Intraocular pressure values using icare® rebound tonometer and correlation with postconceptional age in premature infants

Purpose: This study aimed to determine a normative range of intraocular pressure (IOP) values measured with Icare rebound tonometer in premature infants and evaluate IOP variation over time and its correlation with the progression of postconceptional age (PCA). By doing so, we also evaluated advantages of this IOP-measuring method in this population when compared to more traditional methods. Methods: We conducted a single-center prospective study that included premature infants (gestational age ≤32 weeks) who were admitted to the neonatal intensive care unit (NICU) in Hospital Professor Doutor Fernando Fonseca. The study took place between January and December 2021. IOP was measured using Icare tonometer on the occasion of the first retinopathy of prematurity (ROP) screening requested by the NICU and again after a two-week interval if PCA was still ≤37 weeks. IOP measurements were stopped at 37 weeks or if the infant was discharged. The evaluated outcomes were mean IOP values and their correlation with PCA. Results: Thirty-four eyes of 17 preterm infants with a mean gestational age of 29.4 ± 2.3 weeks and a mean birth weight of 1222.9 ± 361.9 gr were evaluated. The mean IOP registered was 16.1 ± 6.4 mmHg, with a median value of 15.3 mmHg. The top 90 mmHg. The average IOP reduction was 4.8 ± 6.7 mmHg (P = 0.0019) within the two-week interval of PCA.

Central corneal thickness and intraocular pressure in type II diabetes

Background: Diabetes is a rapidly-growing global health problem with a significant impact on morbidity and mortality due to diabetes-related complications. Objective: The purpose of this study was to assess the impact of type II diabetes on the central corneal thickness (CCT) and intraocular pressure (IOP). Patients and Methods: This prospective case-control study was performed at the ophthalmic department of Al-Zahraa University Hospital. It was conducted on 30 participants with type II diabetes and 10 healthy control (both eyes were included). Diabetics were categorized into 3 groups, diabetics without retinopathy, with non-proliferative diabetic retinopathy (NPDR) and with proliferative diabetic retinopathy (PDR).Each group contained 10 participants. Complete ophthalmic examination was done for all participants including, visual acuity, slitlamp, fundus examination, measurement of IOP and CCT. Fundus photography and measurement of glycosylated hemoglobin A1c (HbA1c) were done for diabetics. Results: Diabetics with PDR exhibited significantly higher IOP and CCT values compared to other groups. The IOP was significantly correlated with CCT and with the duration of diabetes. Conclusion: Diabetics with PDR had a significantly elevated IOP and thicker corneas than normal subjects. These data emphasize the importance of considering CCT measurements in diabetics for proper interpretation of IOP

Effect of neodymium-yag laser posterior capsulotomy on intraocular pressure

Background: Posterior capsule opacification (PCO) also known as Secondary cataract is the most common complication following cataract surgery. It can occur between few months and many years after implantation of intraocular lenses (IOLs), with incidence figures ranging from <5% to as high as 50%. Objective: The aim of this study was to determine the frequency of intraocular pressure elevation after Nd: YAG laser posterior capsulotomy for treatment of PCO. Patients and Methods: A prospective non-randomized study that was conducted at Al Zahraa University Hospital. The study included a total of 40 eyes of 31 patients. All patients underwent Nd: YAG laser posterior capsulotomy. Patients were followed up at 4 hours, 1 day, 1 week and 1 month after laser capsulotomy. Nine cases were bilateral, 15 were males (48%) and 16 were females (52%). Results: The majority of patients (90%) showed significant improvement in visual acuity after capsulotomy and about 87.5% of patients had final BCVA of 6/6-6/12, visual acuity after 24 hours was 6/9 in 20 eyes (50%) and 20 eyes (30%) had VA of 6/12. All the 40 patients had visual acuity improvement of 1 or more lines after capsulotomy. No one had further decline in visual acuity after capsulotomy. Conclusion: The present study depicts the Nd: YAG laser capsulotomy as a good, successful treatment of PCO, because it was found to be modern, non-invasive, effective mode of treatment of PCO with lesser complications and it does not require hospitalization

Presentation of Glaucoma in the Greater Accra Metropolitan Area of Ghana

Background: This study addresses the prevalence and clinical presentation of patients with primary open angle glaucoma (POAG) in the greater Accra metropolitan area. Methods: This is a retrospective case series of 455 patients (813 eyes) at the Emmanuel Eye Clinic. Patients were diagnosed from May 2008 to Nov 2011. The definition of POAG conformed to the International Society of Geographical and Epidemiological Ophthalmology (ISGEO) criteria. Information collected included basic demographic data; distribution of glaucoma subtypes; measured intraocular pressure (IOP); best corrected visual acuity (BCVA) and optic disc measurements. Results: Nearly 24 presented blind in at least one eye. The average age was 56.7 +/-16.7 years and the average IOP was 33.9 mmHg +/- 12.7 mmHg for right eyes and 33.5 mmHg +/-12.0 mmHg for left eyes. The mean vertical cup to disc ratio (vCDR) was 0.83 for right eyes versus 0.82 for left eyes. A total of 32 patients (53 eyes) were diagnosed with normal tension glaucoma (NTG). Statistically significant differences between the NTG and high tension groups included age (45.3 +/- 16.7 vs. 56.7 +/-16.7; p0.001); mean IOP (19.1 mmHg +/- 4.5 mmHg vs. 33.7 +/- 12.4 mmHg; p0.001) and mean vCDR (0.76 +/- 0.17 vs. 0.83 +/- 0.10; p0.01). Comparing age-matched NTG patients with high tension glaucoma patients showed no significant difference in vCDR. Conclusions: The clinical presentation of POAG at the Emmanuel Eye Center is characterized by elevated IOP and grossly advanced optic neuropathy. Significant differences between high tension glaucoma and NTG were identified

The Effect of Medical Therapy on IOP Control in Ghana

Background: To investigate IOP control following twelve months of continuous medical therapy in Ghana. Methods: This retrospective case series included 163 glaucoma patients diagnosed at a referral eye center between 1996 and 2006. Information collected included age; gender; IOP at presentation; six months and one year post treatment and types of anti-glaucoma medications prescribed. Optimal IOP control was defined according to results from the Advanced Glaucoma Intervention Study (AGIS); which demonstrated arrest of visual field progression in patients with IOP 18 mmHg at all visitations: Level 1 (post-treatment IOP . 21 mmHg); Level 2 (. 18 mmHg) and level 3 (. 16 mmHg). The principal outcome measure was the achievement of IOP 18 mmHg at six months and twelve month visitations. Results: One hundred sixty three patients were analyzed. These included 68 males (41.7) and 95 females (58.3). The mean age was 57}16 (median 59 years; range 7 . 95 years). There was no significant difference in age (p

Prevalence of Glaucoma Suspects and Pattern of Intra-Ocular Pressure (IOP) Distribution in Ahoada-East Local Government Area of Rivers State

Background: Glaucoma is the commonest cause of irreversible blindness in the world. Some glaucoma patients start out as glaucoma suspects for years. Aim: To determine the prevalence of glaucoma suspects and pattern of intra-ocular pressure distribution in glaucoma suspects. Methods: This survey was carried out in Ahoada-East local government area (LGA) of Rivers State. The study took place in 6 communities in the LGA. Multi-stage sampling technique was used to select the study sample which consisted of 960 persons drawn from the 6 communities. Ocular examination was carried out and consisted of visual acuity; basic eye examination and direct funduscopy. Subjects with pathologically cupped discs or cup/disc asymmetry of ? 0.2 had their intra-ocular pressures (IOP) measured. Data was recorded primarily on the WHO/PBL eye examination form and entered into Epi-Info version 6 for analysis. Results: A total of 34 subjects who had vertical cup/disc ratio 0.5 had their intra-ocular pressures measured. Of this; 23 were glaucoma suspects. There were 15 males (65.2) and 8 females (34.8) and those aged 40-79 years made up 69.6of the study sample. Most eyes (97.8) had normal intra-ocular pressures (10-21mmHg) while one had an IOP of 8 mmHg. Out of 866 subjects; 23 were glaucoma suspects giving a prevalence of 2.7. Conclusion: Since glaucoma is a leading cause of irreversible blindness in the world; the availability of data on glaucoma suspects; the type of glaucoma they have and the age groups most at risk would facilitate early diagnosis and follow up thus preventing unnecessary blindness from glaucoma

Intraocular pressure changes in patients undergoing cataract extraction and lens implantation: laryngeal mask airway versus endotracheal tube

Objectives: To investigate the influence on intraocular pressure (IOP) of airway management with a laryngeal mask airway (LMA) or tracheal tube (ETT); and secondly to compare the devices with regard to their impact on IOP. Design: Prospective; randomized observational study over a four-month period (August - November 2002) Setting: University-affiliated tertiary level hospital in Pretoria; South Africa Subjects: Forty ASA I and II adult patients undergoing unilateral cataract extraction and lens implantation under general anaesthesia Outcome measures: Changes in intraocular pressure after placement of airway device Methods: Following a standard anaesthestic induction with propofol and atracurium; airway management was randomized to LMA or ETT. IOP was measured pre-induction; 3 min post induction but before airway manipulation; 20 sec post LMA or ETT insertion and finally 2 min post airway instrumentation. Results: There was a small increase in mean IOP in the LMA group; which was statistically insignificant. However there was a significant rise in mean IOP in the ETT group (p = 0.0001) which returned to almost pre-insertion levels at 2 minutes. Conclusions: The LMA causes minimal changes in intraocular pressure when used to secure the airway during cataract surgery. The rise in IOP following tracheal intubation is significant; yet transient and probably clinically insignificant

A Review of trabeculectomies at a Nigerian teaching hospital

Background: Trabeculectomy is the commonest surgical procedure for glaucoma. The outcome of trabeculectomy in the treatment of all types of glaucoma over a 4-year period in a Nigerian population was reviewed. Objective: To determine the surgical rate and effectiveness of trabeculectomy in lowering of intra ocular pressure (IOP) and preservation of visual acuity. Methods: Retrospective review of all trabeculectomies (TEs) done at the Obafemi Awolowo University Teaching Hospital; Ile-Ife between January 1999 and December 2002. The outcome of trabeculectomy was correlated with the biomicroscopic appearance of the filtering bleb; visual acuity and IOP levels. Descriptive statistics were applied to the data. Results: Of the 647 glaucoma patients only fifty-three (8.2); 34 males and 19 females; had trabeculectomy done during the study period. Seventy-two consecutive eyes of these 53 Nigerian patients were operated upon. Majority; 63 (87.5) were in the primary glaucoma group of which 46 63.9) were open angle glaucoma type. Nine eyes (12.5) belonged to the secondary glaucoma group (neovascular; uveitic and traumatic angle recession). Successful control of intra-ocular pressure with medical therapy was recorded only in 13.9f the patients. The mean pre-operative and first post-operative day IOP were 32.5+/- 6.2mmHg and 10.6+/- 2.3mmHg respectively. Mean post-op IOP at 3 months and one year were 14.6+/- 4.2mmHg; and 13.5+/- 5.8mmHg respectively. One year after surgery 34 eyes (61.8) had intraocular pressure (IOP) of 20mm Hg or less without glaucoma medication. Hyphema 11 (15.3) was the commonest post-operative complication documented. Conclusions: Surgical intervention in the management of glaucoma; especially trabeculectomy is not commonly done in this Teaching Hospital. IOP control with medication alone is not adequate in the long term. A significant proportion of the eyes (61.8) had complete success in IOP control following trabeculectomy

Scientific Letter : The Prevalence of the Diagnosis of Increased Intra-Ocular Pressure in a General Practice

Glaucoma is one of the main causes of blindness. The disease occurs in 3 to 4 of all people over the age of 70 years. As many as 50 of patients suffering from this disease are unaware of their condition until a comparatively late stage; due to the asymptomatic nature of the disease

Glaucome a pression normale: probleme diagnostique

Les auteurs rapportent une serie de glaucomes a pression normale et soulignent les problemes diagnostiques qu'ils soulevent