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PubMed1990

Intraocular pressures during high-flux hemodialysis.

The intraocular pressures of 16 patients with end stage renal failure treated with high-flux dialysis were measured before and during a high-flux dialysis treatment. The patients were selected so as not to have glaucoma or history of glaucoma. Intraocular pressures did not change significantly in any patients during or following a high-flux hemodialysis treatment. These data suggest that high-flux hemodialysis does not result in increases in intraocular pressure nor does it precipitate acute glaucoma in well-dialyzed patients undergoing intermittent in-center hemodialysis.

Adult↗
PubMed1998

Comparison of glaucomatous progression between untreated patients with normal-tension glaucoma and patients with therapeutically reduced intraocular pressures. Collaborative Normal-Tension Glaucoma Study Group.

PURPOSE: To determine if intraocular pressure plays a part in the pathogenic process of normal-tension glaucoma. METHODS: One eye of each eligible subject was randomized either to be untreated as a control or to have intraocular pressure lowered by 30% from baseline. Eyes were randomized if they met criteria for diagnosis of normal-tension glaucoma and showed documented progression or high-risk field defects that threatened fixation or the appearance of a new disk hemorrhage. The clinical course (visual field and optic disk) of the group with lowered intraocular pressure was compared with the clinical course when intraocular pressure remained at its spontaneous untreated level. RESULTS: One hundred-forty eyes of 140 patients were used in this study. Sixty-one were in the treatment group, and 79 were untreated controls. Twenty-eight (35%) of the control eyes and 7 (12%) of the treated eyes reached end points (specifically defined criteria of glaucomatous optic disk progression or visual field loss). An overall survival analysis showed a statistically significant difference between the two groups (P < .0001). The mean survival time +/-SD of the treated group was 2,688 +/- 123 days and for the control group, 1,695 +/- 143 days. Of 34 cataracts developed during the study, 11 (14%) occurred in the control group and 23 (38%) in the treated group (P = .0075), with the highest incidence in those whose treatment included filtration surgery. CONCLUSIONS: Intraocular pressure is part of the pathogenic process in normal-tension glaucoma. Therapy that is effective in lowering intraocular pressure and free of adverse effects would be expected to be beneficial in patients who are at risk of disease progression.

Aged↗
PubMed1978

A study on the postulated transoptic regulation of the intraocular pressure.

The possibility that fibers regulating the intraocular pressure originate in the hypothalamus and course in the optic nerve, has been investigated in albino rabbits with different techniques. By means of horseradish perixodase tracing-technique, oculohypothalamic but no hypothalamoocular connections were observed. The water-loading effect on the intraocular pressure was studied after unilateral optic nerve transection. The transection was performed in three experimental groups in the following way: Intracranial transection of one optic nerve, retrobulbar transection of one optic nerve and sham operation on the other side, retrobulbar transection of one optic nerve without sham operation on the other side. In contrast to previous reports, we found no significant side difference in intraocular pressure after water-loading in any of these groups.

Animals↗
PubMed1979

[Effect of premedication and various anesthetics on intraocular pressure].

On the basis of investigations of the intraocular pressure in 172 patients the authors conclude that when choosing anesthetics and other drugs it is necessary to take into consideration their influence upon the intraocular pressure. In patients with high intraocular pressure the peridural anesthesia is expedient.

Adult↗
PubMed2004

Elevated intraocular pressure following vitreoretinal surgery.

Elevated intraocular pressure is a common occurrence following vitreoretinal surgery. The use of silicone oil or intravitreal gas in conjunction with pars plana vitrectomy increases the likelihood of postoperative intraocular pressure elevation. Fortunately, the pressure elevation is usually transient and managed medically. In certain instances, surgical intervention is warranted. Therapeutic intervention should be tailored to the individual patient based on the mechanism of pressure elevation.

Humans↗
PubMed2000

Religious fasting and intraocular pressure.

PURPOSE: To determine the effects of Islamic religious fasting on intraocular pressure. METHODS: The authors measured diurnal intraocular pressure values during religious fasting and 1 month later in 38 healthy male volunteers with a mean age of 22.4 +/- 2.7 years. Body weight and urine specific gravity were determined to assess the extent of dehydration caused by fasting. RESULTS: Although each patient had weight loss (0.1-1.4 kg) representing a slight dehydration caused by fasting, intraocular pressure values were not statistically different between fasting and nonfasting periods (P > 0.05). CONCLUSION: Fasting did not alter diurnal intraocular pressure values in healthy people.

Adult↗
PubMed2000

Optic nerve oxygen tension: effects of intraocular pressure and dorzolamide.

AIM: To investigate the influence of acute changes in intraocular pressure on the oxygen tension in the vicinity of the optic nerve head under control conditions and after intravenous administration of 500 mg of the carbonic anhydrase inhibitor dorzolamide. METHODS: Domestic pigs were used as experimental animals. Oxygen tension was measured by means of a polarographic electrode in the vitreous 0.5 mm anterior to the optic disc. This entity is called the optic nerve oxygen tension. Intraocular pressure was controlled by a hypodermic needle inserted into the anterior chamber and connected to a saline reservoir. RESULTS: When the intraocular pressure was clamped at 20 cm H2O optic nerve oxygen tension was 20 (5) mm Hg (n=8). Intravenous administration of dorzolamide caused an increase in optic nerve oxygen tension of 43 (8)% (n=6). Both before and after administration of dorzolamide optic nerve oxygen tension was unaffected by changes in intraocular pressure, as long as this pressure remained below 60 cm H2O. At intraocular pressures of 60 cm H(2)O and below, dorzolamide significantly increased optic nerve oxygen tension. CONCLUSION: Intravenous administration of 500 mg dorzolamide increases the oxygen tension at the optic nerve head during acute increases in intraocular pressure.

Animals↗
PubMed2005

Is intraocular pressure in the early postoperative period predictive of antimetabolite-augmented filtration surgery success?

PURPOSE: To determine whether intraocular pressure (IOP) in the early postoperative period after trabeculectomy or combined phacoemulsification-trabeculectomy, augmented with antimetabolite, correlates with IOP at one year in surgeries considered to be successful at that time point. DESIGN: Retrospective case series. METHODS: A chart review of antimetabolite-augmented surgical procedures done by DJG and JBS between January 1994 and November 2000 identified 82 primary or secondary trabeculectomies and 53 combined phacoemulsification-trabeculectomies with at least one year of follow-up. The success rate for each surgical subgroup was calculated and IOP on postoperative days (POD +/- SD) 1, 7 (+/-2), 30 (+/-5), 90 (+/-10), and 180 (+/-20) was correlated with IOP at one year (POY 1, between month 12 and 15) using linear regression. IOP at each time point was compared among eyes that achieved success at one year with and without the use of IOP-lowering agents. RESULTS: Of the 82 eyes having undergone antimetabolite-augmented trabeculectomies and the 53 eyes having undergone combined surgeries with at least one year of follow-up, the surgical success rates at POY 1 were 87.8% (72 of 82 eyes) and 92.5% (49 of 53 eyes). Of these, 42 eyes (58.3%) from 39 patients in the trabeculectomy group and 27 eyes (55.1%) from 24 patients in the combined surgery group did not require glaucoma medications at one year postsurgically, and were considered complete surgical successes. Mean preoperative IOP mm Hg +/- SD was 26.0 +/- 8.5 for the trabeculectomy group and 18.2 +/- 4.5 for the phaco-trabeculectomy group. Postoperative IOP at POD 1, POD 7, POD 30, POD 90, POD 180, and POY 1 respectively for the eyes undergoing trabeculectomy were 13.9 +/- 10.4, 9.5 +/- 6.2, 12.0 +/- 5.5, 12.0 +/- 5.2, 12.8 +/- 5.9, and 12.1 +/- 4.3, and for the combined surgery group were 20.8 +/- 12.5, 9.7 +/- 5.7, 12.2 +/- 5.4, 11.1 +/- 3.4, 11.6 +/- 4.6, and 10.3 +/- 4.3. Intraocular pressure on postoperative day one correlated poorly with intraocular pressure at POY 1 for the trabeculectomy group (R2 = 0.0788), and not at all for the combined procedures group (R2 = 0.018). The correlation was slightly better for intraocular pressure at postoperative day 90 for the trabeculectomy group (R2 = 0.546), and at postoperative day 180 for the combined group (R2 = 0.37), but still rather low. Eyes requiring glaucoma medication use at POY 1 in the trabeculectomy group had higher (P < 0.009) intraocular pressure at POD 30 and at all subsequent visits than eyes not requiring these medications. Eyes requiring glaucoma medication use at POY 1 in the phaco-trabeculectomy group had higher (P < 0.0025) intraocular pressure at POD 30, POD 180, and POY 1 than eyes not requiring these medications. CONCLUSION: Intraocular pressure in the early postoperative period correlates very poorly with intraocular pressure one year after successful antimetabolite-augmented trabeculectomy or combined cataract extraction and trabeculectomy. Starting one month after glaucoma surgery, intraocular pressure is substantially lower in eyes that will ultimately not require the use of ocular hypotensive agents to achieve clinical success one year postoperatively.

Aged↗
PubMed2000

Intraocular pressure and progression of glaucomatous visual field loss.

PURPOSE: To evaluate the relationship between intraocular pressure and visual field progression in patients with primary open-angle glaucoma. METHODS: We prospectively followed 113 patients with early to moderate glaucomatous field damage. Conventional automated static perimetry, high-pass resolution perimetry, and intraocular pressure measurements were carried out at 6-month intervals. The mean and the highest intraocular pressure in the follow-up were compared in stable and progressing patients with each perimetric technique. RESULTS: The mean (+/- SD) follow-up was 4.5 +/- 0.9 years. The mean (+/- SD) intraocular pressure in patients remaining stable with conventional perimetry [18.2 +/- 3.3 mm Hg, n = 81 (71.7%)] was not significantly different (P =.65) from those in whom it progressed (17.9 +/- 3.3 mm Hg, n = 32 [28.3%]). The mean intraocular pressure in patients remaining stable with high-pass resolution perimetry (17. 9 +/- 3.5 mm Hg, n = 63 [55.8%]) was not significantly different (P =.33) from those in whom it progressed (18.5 +/- 3.0 mm Hg, n = 50 [44.2%]). The mean (+/- SD) of the highest (single or three highest) pressure during follow-up for stable and progressing patients with conventional perimetry was not significantly different (22.6 +/- 5.0 and 23.0 +/- 4.6 mm Hg, respectively, P =.76). However, for high-pass resolution perimetry, the difference was highly significant (21.6 +/- 4.5 and 24.1 +/- 4.9 mm Hg, respectively, P <. 01). Furthermore, patients who progressed with high-pass resolution perimetry had more damaged baseline fields compared with those who remained stable (P <.01). CONCLUSIONS: The mean level of intraocular pressure does not differentiate glaucoma patients with progressive visual field loss from ones who remained stable. Baseline visual field status and peak intraocular pressure of patients who progress with high-pass resolution perimetry are significantly different from those who remain stable.

Adolescent↗
PubMed2003

Effects of twice daily application of 2% dorzolamide on intraocular pressure in normal cats.

The effect of the topical carbonic anhydrase inhibitor, dorzolamide, on intraocular pressure in cats was studied. The intraocular pressure of both eyes of eight healthy cats was measured using applanation tonometery (Tono-Pen) during two phases: control and treatment. Both eyes were treated with 2% dorzolamide twice a day during the treatment phase. Application of dorzolamide resulted in a significant decrease of intraocular pressure over the treatment phase. By the fourth and fifth day of treatment, the mean intraocular pressure (+/- standard deviation) was 9.7 (+/- 1.5) mmHg, whereas the mean (+/- standard deviation) for the last 2 days of the control period was 12.2 (+/- 2.0) mmHg. Based on this study, dorzolamide is a potentially effective treatment for glaucoma in cats, significantly lowering intraocular pressure.

Administration, Topical↗
PubMed2000

Optic disk topography after medical treatment to reduce intraocular pressure.

PURPOSE: We examined changes in optic disk topography using confocal scanning laser ophthalmoscopy after reducing intraocular pressure with administration of latanoprost. METHODS: Twenty-nine patients with glaucoma or ocular hypertension were imaged using the Heidelberg Retina Tomograph before and after the administration of latanoprost to decrease intraocular pressure. Average time between pretreatment and posttreatment imaging was 2.7 +/- 1.8 weeks. Heidelberg Retina Tomograph software-measured parameters were mean height of contour, cup area, cup volume, mean cup depth, maximum cup depth, cup shape, rim area, rim volume, cup-to-disk ratio, and retinal nerve fiber thickness. RESULTS: Average intraocular pressure decreased significantly (mean +/- SD) by 7.2 +/- 5.4 mm Hg (25 +/- 16% decrease). No statistically significant changes in measured topographic parameters were found. When data from patients with decreases in intraocular pressure of 7 mm Hg or greater were analyzed separately (mean intraocular pressure decrease = 10.79 +/- 4.32 mm Hg, 36 +/- 8% decrease), cup area (P =.005), cup volume (P =. 002), and cup-to-disk ratio (P =.005) decreased significantly, and rim area (P =.005) increased significantly. Linear regression analysis of the data from all subjects showed that a change in intraocular pressure after latanoprost administration accounted for 12% or more of the variance in two measured topographic parameters (mean cup depth and cup shape). CONCLUSIONS: These results suggest that, in some patients, moderate decreases in intraocular pressure may affect disk topography, as measured by Heidelberg Retina Tomograph. Intraocular pressure should be considered when analyzing consecutive confocal scanning laser ophthalmoscopy images for glaucomatous progression.

Antihypertensive Agents↗
PubMedDate not supplied

Effect of esmolol on hemodynamics and intraocular pressure response to succinylcholine and intubation following low-dose alfentanil premedication.

STUDY OBJECTIVE: To determine the effectiveness of esmolol hydrochloride (Brevibloc) as an additional adjunct to low-dose alfentanil premedication in controlling the hemodynamic response [heart rate (HR), mean arterial pressure (MAP), and intraocular pressure (IOP)] to succinylcholine and endotracheal intubation. DESIGN: Randomized, double-blind, placebo-controlled, prospective study. SETTING: Ambulatory gynecologic surgery at a university medical center. PATIENTS: Twenty ASA physical status I and II female patients scheduled for outpatient laparoscopy under general anesthesia. INTERVENTIONS: All patients received alfentanil 10 micrograms/kg as a preoperative medication 4 minutes prior to induction of anesthesia. Study patients (n = 10 in each group) received either esmolol 1.5 mg/kg or a placebo (normal saline) 30 seconds prior to induction (210 seconds after alfentanil and 90 seconds prior to endotracheal intubation). Anesthesia was induced with thiopental sodium 5 mg/kg and succinylcholine 1 mg/kg. Postintubation, 70% nitrous oxide, 30% oxygen, and 1% isoflurane were administered. MEASUREMENTS AND MAIN RESULTS: Time of study drug administration was defined as time zero. Measurements of HR, MAP, and IOP were made at baseline (patient awake) and at each minute from minutes 1 through 6 after administration of the study drug (time zero). Analysis of variance was used to analyze the data, with a value of p less than 0.05 considered significant. Esmolol 1.5 mg/kg was found to blunt the maximum increase in HR but not MAP or IOP following low-dose alfentanil premedication. CONCLUSIONS: In an eye patient with coronary artery disease, or in any patient in whom tachycardia may be detrimental, esmolol may be a useful adjunct in combination with low-dose alfentanil to attenuate the increase in HR due to laryngoscopy and endotracheal intubation.

Adrenergic beta-Antagonists↗
PubMed1991

Autonomic mechanisms underlying intraocular pressure changes during insulin-induced hypoglycaemia in normal human subjects: effects of pharmacological blockade.

1. A fall in intraocular pressure is induced by acute hypoglycaemia in humans. The role of the autonomic nervous system in mediating this response was investigated in 24 normal volunteers in whom hypoglycaemia was induced with intravenous soluble insulin, under four experimental conditions: (1) control (n = 6), (2) non-selective alpha-adrenoceptor blockade (phentolamine) (n = 6), (3) non-selective beta-adrenoceptor blockade (propranolol) (n = 6) and (4) cholinergic blockade (atropine) (n = 6). Intraocular pressure was measured by using an applanation tonometer. In 12 subjects intraocular pressure was measured during each type of pharmacological blockade of similar duration without induction of hypoglycaemia, to assess the effects of individual antagonists. 2. In the control study intraocular pressure fell during hypoglycaemia from 15 +/- 1.0 to 10 +/- 1.3 mmHg (P less than 0.01) 10 min after the autonomic reaction. beta-Adrenoceptor blockade caused a reduction in intraocular pressure from 15 +/- 1.1 to 9 +/- 1.0 mmHg (P less than 0.001) before the administration of insulin, and when hypoglycaemia was induced intraocular pressure decreased further to 7 +/- 1.0 mmHg (P less than 0.05, compared with immediately before insulin). A decrease in intraocular pressure of similar magnitude was observed with propranolol alone (16 +/- 1.0 to 10 +/- 1.0 mmHg, P less than 0.05). 3. Cholinergic blockade had no immediate effect on intraocular pressure, and the reduction in intraocular pressure during hypoglycaemia was of similar magnitude to that observed during the control study.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Intraocular pressure in patients with Cushing's disease.

Externally applied corticosteroids increase the intraocular pressure in one-third of the general population. We evaluated the intraocular pressure in 62 patients with endogenously elevated serum cortisol levels due to hypothalamic pituitary-dependent Cushing's disease. All patients underwent transphenoidal microsurgical sella exploration within 4 years after the onset of subjective symptoms. The intraocular pressure (preoperative mean, 14.9 +/- 3.5 mm Hg) exceeded 21 mm Hg in four eyes before surgery and in one eye after surgery (postoperative mean, 14.3 +/- 2.8 mm Hg). In patients attaining postoperative remission and whose pressure readings were taken at least 3 months after surgery, the postoperative intraocular pressure was significantly (P = 0.04) lower than that measured preoperatively (14.2 +/- 2.7 vs 13.0 +/- 2.0 mm Hg). Biomorphometry of the optic disc topography and the retinal nerve-fiber layer in 19 patients revealed no glaucomatous changes. In contrast to topically applied corticosteroids, endogenously elevated serum cortisol levels in patients with hypothalamic pituitary-dependent Cushing's disease increased intraocular pressure only slightly, with no great risk of glaucomatous optic nerve damage.

Adolescent↗
PubMed1995

[Postoperative intraocular pressure in the first days after intraocular administration of hyaluronic acid solution with different viscosities].

BACKGROUND: Viscoelastic substances are used in anterior segment surgery to reduce tissue trauma and endothelial cell loss and to serve as space maintainer. Healon GV (approximately greater viscosity), a hyaluronic acid product with a ten times higher viscosity than Healon, is utilized in complicated procedures (vitreous pressure, flat anterior chamber, congenital cataracts, etc.) and often in phacoemulsification. Intraocular pressure (IOP) rise following incomplete removal is a known problem. MATERIALS AND METHODS: A prospective randomized study was performed to evaluate the IOP following cataract surgery with Healon or Healon GV and different removal times (RT). Forty patients (forty eyes) having uncomplicated phacoemulsification with foldable silicone posterior chamber lens implantation and identical viscoelastic removal technique were assigned to four groups: Healon with 20 or 40 seconds (sec.) RT, Healon GV with 20 or 40 sec. RT. All surgeries were performed by the same surgeon using the same technique especially for the removal of the viscoelastic. All patients had an identical pre- and postoperative medication. Intraocular pressures were obtained using Goldman's applanation tonometry preoperatively, six, 24, 36, and 48 hours postoperatively. RESULTS: The IOP follow-up showed no significant difference between the two viscoelastic substances and the two different removal times of 20 and 40 sec. (t-test). In four patients (two of the Healon-groups, two of the Healon GV-groups) the IOP required treatment. On the second postoperative day, the same four patients showed IOP lower than 22 mm Hg. The highest mean-IOP (mm Hg) in both Healon-groups was obtained at 24 hours postoperatively: 18.5 +/- 3.9 SD (Healon); 17.3 +/- 5.9 SD (Healon GV). CONCLUSION: The incidence of postoperative rise in IOP using high viscosity hyaluronic acid (Healon GV) can be minimized by the applied removal technique. Both viscoelastics-despite of higher molecular weight and viscosity-can be removed equally from the anterior chamber following phacoemulsification and posterior chamber lens implantation utilizing IOP as a parameter in vivo.

Aged↗
PubMed1982

Effect on the intraocular pressure of hypotensive anaesthesia with intravenous trimetaphan.

The intraocular pressure was measured at 5-minute intervals with a Perkins applanation tonometer in 5 patients undergoing routine dacryocystorhinostomy under low-tension anaesthesia with a continuous intravenous infusion of trimetaphan (Arfonad), the systolic pressure being maintained at 66 mmHg. Twelve patients undergoing cataract surgery under the same premedication and anaesthesia but in whom the systemic blood pressure was maintained at normal levels served as controls. A sudden and dramatic lowering of the intraocular pressure to very low levels was noted when the systolic blood pressure was reduced to 60 mmHg. It seems likely that a collapse of the choroidal circulation rather than a decreased aqueous formation due to low perfusion pressure is the most likely cause of the sudden lowering of intraocular pressure.

Humans↗
PubMed2002

Additive intraocular pressure lowering effect of various medications with latanoprost.

PURPOSE: To determine the additive intraocular pressure reduction of various topical glaucoma agents used adjunctively with latanoprost. DESIGN: Retrospective interventional case series. METHODS: Retrospective evaluation of 73 eyes of 73 patients with glaucoma and inadequate intraocular pressure control on latanoprost alone. Each patient received adjunctive treatment with an additional glaucoma agent (dorzolamide, brimonidine, timolol, or other beta-blockers) for 1 year. RESULTS: When added to latanoprost, dorzolamide lowered intraocular pressure an additional 3.9 mm Hg (19.7%, P <.001); beta-blockers further reduced intraocular pressure by 2.0 mm Hg (12.3%, P <.001), and brimonidine further reduced intraocular pressure by 2.0 mm Hg (9.3%, P =.0011). Dorzolamide dosed twice or three times daily was as effective as adjunctive therapy with latanoprost (P =.92). CONCLUSION: Adjunctive therapy with dorzolamide provided a statistically significant intraocular pressure reduction at 1 year in eyes that were inadequately controlled with latanoprost alone.

Adrenergic alpha-Agonists↗
PubMed2006

The effect of lidocaine and sufentanil in preventing intraocular pressure increase due to succinylcholine and endotracheal intubation.

BACKGROUND AND OBJECTIVE: Succinylcholine administration, laryngoscopy and tracheal intubation are followed by increased intraocular pressure. Various premedications have been advocated for preventing increases in intraocular pressure, especially in patients undergoing surgical repair of open globe due to penetrating eye trauma. Results of studies in this area have been controversial. METHODS: In this double-blind study, three groups of 70 patients receiving sufentanil, lidocaine and placebo 90 s prior to intubation were evaluated and compared for intraocular pressure changes following succinylcholine administration, laryngoscopy and tracheal intubation. RESULTS: Mean intraocular pressure measured 2 and 3 min after succinylcholine administration in groups receiving sufentanil and lidocaine was significantly lower than in the placebo group. Mean intraocular pressure changes in the three groups were -1.84, -2.03 and +2.82 mmHg, respectively in minute 2; -4.78, -4.73 and +1.35 mmHg, respectively in minute 5. There was a significant intraocular pressure decrease in the sufentanil and lidocaine groups, compared to the placebo group. The eye surgeons' satisfaction was also significantly higher with the sufentanil and lidocaine groups. CONCLUSION: Previous studies have yielded controversial results as to the effect of sufentanil and lidocaine in preventing intraocular pressure following succinylcholine administration, laryngoscopy and tracheal intubation. The present study affirms the preventive effect of these drugs on intraocular pressure increase.

Adult↗