Gonioscopy-assisted transluminal trabeculotomy in patients with advanced glaucoma

Purpose: To evaluate the efficacy and safety of gonioscopy?assisted transluminal trabeculotomy (GATT) in patients with advanced glaucoma. Methods: Records of 46 patients with advanced glaucoma were reviewed retrospectively in this single?center chart review. The main outcome measure was surgical success; intra?ocular pressure (IOP) and IOP lowering medication use were secondary outcome measures. Success was defined as an IOP of 18 mmHg or lower (criterion A) or 14 mmHg or lower (criterion B) and one of the following: IOP reduction >30% from baseline on the same or fewer medications or IOP ? of baseline on fewer medications as compared to baseline. Results: Forty?seven eyes were included in the analysis. The average mean deviation was ?17.5 ± 7.2 dB (range ?8.0 to ?33.0). The average follow?up was 6.8 months (range 3.2–22.3). Success at 6 months was 91% for criterion A and 75% for criterion B (n = 33). Mean IOP was reduced from 19.3 ± 6 mmHg (12–40) on 3.7 ± 1.4 medications to 13.2 ± 5.8 mmHg on 1.6 ± 1.4 medications at the 6th post?operative month (P < 0.001 for both IOP and medications). At the last follow?up visit, 37 patients (78%) had an IOP of 14 mmHg or lower, and ten of these patients were unmedicated. Transient hyphema and IOP spikes were the most prevalent adverse events following surgery. Three eyes required further surgery for IOP control. None of the patients lost vision because of surgery. Conclusions: GATT is a viable surgical option in cases of advanced glaucoma. Careful patient selection and attentive post?operative management are imperative.

Effect of Muslim Prayer (Salat) positions on the intra-ocular pressure in healthy young individuals

Purpose: There is a lack of research examining the effects of Muslim prayer (Salat) positions on the intra?ocular pressure (IOP). Considering its involvement with postural changes, this study aimed to investigate the changes in the IOP upon assuming Salat positions before, immediately after, and after 2 minutes of prayer in healthy young adults. Methods: This prospective, observational study recruited healthy young individuals aged between 18 and 30 years. The IOP measurements were obtained in one eye using Auto Kerato?Refracto?Tonometer TRK?1P, Topcon at baseline before assuming prayer positions, immediately after, and after 2 minutes of the prayer. Results: Forty female participants were recruited, with a mean age of 21 ± 2.9 years, a mean weight of 59.7 ± 14.8 (kg), and a mean body mass index (BMI) of 23.8 ± 5.7 (kg/m²). Only 16% had a BMI ?25 kg/m² (n = 15). All participants started with a mean IOP at baseline of 19.35 ± 1.65 mmHg, which increased to 20 ± 2.38 mmHg and declined to 19.85 ± 2.67 mmHg after 2 minutes of Salat. The difference between the mean IOPs at baseline, immediately after, and after 2 minutes of Salat was not significant (p = 0.06). However, there was a significant difference between the baseline IOP measurements and those immediately after Salat (p = 0.02). Conclusion: A significant difference was found between the IOP measurements at baseline and immediately after Salat; however, this was not clinically significant. Further investigation is warranted to confirm these findings and explore the effect of a longer duration of Salat in glaucoma and glaucoma suspect patients.

The Beneficial Effects of Photobiomodulation to Reduce Intraocular Pressure in Primary Open-Angle Glaucoma

Purpose: The aim of this trail was to study the efficacy of photobiomodulation (PBM) treatment to reduce the intraocular pressure in subjects with primary open angle glaucoma disease.Methods: Twenty eyes suffering from open angle glaucoma with high IOP level were selected, examined and treated with Thera-RED light diode system. The subjects were divided into two groups (n=10); treated and placebo group respectively; this system provide two lights (red at 660n.m continue and Near IR light micro-pulsed at 850 n.m), the patients received two series of treatment (ten per month within three months between every series of sessions) over five months and follow up taking ocular pressure measurements after every diode delivery session.Results: A significant decrease in IOP has been observed from the first month of the treatment compared to the placebo group (from 22.6mmHg before treatment to 15 mmHg after the tenth session) this amelioration has been also remarked during the second session of treatment (fifth month) to attempt 14.2 mmHg. Conclusion: Thera-RED light diode system treatment shows a significant decrease of IOP and remained to be stable under 14.2 mmHg in all the follow up, which confirm that photobiomodulation help in reducing the intraocular pressure in glaucomatous patients .

Consensual eye intra-ocular pressure rise following unilateral glaucoma surgery

Purpose: Consensual eye intra?ocular pressure (IOP) increase has been reported following ipsilateral glaucoma surgery. The study evaluated the need for increase in anti?glaucoma medications (AGM) ± glaucoma surgery to control the IOP in consensual eye following unilateral glaucoma surgery. Methods: Data of 187 consecutive patients who underwent either trabeculectomy or AGV implant were collected. Index (IE) and fellow eye (FE) IOP (baseline, follow?up day 1, week 1, months 1 and 3), acetazolamide and AGM use, FE surgery, glaucoma status, and relevant ophthalmological data were collected. Results: A significant increase from a baseline IOP of 14.4 mmHg was noted at week 1 (15.8 mmHg, p?0.005) and month 1 (15.62 mmHg, p?0.007) in FE (n?187). Among the 61 patients (33%, n?187) who needed additional intervention to reduce FE IOP, 27 (14.4%) underwent FE trabeculectomy. In the IE trabeculectomy group (n?164), significant increase in FE IOP was noted in week 1 (15.87 mmHg, p?0.014) and month 1 (15.61 mmHg, p?0.02), and in the IE AGV group (n?23) at day 1 (15.91 mmHg, p?0.06). Pre?operative acetazolamide resulted in significant increase in FE IOP at week 1 and month 1. Maximum increase in FE IOP of nearly 3.5 mm Hg was noted when IE IOP was persistently <5 mmHg at one month following surgery. Mean FE IOP remained elevated at all visits. Conclusion: An increase in fellow eye IOP needing any additional intervention in a third and surgical intervention in nearly a sixth meant that FE IOP be strictly monitored and addressed following unilateral glaucoma surgery

Analysis of aerobic exercise influence on intraocular pressure and ocular perfusion pressure in patients with primary open-angle glaucoma: A randomized clinical trial

Purpose: To investigate the change pattern of ocular perfusion pressure (OPP) and intra?ocular pressure (IOP) after short?term and long?term aerobic exercise. Methods: In this prospective, single?masked, randomized clinical trial, 123 patients with a primary open angle glaucoma that locally used prostaglandin analog alone were randomly divided into the exercise and control groups. In the short?term study, all individuals underwent a cycling exercise at moderate intensity (20% Wmax for 10 minutes) and high intensity (60% Wmax for 5 minutes). During the long?term study, the exercise group is characterized by regular jogging exercise lasting for 30 minutes during 6: 00–10: 00 in the morning for 3 months, with the exercise frequency of at least 20 times per month, and with the intensity reflected by the target heart rate. The control group is designed as a group with irregular exercise. Results: After short?term aerobic exercise, IOP significantly decreased, whereas the ocular perfusion pressure (OPP) significantly increased. The decreasing amplitude of IOP is related to the baseline of IOP, the intensity of exercise, gender, and so on. After 3 months of long?term exercise, the changes in the IOP level of the exercise group indicated a decreasing trend. Conclusion: The significant decrement of IOP and the increment of OPP suggest that aerobic exercise is beneficial for patients with primary open?angle glaucoma and appropriate aerobic exercise is appropriate in treating glaucoma patients.

Evaluation and correlation of corneal endothelium parameters with the severity of primary glaucoma

Purpose: To evaluate and correlate corneal endothelium parameters with the severity of primary glaucoma. Methods: This prospective case?control study was conducted on 150 eyes of 80 newly diagnosed primary open?angle glaucoma (POAG), chronic primary angle?closure glaucoma (cPACG), and normal?tension glaucoma (NTG) patients in a tertiary care center. Endothelial parameters including endothelial cell count (ECC), percentage of hexagonal cells, and coefficient of variation of cell size were analyzed. Glaucoma cases were further sub?grouped into early, moderate, and severe glaucoma and compared for endothelial parameters. Chi?square, Fischer’s exact test, independent sample t?test, and analysis of variance were performed using IBM® SPSS® Statistics version 28. Results: The ECC was markedly reduced in cases (2281 cells/mm2) versus controls (2611 cells/mm2) (P < 0.001). The POAG (2251 cells/mm2) and cPACG (2287 cells/mm2) eyes had significantly a lower ECC compared to healthy controls (P < 0.001), whereas NTG eyes had a lower mean ECC (2538 cells/mm2), but it was not statistically significant (P > 0.05) when compared with controls. The ECC decreased with an increase in severity as patients with early glaucoma had an ECC of 2284 cells/mm2, moderate 2261 cells/mm2, and severe 2086 cells/mm2, and the difference was statistically significant. Conclusion: A significant decrease in corneal ECC was observed in POAG and cPACG patients when compared with healthy controls of the same age group. Mechanical damage following an elevated intra?ocular pressure for a longer duration may be attributed to morphological and consequent functional damage to endothelial cells.

Outcomes of medical and surgical management in eyes with idiopathic elevated episcleral venous pressure

Purpose: Idiopathic elevated episcleral venous pressure (IEEVP) is a rare cause of secondary glaucoma and is a diagnosis of exclusion. The aim of this study was to describe the clinical presentation and analyze the outcomes of medical and surgical management in eyes diagnosed with idiopathic elevated episcleral venous pressure. Methods: A retrospective analysis of eyes diagnosed with IEEVP over a 5?year period between April 2012 and March 2016 was performed. The demographic details, medical history, and clinical course of the cases were obtained from the medical records. Data pertaining to the severity of glaucomatous damage, response to medical management, need for surgical intervention, and their outcomes were analyzed. Results: Fifteen eyes of 13 patients were included. Thirteen eyes (86.6%) had open angle configuration. Among the 13 eyes that had glaucoma, eight eyes (61.5%) had severe glaucoma, four eyes (30.7%) had moderate glaucoma, and one eye (7.6%) had mild glaucoma. The median follow?up was 210 days. Seven of the 15 eyes (46.6%) required a glaucoma filtration procedure, and three underwent prophylactic sclerotomies. 71.4% of these eyes had complete success. One out of the seven operated eyes required choroidal drainage post?operatively. Conclusion: IEEVP is an extremely rare condition and presents with raised intra?ocular pressure and tortuous episcleral vessels. The management of IEEVP is similar to that of primary open angle glaucoma. Uveal effusion is to be anticipated, and hence, combining trabeculectomy with prophylactic sclerotomies is advisable.

Pragmatic adjunctive usage of netarsudil: A retrospective chart review from a tertiary care center

Purpose: This retrospective chart review of netarsudil (Rhopressa) characterizes intra-ocular pressure (IOP) reduction, drug tolerance, drug cost, and compliance in a tertiary university Midwest clinic in a variety of glaucoma diagnoses on patients prescribed netarsudil 01/2017 to 5/2020. Methods: Patient demographics, primary diagnosis, indication for medication, prescription date, prescription fill status, duration of use, discontinuation reason, and number of IOP-lowering medications were noted. Confounding medication changes were excluded from IOP analysis. The IOP difference between the first visit after starting netarsudil and the baseline (mean before starting netarsudil on the stable medication regimen) was calculated. Results: A total of 133 patients were prescribed netarsudil (age 69 ± 20 years, 59% females, 79% white, 86% primary glaucoma) as adjunct glaucoma medication (mean medications 3.2 ± 0.9). Indications were lowering IOP (mean baseline IOP 20.0 ± 6 mmHg) and drug regimen simplification. Prescription was not filled by 22/133 subjects because of the cost (68%) and the need for surgery (23%). No demographic factors were associated with prescription fill status. A total of 101 eyes of 76 patients were used for IOP analysis. The mean change in IOP was –0.8 ± 6.4 mmHg, (IOP decrease in 67%, increase or no change in 33% eyes). Netarsudil was discontinued in 52% (50/96) patients; the reasons include surgery for IOP control (42%), allergies (30%), cost (14%), and paradoxical rise in IOP (12%). Conclusion: Netarsudil was used as adjunct third or fourth line medication at a glaucoma practice in Midwestern USA. 17% of prescriptions went unfilled; netarsudil was discontinued in 52% of patients. IOP response was variable in this population with severe complex glaucoma.

A study of changes in Mean Ocular Perfusion Pressure and Intra-Ocular Pressure among pa?ents undergoing hemodialysis

Background:During hemodialysis there is decrease in both systolic blood pressure (SBP) and diastolic blood pressure (DBP) and hence Mean Arterial Pressure (MAP) due to decrease in body fluid volume. Due to reduc?on in MAP there is decrease in Mean Ocular Perfusion Pressure (MOPP) and also there is increase in IOP during dialysis. Objec?ve:To study changes in MOPP and IOP among pa?ents undergoing hemodialysis Methods:An observa?onal study was carried out among 100 pa?ents undergoing hemodialysis Under asep?c condi?on, Proparacaine eye drops were ins?lled in both eyes, IOP was measured by Schiotz Indenta?on Tonometer 30 min before, during hemodialysis and 30 min a?er hemodialysis in supine posi?on. Tonometer was sterilized by Isopropyl alcohol and was washed with normal saline before using on next pa?ent. Systolic and diastolic blood pressure were measured by using sphygmomanometer 30 min before, during and 30 min a?er hemodialysis. Results:The varia?ons in the SBP, DBP and MAP before, during and a?er hemodialysis were not sta?s?cally significant (p>0.05). There was significant differences for IOP between before, during and a?er hemodialysis and same for MOPP except before and 30 min a?er hemodialysis (p < 0.0001). Conclusion:Significant fluctua?ons were seen from the present study in the intra-ocular pressure and mean ocular perfusion pressure during, before and a?er hemodialysis.

Comparison of 0.75 % Ropivacaine with 0.5 % Bupivacaine in Peribulbar Block in Ophthalmic Surgeries

Bupivacaine as local anaesthetic has cardiovascular and neurological toxic effects; ropivacaine on the other hand is known to have fewer side effects. Its safety and some its ability to reduce intra ocular pressure has led to its widespread usage. The aim of our study was to compare the efficacy of inj. Ropivacaine 0.75 % + hyaluronidase 50 IU / mL with inj. bupivacaine 0.5 % + hyaluronidase 50 IU / mL in cataract surgeries under regional anaesthesia. MethodsWe evaluated 60 patients who were posted for small incision cataract surgeries. They were randomly divided by drawing chits in to 2 groups according to the anaesthetics used (ropivacaine / bupivacaine). Evaluation of these patients was done on the basis of sensory onset, motor onset using akinesia score, requirement of rescue analgesic, and time of motor and sensory offset of the local anaesthetic. ResultsInj. ropivacaine 0.75 % showed greater reduction in IOP (p < 0.05). Other parameters such as motor block, sensory block, akinesia score, and requirement of rescue analgesia were comparable between the two groups (p > 0.05). ConclusionsIn patients posted for intra ocular / cataract surgeries, ropivacaine 0.75 % and bupivacaine 0.5 % are comparable, with ropivacaine having better haemodynamic profile and also reduces intra ocular pressure.

Association of Central Corneal Thickness with Age and Serum Electrolytes in Hypertensive and Non-Hypertensive Patients

Background and Objectives: The normal Central corneal thickness (CCT) ranges about 510-520 microns. It is normally seen in clinical practice that corneas which are thicker are linked with greater intraocular pressures (IOPs). The purpose of the study was to determine the central corneal thickness and establish its relationship with age and serum electrolytes in hypertensive and non-hypertensive patients. Methodology: A total of 108 subjects were included in our cross-sectional comparative study (54 hypertensive and 54 non-hypertensive). Written informed consent was taken. We measured blood pressure with mercuric sphygmomanometer. Ultrasound pachymeter was used to measure central corneal thickness while we drew 5 ml of blood for estimation of the serum electrolytes. Data was entered and evaluated using IBM SPSS 17. Quantitative variables were presented as Mean ± SD. Pearson correlation was used to find correlation of normally distributed variables p-value ≤ 0.05 was considered to be statistically significant. Results: Central corneal thickness was statistically same in hypertensive and non-hypertensive subjects. Serum Na+ was significantly increased in hypertensive subjects while serum K+ and Cl- were significantly decreased in hypertensive subjects. No significant correlation was seen in hypertensive while weak negative correlation was observed between CCT and age in non-hypertensive patients. Weak positive correlation was observed between CCT and Na+ both in hypertensive and non-hypertensive. Significant correlation was observed in CCT and K+ in hypertensive while negative correlation was seen in non-hypertensive. Weak correlation was observed in CCT and Cl- both in hypertensive and non-hypertensive. Conclusion: Mean CCT was significantly lower in hypertension. CCT and age showed weak and positive correlation in hypertensive while weak and negative correlation in non-hypertensive. Serum electrolytes and CCT showed no significant correlation.

Effects of ND YAG Laser Capsulotomy on Intra ocular Pressure and Macular Thickness

AIM- This study was aimed to find the changes in macular thickness and intra-ocular pressure overtime after ND-YAG laser capsulotomy. Methods: 100 pts fulfilling the inclusion criteria were included in the study and underwent a detailed ophthalmic examination. Pts IOP and macular thickness was measured by goldmann applanation tonometery and ocular coherence tomography (OCT) respectively before performing the procedure. Each patient was called for follow up on day 1, 1 week, 4 weeks, 8 weeks and 12 weeks. During all the follow up visits complete eye examination, IOP measurement, and macular thickness measurement were noted. Results: For this study, a total of 100 eyes of 100 patients (54 males, 46 females) aged 18to 80 years (mean age 51.98±14.01 years) fulfilling the inclusion and exclusion criteria were enrolled in the study.IOP was significantly higher at all the follow-up intervals among those in whom >40 mJ energy was used as compared to those in whom <40 mJ energy was used Mean change in macular thickness was found to be significantly higher at day 1 and week 1 among those in whom >40 mJ energy was used as compared to those in whom <40mJ energy was used. However, at subsequent follow-up intervals, the difference was not significant statistically. Conclusion: Nd-YAG laser capsulotomy results in increased IOP and macular thickness which sustains upto a substantial period.Rise in IOP following Nd:YAG laser posterior capsulotomy is correlated with the amount of energy used.Change in macular thickness following Nd:YAG laser posterior capsulotomy is weakly/mildly correlated with the amount of energy used during the initial follow-up, however, subsequently it does not show a correlation with amount of energy used.

Study Of Intra Ocular Pressure In Patients With Type 2 Diabetes Mellitus Of Udaipur District, Rajasthan, India

Background: Intraocular pressure constitutes the most important risk factor for the emergence of glaucoma, apathology often associated with diabetes mellitus.Objective: The purpose of the study was to analyze the relationship between intraocular pressure and type 2diabetes mellitus and to investigate the effects of chronic hyperglycaemia on the intraocular pressure (IOP).Materials and Methods: We prospectively measured the IOP by applanation tonometry in 100 patients with type2 diabetes (Group I) and in 100 Normal subject as a control(Group II). The glycosylated haemoglobin (HbA1c)levels of the subjects with diabetes were determined and based on that, they were divided into 3 subgroups asgroup Ia with HbA1c levels of < 7% (n = 40); group Ib with HbA1c levels of 7 to 8.0%(n = 32); and group Ic withHbA1c levels of > 8.0% (n = 28 ) All the data were expressed as means ± standard deviations.The statisticalanalysis was performed by the Student’s t test. The correlation between HbA1c and IOP was analyzed by thePearson’s correlation coefficient. A p value of < 0 .05 was considered to be significant.Results: We observed that the IOP values were higher in the subjects with diabetes (Mean = 21.50 ± 3.50) than inthe age and sex matched control groups. The mean IOP in the groups Ia, Ib and Ic were 16.32 ± 2.10 , 20.54 ± 2.50mm Hg, and 21.95 ± 3.20 mm Hg respectively. The difference in the IOP between the groups Ib and Ic was found tobe statistically significant (P = .001)Conclusion: Diabetic subjects with elevated HbA1c levels exhibited significantly higher IOPs compared to thosewith lower HbA1c levels. Findings from this study indicate an association between hyperglycemia and elevatedIOP and that poor glycemic control may contribute to increased IOP levels in long-term diabetic patients.

Safety and efficacy of Nd:YAG laser capsulotomy in management of posterior capsular opacification

Background: At present, the only effective treatment of posterior capsular opacification (PCO), which is the most common complication of modern cataract surgery, is Neodymium-Yttrium Aluminum Garnet (Nd:YAG) laser capsulotomy. There are few complications associated with this easy and quick laser capsulotomy. The current study was conducted in a tertiary hospital of Odisha with an objective to find the safety and efficacy of Nd:YAG laser capsulotomy in the management of defective vision due to posterior capsular opacity.Methods: The study was conducted among the patients attending the Ophthalmology out patient department of a tertiary hospital in Odisha with defective vision due to posterior capsular opacity after cataract surgery. Nd:YAG laser capsulotomy was carried out in all patients with significant PCO. Visual acuity and intraocular pressure were recorded before and after the procedure. The cases were carefully followed up and looked for any complication and visual acuity was assessed during follow up visits.Results: In the study 184 participants were included. Visual improvement was observed in 97.8% participants. Visual acuity improved to 6/6 in 21.73 %, 6/9 in 36.41 % cases, 6/12 in 15.21 % cases. Raised IOP was recorded among 46% of participant after 4 hrs of laser capsulotomy which was later observed among 12% of participants on follow up visit at 1 week. The most common complication recorded was transient rise of IOP (46.3%) followed by aqueous flare (28.8%).Conclusions: Nd:YAG laser capsulotomy is a noninvasive, effective, relatively safe procedure for PCO with good visual outcome.

Netarsudil: a novel intra-ocular pressure lowering agent

Optic disc health is an important indicator of visual functions. The first line of management to prevent/halt the damage to optic disc is to control responsible pathological condition, if identified. In absence of identifiable cause, the most validated approach is lowering of intra-ocular pressure (IOP). Individually, as well as combinations of currently available drugs are not fully effective in all patients of glaucoma in achieving desired IOP control. Hence, there is a need of newer alternatives which address this unmet need. Recently, a newer IOP lowering agent with a novel mechanism of action, netarsudil, has been approved by United States Food and Drug Administration (US-FDA) in December 2017. Netarsudil acts by inhibiting Rho-associated protein kinase resulting in lowering of overall tone of the contractible cells in trabecular meshwork thereby improving drainage of aqueous humor outflow and lowering of IOP. Though in its early days, this drug gives an armamentarium to ophthalmologists and physicians to control IOP in patients of open-angle glaucoma and ocular hypertension.

A comparative study on safety and efficacy of travoprost and brimonidine/timolol fixed combination in patients of primary open‑angle glaucoma.

Background: The purpose of this study was to compare and evaluate the clinical efficacy of topically applied travoprost 0.004% eye drops versus brimonidine/timolol fixed combination eye drops in the management of primary open-angle glaucoma. Methods: In this prospective, randomized study, 65 patients received either travoprost eye drops once daily in the morning (n=33) or brimonidine/timolol fixed combination eye drops twice daily (n=32). Intra ocular pressure (IOP) was assessed at 2, 4, 8, and 12 weeks. The primary outcome measure was mean reduction in IOP. Results: The baseline mean IOP values were similar between two groups. Mean reduction of IOP in the right eye for brimonidine/timolol fixed combination group was 9±2.9 mmHg, whereas in the left eye it was 10.9±2.8 mmHg. In the travoprost group, the reduction in IOP of the right eye was 7.8±2.9 mmHg (p=0.0002) and 7.5±3.4 mmHg (p=0.0001) in the left eye. The mean reduction of IOP for the brimonidine/timolol group was 9.95 mmHg and for the travoprost group it was 7.6 mmHg (p<0.0001) in both the eyes. Conclusions: The fixed combination brimonidine/timolol twice daily demonstrated superior mean IOP lowering efficacy compared to travoprost 0.004% in patients with open-angle glaucoma.

Diurnal variation in central corneal thickness and intraocular pressure in eyes with pseudoexfoliation syndrome without glaucoma.

Aim: The aim was to ascertain if any differences exist in diurnal central corneal thickness (CCT) and intra‑ocular pressure (IOP) between eyes with pseudoexfoliation (PXF) syndrome without glaucoma and eyes with no ocular pathology. A secondary aim was to determine whether there was a significant relationship between CCT and IOP. Settings and Design: This study was a prospective design conducted within a hospital setting. Materials and Methods: The experimental group consisted of seven participants with bilateral PXF (14 eyes) and the control group comprised of 15 participants (30 eyes). Testing included CCT and IOP measured at four different times on one given day (8.00 a.m.; 11 a.m.; 2 p.m. and 5 p.m.). Statistical Analysis: The data were analyzed with the generalized linear latent mixed model. Results: PXF eyes displayed a significantly thinner overall mean CCT (520 μm) compared to controls (530 μm). Furthermore, a significant reduction in CCT and IOP occurred in the PXF group from 8 a.m. to 5 p.m. The mean overall IOP in PXF eyes was significantly lower than the control group. A significant association between IOP and CCT was also found in PXF eyes. Conclusions: Displaying a significantly thinner mean CCT highlights the importance of measuring CCT in an ophthalmic clinical setting as to avoid falsely underestimated IOP measurements in such a high‑risk glaucoma population. Furthermore, a statistically significant correlation between IOP and CCT in PXF eyes suggests that the reduction in CCT that occurred in PXF eyes between 8 a.m. and 5 p.m. may be partly responsible for the reduction in IOP measurements.

Assessment of the central corneal thickness and intraocular pressure in premature and full-term newborns.

Purpose: To assess the central corneal thickness (CCT) and intraocular pressure (IOP) in premature and full-term newborns. Materials and Methods: In this study, we evaluated measurements of CCT and IOP in 45 premature and 45 full-term newborns. IOP was determined with topical anesthesia using a Tono-Pen AVIA, applanation tonometer and a wire lid retractor in premature newborns undergoing screening for retinopathy. Full-term newborns were used as a control group. CCT was determined with a portable pachymeter after IOP measurements had been made in both groups. Because there was high correlation of CCT and IOP between right and left eyes, only the right eye data were used for further analyses. Results: The mean gestational age was 31.5 ± 2.7 weeks (ranging 25-35 weeks) and the mean age at measurement after birth was respectively 36.3 ± 0.9 weeks (ranging 33-37 weeks) in premature newborns and 38.2 ± 0.7 weeks (ranging 38-41 weeks) and 42 ± 2.2 weeks (ranging 39-46 weeks) in full-term newborns. The mean IOP was 16.2 ± 2.7 mmHg (ranging 10-22 mmHg) in premature and 16.6 ± 2.3 mmHg (ranging 10-22 mmHg) in full-term newborns. The mean CCT was found 600 ± 50 μm (ranging 515- 790 μm) in the premature group and 586 ± 48 μm (ranging 475-730 μm) in the full-term group. Mean CCT was greater in premature newborns than in full-term newborns, but the diff erence between groups was not statistically signifi cant (P = 0.7). Mean IOP measurement in two groups was found very similar and the diff erence also was not statistically signifi cant (P = 0.27). There was no correlation between IOP and CCT, gestational age, gestational weight, age at measurement, weight at measurement neither right nor left eye in both groups in multiple regression analysis. Conclusion: We found that premature infants have slightly thicker corneas but no high IOP measurements than full-term newborns. It could be concluded that in premature at the mean gestational age of 36 weeks CCT is not diff erent from that of full-term newborns.

Influência da idade no comportamento da pressão intraocular em uma população da região Sul-brasileira / Influence of age on intraocular pressure in a South Brazilian population

OBJETIVO: Verificar influência da idade no comportamento da pressão intraocular (PIO) em população acima de 40 anos. MÉTODOS: Neste estudo observacional transversal realizado no município de Piraquara - PR, a PIO foi aferida através da tonometria de Goldmann. Todos os indivíduos foram submetidos a exame de triagem, sendo os suspeitos de glaucoma ou hipertensão ocular encaminhados ao atendimento de retorno para realização de exame oftalmológico completo. Para fins de análise estatística, os pacientes foram divididos em grupos etários (40-49; 50-59; 60-69 e acima de 70 anos). Posteriormente todos os pacientes portadores de glaucoma ou suspeita, hipertensão arterial sistêmica (HAS) ou Diabetes mellitus (DM) foram excluídos. RESULTADOS: Avaliaram-se 3360 indivíduos com média de idade de 54,04 ± 10,52 anos, sendo 59,79 por cento do sexo feminino. Não se observou diferença estatisticamente significativa entre a média da PIO nos diferentes grupos etários (p=0,19; teste ANOVA). Da mesma forma, não foi observada correlação significativa entre a PIO e a idade (p = 0,11; correlação linear de Pearson). Após exclusão dos indivíduos portadores de HAS (1671), DM (n=360), glaucoma ou suspeita de glaucoma (n=161) não se observou diferença estatisticamente significativa entre a média da PIO e a idade (p=0,17; teste ANOVA). No entanto, uma fraca correlação negativa, porém significativa, foi encontrada entre PIO e idade (p=0,03; R=-0,055, correlação linear Pearson). CONCLUSÃO: Na presente amostra, não foi observada influência significativa da idade na PIO, entretanto, após a exclusão de indivíduos com glaucoma, HAS e DM, observou-se uma fraca correlação linear negativa e significativa entre as duas variáveis.

PURPOSE: To assess the influence of age on intra-ocular pressure (IOP) in subjects aged over 40 years old. METHODS: This transversal and observational study realized at Piraquara city (PR) measured the IOP using Goldmann applanation tonometry. All subjects were submitted to a screening exam and patients considered as glaucoma suspects or ocular hypertensive patients were invited to a second evaluation, where a complete ophthalmological exam was performed. For the data analysis, all subjects were separated by age (40-49; 50-59; 60-69; and above 70 years of age). Further analysis excluded all patients with glaucoma and/or glaucoma suspects, systemic arterial hypertension (SAH) and diabetes. RESULTS: A total of 3360 subjects were evaluated of whom 2001 (59,79 percent) were females. The mean age was 54,04 ± 10,52 years. There was no difference in mean IOP among age groups (p = 0.19; ANOVA test). It was not observed any significant correlation between age and IOP (p = 0,11; Pearson linear correlation). When all the subjects with glaucoma and/or glaucoma suspects (n=161), DM (n=360) and SAH (n=1671) were excluded, there was no difference in mean IOP among age groups (p = 0.17; ANOVA test). However, it was observed a weak and significant negative correlation between age and IOP (p = 0,03; R = - 0,055; Pearson linear correlation). CONCLUSION: In our sample, there was no significant influence of age in IOP. However, after all subjects with glaucoma and/or glaucoma suspects, diabetes and SAH were excluded, it was observed a weak negative influence of age in IOP.