMI is weakly correlated with IOP and ΔIOP in postural changes.

Oculars Pain and Intraocular Hypertension in Hemodialysis Patient with Glaucoma: A Case Report and Review of the Literatures

Resistance hypertension in hemodialysis patient usually is common and sometimes difficult to get achieved target blood pressure control. In patient with intradialytic hypertension, eye pain may occur which can be relate to the severity of the hypertension itself. Hemodialysis has relationship to Intraocular Pressure (IOP). Hemodialysis was be Increased Intraoccular Pressure (IOP) and may be the cause of eye pain during hemodialysis due to ocular dialysis disequilibrium. And this receives inadequate attention by nephrologist as a cause of intradialytic hypertension. In this article, we report a patient with resistant hypertension who complain of right eye pain during and after dialysis. After anterior chamber tapping and the aqueous humor was drained. The symptoms and hypertension improved. Undetected significant increase in IOP during hemodialysis may lead to permanent optic nerve damage and should be recognized as a cause of hypertension. An interesting point of this report was the intraocular hypertension get worsed in hemodialysis patients and could be a cause of resistance hypertension. We suggest regular ophthalmologic evaluation in ESKD (End Stage Kidney Disease) patients should be necessary especially in the patient with poorly controlled hypertension, have previous glaucoma, diabetic retinopathy, eye pain, blurred vision, conjunctivitis and headache.

The Short-Term Effect of 1% Tropicamide Drop on Pupillary Diameter and Intraocular Pressure Change in Patients With Pseudoexfoliation Material.

In this study, in patients with pseudoexfoliation syndrome (PXS) or glaucoma, changes in intraocular pressure (IOP) and pupil size after 1% tropicamide used for pupil dilation, compared with healthy patients were quantitatively demonstrated up to 4 hours after dilation. The purpose of this study was to evaluate pharmacological dilatation with one drop of 1% tropicamide on pupillary diameter and IOP changes in patients with PXS and glaucoma (PXG). Eighty-two patients with PXS, 78 Patients with PXG, and 35 healthy subjects were included in the study. PXG and PXS were diagnosed based on IOP assessment, corneal pachymetry, optic disc examination, visual field testing, and peripapillary retinal nerve fiber analysis. IOP and the diameter of pupil size were measured before dilatation and at postdilatation first, second, and fourth hours. The mean pupillary diameter values at postdilatation second and fourth hours were statistically significantly different between the patients with PXS and PXG ( P <0.001, for each). Also, there were significant differences between the PXS group and the control group in terms of the mean pupillary diameter values at predilatation and postdilatation at the first hour and postdilatation second hour ( P =0.007, <0.001, respectively). The mean pupillary diameter at all times was statistically significantly different between PXG and control groups ( P <0.001 for each). Significant IOP increases were observed in all groups after dilatation. The mean IOP at predilatation and postdilatation fourth hour was statistically significantly different between PXG and PXS groups ( P =0.042, <0.001, respectively). Whereas the mean IOP at predilatation, postdilatation first hour, postdilatation second hour, and postdilatation fourth hour were statistically significantly different between PXG and control group ( P <0.001 for each). Significant IOP increases have been observed in our study with 1% tropicamide in the PXG and PXS groups, with the peak effect at the second hour in the postdilatation period. Furthermore, the mean pupil diameter was found to be significantly lower in PXG patients compared with the control group.