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  1 / 5855 MEDLINE  
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PMID:29368595
Autor:Park J; Lee M
Endereço:Department of Ophthalmology, College of Medicine, Dankook University, 119, Dandae-ro, Dnognam-gu, Cheonan-si, Chungchungnam-do, Republic of Korea.
Título:Short-term effects and safety of an acute increase of intraocular pressure after intravitreal bevacizumab injection on corneal endothelial cells.
Fonte:BMC Ophthalmol; 18(1):17, 2018 Jan 25.
ISSN:1471-2415
País de publicação:England
Idioma:eng
Resumo:BACKGROUND: The purpose of this study is to evaluate short-term effects and safety of an acute increase of intraocular pressure (IOP) after single-dose intravitreal bevacizumab injection on corneal endothelial cells and central corneal thickness. METHODS: Forty-two patients who underwent intravitreal injection of 2.5 mg/0.1 ml bevacizumab because of central serous chorioretinopathy or diabetic macular edema were included in this study. The changes of IOP, corneal endothelial cells, and corneal thickness at baseline, 2 min, 5 min, and 30 min after injection were analyzed prospectively with a specular microscope. RESULTS: In all patients, the mean IOPs at baseline, 2 min, 5 min, and 30 min after injection were 11.48 ± 2.22 mmHg, 49.71 ± 10.73 mmHg, 37.64 ± 11.68 mmHg, and 14.88 ± 4.77 mmHg, respectively. These changes were significant (p < 0.01). In only one eye, IOP did not decrease to ≤30 mmHg even at 30 min after injection. According to changes in IOP with time, the coefficient of variation of the corneal endothelium significantly increased (p = 0.03), but cell density, hexagonality of the corneal endothelium, and central corneal thickness did not change (p = 0.79, 0.21, and 0.08, prospectively). One week after injection, there was no sign of inflammation or any other complications in all 42 eyes. CONCLUSIONS: After intravitreal injection, IOP rapidly increases, then decreases to the normal range in most eyes 30 min after injection and it is tolerable to corneal endothelium. TRIAL REGISTRATION: Clinical Research Information Service (CRiS), Republic of Korea, KCT0002645 . Retrospectively registered 9 January 2018.
Tipo de publicação: CLINICAL TRIAL; JOURNAL ARTICLE
Nome de substância:0 (Angiogenesis Inhibitors); 0 (Vascular Endothelial Growth Factor A); 2S9ZZM9Q9V (Bevacizumab)


  2 / 5855 MEDLINE  
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PMID:29301514
Autor:McCafferty S; Levine J; Schwiegerling J; Enikov ET
Endereço:Department of Ophthalmology, Intuor Technologies, University of Arizona- College of Medicine, University of Arizona- College of Optical Science, LLC 6422 E. Speedway Blvd. Suite 100, Tucson, AZ, 85710, USA. sjmccafferty66@hotmail.com.
Título:Goldmann and error correcting tonometry prisms compared to intracameral pressure.
Fonte:BMC Ophthalmol; 18(1):2, 2018 Jan 04.
ISSN:1471-2415
País de publicação:England
Idioma:eng
Resumo:BACKGROUND: Compare Goldmann applanation tonometer (GAT) prism and correcting applanation tonometry surface (CATS) prism to intracameral intraocular pressure (IOP), in vivo and in vitro. METHODS: Pressure transducer intracameral IOP was measured on fifty-eight (58) eyes undergoing cataract surgery and the IOP was modulated manometrically to 10, 20, and 40 mmHg. Simultaneously, IOP was measured using a Perkins tonometer with a standard GAT prism and a CATS prism at each of the intracameral pressures. Statistical comparison was made between true intracameral pressures and the two prism measurements. Differences between the two prism measurements were correlated to central corneal thickness (CCT) and corneal resistance factor (CRF). Human cadaver eyes were used to assess measurement repeatability. RESULTS: The CATS tonometer prism measured closer to true intracameral IOP than the GAT prism by 1.7+/-2.7 mmHg across all pressures and corneal properties. The difference in CATS and GAT measurements was greater in thin CCT corneas (2.7+/-1.9 mmHg) and low resistance (CRF) corneas (2.8+/-2.1 mmHg). The difference in prisms was negligible at high CCT and CRF values. No difference was seen in measurement repeatability between the two prisms. CONCLUSION: A CATS prism in Goldmann tonometer armatures significantly improve the accuracy of IOP measurement compared to true intracameral pressure across a physiologic range of IOP values. The CATS prism is significantly more accurate compared to the GAT prism in thin and less rigid corneas. The in vivo intracameral study validates mathematical models and clinical findings in IOP measurement between the GAT and CATS prisms.
Tipo de publicação: JOURNAL ARTICLE


  3 / 5855 MEDLINE  
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PMID:29278546
Autor:Meier-Gibbons F; Berlin MS; Töteberg-Harms M
Endereço:Eye Center Rapperswil, Merkurstrasse 50, Rapperswil, Switzerland.
Título:Twenty-four hour intraocular pressure measurements and home tonometry.
Fonte:Curr Opin Ophthalmol; 29(2):111-115, 2018 Mar.
ISSN:1531-7021
País de publicação:United States
Idioma:eng
Resumo:PURPOSE OF REVIEW: IOP is the only treatable risk factor contributing to glaucoma and most management and treatment of glaucoma is based on IOP. However, current IOP measurements are limited to office hours and control of glaucoma in many patients would benefit from the ability to monitor IOP diurnally so as not to miss abnormal pressures, which occur outside of office hours Consequently, to improve patient care, the ability to enable accurate and minimally disruptive diurnal IOP monitoring would improve caring for these patients. RECENT FINDINGS: The studies we selected for this review can be divided into three categories: self-/home-tonometry, continuous invasive intraocular pressure measurements, and continuous noninvasive ocular measurements. SUMMARY: The desire to obtain better insight in our patients' true diurnal IOP has led to the development of home-tonometers, in addition to extraocular and intraocular continuous pressure measurement devices. All of the devices have respective advantages and disadvantages, but none to date completely fulfills the goal of providing a true diurnal IOP profile.Video abstracthttp://links.lww.com/COOP/A27.
Tipo de publicação: JOURNAL ARTICLE; REVIEW


  4 / 5855 MEDLINE  
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PMID:29393309
Autor:Ali S; Ranney ML; Jarman AF
Endereço:Resident Physician, Department of Emergency Medicine, Alpert Medical School of Brown University.
Título:Transient Orbital Compartment Syndrome Caused by Spontaneous Lamina Papyracea Dehiscence.
Fonte:R I Med J (2013); 101(1):30-32, 2018 Feb 02.
ISSN:2327-2228
País de publicação:United States
Idioma:eng
Resumo:Orbital compartment syndrome typically occurs due to trauma or burns. Here we discuss a case of spontaneous lamina papyracea dehiscence associated with transient orbital compartment syndrome. A previously healthy woman presented to the Emergency Department complaining of unilateral eye pain after nose blowing. The patient did not have any pupillary or extra-ocular movement abnormalities; however, she did have mildly decreased visual acuity in the affected eye. Intraocular pressure was found to be elevated and a subsequent CT scan showed orbital emphysema with spontaneous dehiscence of the lamina papyracea. The intraocular pressure decreased within hours, and ultimately, she required no intervention. [Full article available at http://rimed.org/rimedicaljournal-2018-02.asp].
Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE


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PMID:29390457
Autor:Xu X; Xiao H; Guo X; Chen X; Hao L; Luo J; Liu X
Endereço:State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Título:Diagnostic ability of macular ganglion cell-inner plexiform layer thickness in glaucoma suspects.
Fonte:Medicine (Baltimore); 96(51):e9182, 2017 Dec.
ISSN:1536-5964
País de publicação:United States
Idioma:eng
Resumo:The purpose is to assess the diagnostic ability for early glaucoma of macular ganglion cell-inner plexiform layer (GCIPL) thickness in a Chinese population including glaucoma suspects.A total of 367 eyes with primary open-angle glaucoma (168 early glaucoma, 78 moderate glaucoma, and 121 advanced glaucoma), 52 eyes with ocular hypertension (OHT), 59 eyes with enlarged cup-to-disc ratio (C/D), and 225 normal eyes were included. GCIPL thickness (average, minimum, superotemporal, superior, superonasal, inferonasal, inferior, and inferotemporal), retinal nerve fiber layer (RNFL) thickness, and optic nerve head (ONH) parameters were measured using Cirrus high-definition optical coherence tomography (OCT) and compared. The diagnostic ability of OCT parameters was assessed by area under receiver operating characteristic curve (AUROC) in 3 distinguishing groups: normal eyes and eyes with early glaucoma, normal eyes and eyes with glaucoma regardless of disease stage, and nonglaucomatous eyes (normal eyes, eyes with OHT, and enlarged C/D) and early glaucomatous eyes.Glaucomatous eyes showed a significant reduction in GCIPL thickness compared with nonglaucomatous eyes. In all 3 distinguishing groups, best-performing parameters of GCIPL thickness, RNFL thickness, and ONH parameters were minimum GCIPL thickness (expressed in AUROC, 0.899, 0.952, and 0.900, respectively), average RNFL thickness (0.904, 0.953, and 0.892, respectively), and rim area (0.861, 0.925, and 0.824, respectively). There was no statistical significance of AUROC between minimum GCIPL thickness and average RNFL thickness (all P > .05).GCIPL thickness could discriminate early glaucoma from normal and glaucoma suspects with good sensitivity and specificity. The glaucoma diagnostic ability of GCIPL thickness was comparable to that of RNFL thickness.
Tipo de publicação: JOURNAL ARTICLE


  6 / 5855 MEDLINE  
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PMID:29382007
Autor:Lin HY; Lee CY; Huang JY; Yang SF; Chao SC
Endereço:Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua.
Título:Concurrent injection of dexamethasone intravitreal implant and anti-angiogenic agent in patients with macular edema: A retrospective cohort study.
Fonte:Medicine (Baltimore); 96(47):e8868, 2017 Nov.
ISSN:1536-5964
País de publicação:United States
Idioma:eng
Resumo:To evaluate the safety and efficiency in macular edema patients who concurrently received a single injection of a dexamethasone intravitreal implant (DEX, 0.7 mg) and ranibizumab (2.3 mg).A retrospective cohort study was conducted, and medical records from 2012 to 2016 were reviewed. Patients who received concurrent DEX and ranibizumab injections with a follow-up period of at least 3 months were enrolled in the study group. An age and gender-matched group received ranibizumab injections and was designated the control group. The best-corrected visual acuity (BCVA), central macular thickness (CMT) and intraocular pressure (IOP) were included in the analysis. Steroid-induced ocular hypertension (SIOH) is defined as either an elevation of more than 10 mmHg from baseline or a single IOP measurement of more than 30 mmHg.A total of 26 patients were enrolled in the current study with 13 patients in each group. Both the BCVA (P = .04) and CMT (P < .01) achieved significant improvement after the follow-up period in the study group. The IOP increased after the injection but no significant elevation was observed throughout the follow-up period in the study group (P = .15). For SIOH, 1 patient in the study group had an elevated IOP of 10 mmHg (7.7%) at 2 postoperative months, and no single IOP measurement of more than 30 mmHg was obtained. Five patients (38.5%) in the study group received medical treatment that successfully retarded their IOP elevation, and no individuals required surgical management. In the control group, there were no significant fluctuations concerning BCVA, CMT, and IOP, and no ocular hypertension was observed. According to the inter-group analysis, the CMT and BCVA recovered more significantly in the study group than in the control group.Concurrent injection of DEX and ranibizumab is a preliminary method that shows effectiveness in treating ME. Furthermore, safety is also guaranteed, with moderate levels of severity and transient IOP elevation being observed. A future large-scale study is necessary to evaluate the long-term effects and safety of this combined treatment.
Tipo de publicação: EVALUATION STUDIES; JOURNAL ARTICLE
Nome de substância:0 (Angiogenesis Inhibitors); 0 (Drug Implants); 7S5I7G3JQL (Dexamethasone); ZL1R02VT79 (Ranibizumab)


  7 / 5855 MEDLINE  
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PMID:29241233
Autor:Elder MJ; Rawstron JA; Davis M
Endereço:Ophthalmology Department, Christchurch Hospital, Private Bag 4710, Christchurch 8140, New Zealand, mark.elder@cdhb.health.nz.
Título:Hyperbaric oxygen in the treatment of acute retinal artery occlusion.
Fonte:Diving Hyperb Med; 47(4):233-238, 2017 Dec.
ISSN:1833-3516
País de publicação:Australia
Idioma:eng
Resumo:INTRODUCTION: Acute retinal artery occlusion (ARAO) is a major cause of sudden, painless visual loss, often leaving no useful vision in the affected eye. Its incidence is cited at 0.85 per 100,000 persons per year but may be higher because of under-reporting. The natural history is difficult to study, but a spontaneous resolution rate of < 1-8% for acute, non-arteritic ARAO has been cited. Occurrence in an only eye is devastating for the patient. There is currently no consensus regarding management of ARAO and little evidence to support any treatment modality. Despite only limited case series, hyperbaric oxygen treatment (HBOT) is recommended for ARAO by the Undersea and Hyperbaric Medical Society (UHMS) and by the European Committee for Hyperbaric Medicine. METHODS: Between early 2003 and December 2012, all ARAO patients presenting to Christchurch Hospital were referred for consideration of HBOT. These 31 consecutive patients' medical records were reviewed retrospectively. The time delay from onset of visual loss to commencing HBOT; the presenting visual acuity; various demographic data; the HBOT administered and the outcome visual acuity were documented. RESULTS: All 31 patients underwent at least one HBOT (median 4, range 1-7) at a pressure of 203-284 kPa for 1.5 to 2.0 h. One patient's treatment was terminated after 60 min at their request; another declined further HBOT and one suffered middle ear barotrauma. Thirteen patients also received anticoagulants at the discretion of the referring ophthalmologist. Twenty three patients had temporarily improved vision with the first HBOT. Seven patients had permanent, good visual recovery (6/18 or better; Snellen chart); and two only modest improvement (6/60). All nine patients who improved permanently were treated within 10 hours of symptom onset. CONCLUSIONS: Where available, HBOT is indicated for ARAO. Our protocol may not have been aggressive enough and the UHMS protocol is recommended. A multi-centre, randomised controlled trial is feasible, but would be logistically difficult and expensive and may be ethically unsupportable given the lack of alternative, effective treatments.
Tipo de publicação: JOURNAL ARTICLE


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PMID:27774623
Autor:Liu HH; He Z; Nguyen CT; Vingrys AJ; Bui BV
Endereço:Department of Optometry & Vision Sciences, University of Melbourne, Parkville, Australia.
Título:Reversal of functional loss in a rat model of chronic intraocular pressure elevation.
Fonte:Ophthalmic Physiol Opt; 37(1):71-81, 2017 01.
ISSN:1475-1313
País de publicação:England
Idioma:eng
Resumo:PURPOSE: This pilot study considered whether intraocular pressure (IOP) lowering could reverse ganglion cell dysfunction in a rat model of chronic ocular hypertension. METHODS: A circumlimbal suture was applied in one eye to induce ocular hypertension (n = 7) in Long-Evans rats. The contralateral eye served as an untreated control. After 8 weeks of IOP elevation the suture was removed to lower IOP for the remaining 7 weeks. Electroretinogram (ERG) and optical coherence tomography (OCT) were measured at baseline, 2, 4, 8, 12 and 15 weeks. Retinae were collected for histology at week 15. RESULTS: In sutured eyes, IOP was elevated by 7-11 mmHg above control eyes (12 ± 0.2 mmHg [standard error of the mean]). Eight weeks of chronic IOP elevation resulted in a reduction of the ganglion cell mediated positive Scotopic Threshold Response (pSTR, -25 ± 7% of baseline), as well as smaller photoreceptor (-7 ± 4%) and bipolar cell mediated responses (-6 ± 5%). After suture removal, IOP recovered to normal. By 15 weeks the a-wave (0 ± 6%), b-wave (-2 ± 6%) and pSTR had recovered back to baseline (from -25 ± 7% to -4 ± 6%). The retinal nerve fiber layer was thinned by -9 ± 3% at week 8 and showed no further decline at week 15 (-10 ± 2%). Cell numbers in the ganglion cell layer were similar between suture removal and control eyes at week 15 (3543 ± 478 vs 4057 ± 476 cells mm ). CONCLUSIONS: The circumlimbal suture model might be a useful platform to study the reversibility of neuronal dysfunction from chronic IOP challenge.
Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T


  9 / 5855 MEDLINE  
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PMID:29190824
Autor:Liu HH; Zhang L; Shi M; Chen L; Flanagan JG
Endereço:School of Optometry and Vision Science, University of California, Berkeley, California, United States of America.
Título:Comparison of laser and circumlimbal suture induced elevation of intraocular pressure in albino CD-1 mice.
Fonte:PLoS One; 12(11):e0189094, 2017.
ISSN:1932-6203
País de publicação:United States
Idioma:eng
Resumo:Animal models of ocular hypertension are important tools for glaucoma studies. Both acute transient models and chronic models of ocular hypertension may be useful to investigate specific aspects of neurodegeneration. In this study, we compare the intraocular pressure (IOP) and inner retinal changes induced by 1) laser photocoagulation of both episcleral veins and limbal vessels and 2) circumlimbal suture in CD-1 mice. The suture group is divided into 3 subgroups depending on the level of the immediate IOP spike (acute > 55 mmHg or chronic < 55 mmHg) and time period of monitoring (7 or 28 days). The laser group is followed for 7 days. IOP data show that it peaks at 5 hours and returns to normal level within 7 days in the laser group. In all suture groups, IOP spikes initially and decreases gradually, but it remains significantly elevated at 7 days. In 7 days, the acute suture model generates rapid loss of retinal nerve fiber layer (RNFL) and retinal ganglion cells (RGCs) when compared to the gradual loss by the chronic suture model, possibly due to retinal ischemia and reperfusion within the first few hours after treatment. The laser model falls between the acute suture and chronic suture models resulting in less RNFL and RGC loss than the acute suture model but significantly more loss than the chronic suture model. These results suggest that when using suture models of IOP elevation, it is critical to take the initial IOP spike into consideration and to choose between the acute and chronic models depending on respective research purposes.
Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE


  10 / 5855 MEDLINE  
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PMID:29178849
Autor:McCafferty S; Levine J; Schwiegerling J; Enikov ET
Endereço:Intuor Technolgies, LLC, 6422 E. Speedway Blvd. Tucson, Suite 100, Tucson, AZ, 85710, USA. sjmccafferty66@hotmail.com.
Título:Goldmann applanation tonometry error relative to true intracameral intraocular pressure in vitro and in vivo.
Fonte:BMC Ophthalmol; 17(1):215, 2017 Nov 25.
ISSN:1471-2415
País de publicação:England
Idioma:eng
Resumo:BACKGROUND: Goldmann applanation tonometry (GAT) error relative to intracameral intraocular pressure (IOP) has not been examined comparatively in both human cadaver eyes and in live human eyes. Futhermore, correlations to biomechanical corneal properties and positional changes have not been examined directly to intracameral IOP and GAT IOP. METHODS: Intracameral IOP was measured via pressure transducer on fifty-eight (58) eyes undergoing cataract surgery and the IOP was modulated manometrically on each patient alternately to 10, 20, and 40 mmHg. IOP was measured using a Perkins tonometer in the supine position on 58 eyes and upright on a subset of 8 eyes. Twenty one (21) fresh human cadaver globes were Intracamerally IOP adjusted and measured via pressure transducer. Intracameral IOP ranged between 5 and 60 mmHg. IOP was measured in the upright position with a Goldmann Applanation Tonometer (GAT) and supine position with a Perkins tonometer. Central corneal thickness (CCT) was also measured. RESULTS: The Goldmann-type tonometer error measured on live human eyes was 5.2 +/-1.6 mmHg lower than intracameral IOP in the upright position and 7.9 +/- 2.3 mmHg lower in the supine position (p < .05). CCT also indicated a sloped correlation to error (correlation coeff. = 0.18). Cadaver eye IOP measurements were 3.1+/-2.5 mmHg lower than intracameral IOP in the upright position and 5.4+/- 3.1 mmHg in the supine position (p < .05). CONCLUSION: Goldmann IOP measures significantly lower than true intracameral IOP by approximately 3 mmHg in vitro and 5 mmHg in vivo. The Goldmann IOP error is increased an additional 2.8 mmHg lower in the supine position. CCT appears to significantly affect the error by up to 4 mmHg over the sample size.
Tipo de publicação: JOURNAL ARTICLE



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