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Effect of hemodialysis on intraocular pressure.

Intraocular pressure (IOP) was determined in 13 dialysis patients before, during, and after dialysis. The values were compared with those obtained in an age-, sex-, and time-matched normal control group. The IOP values obtained in dialysis patients were significantly lower than those in the control group. An insignificant decrease in IOP was noted during the first 2 h of dialysis. This was followed by a slight rise above the base line by the end of dialysis. Although the middialysis IOP was significantly lower than the postdialysis value, the latter was not significantly different from the predialysis value. Our results are at variance with several earlier studies demonstrating marked increase in IOP during dialysis. Lack of significant rise in IOP during dialysis in our study seems to be due to improved dialytic technique and better uremia control employed here as compared with the earlier studies.

Adult↗

Thiopental and succinylcholine: Action on intraocular pressure.

Intraocular pressure (IOP) measurements were made in a series of 92 male surgical patients, to assess the effects of timing and dosage of succinylcholine given after a standardized sleep dose of thiopental (3 mg./kg.). The major findings of this study were as follows: (1) thiopental alone lowered IOP; (2) a small (0.5 mg./kg.) dose of succinylcholine, given immediately after thiopental, returned IOP to normal; (3) a large (1 mg./kg.) dose of succinylcholine immediately after thiopental maintained the IOP at a low value; (4) if 2 minutes elapsed between thiopental and 1 mg./kg. of succinylcholine, the relaxant raised the IOP to slightly above preanesthetic control values; (5) tracheal intubation caused a significant rise in IOP, more than any effect from succinylcholine itself; (6) succinylcholine drip (0.1 percent), begun after establishment of satisfactory endotracheal halothane-nitrous oxide anesthesia, caused significant IOP elevation in 4 of 11 patients.

Adult↗

Corticosteroid treatment for inflammatory bowel disease in pediatric patients increases intraocular pressure.

Intraocular pressure (IOP) was measured in 54 pediatric patients (aged 7-21 years) with inflammatory bowel disease (IBD) who were treated with oral prednisone for 1-104 months. The difference in mean IOP between the treated patients (mean +/- SD, 15.62 +/- 4.11 mm Hg) and 55 age-matched controls (13.83 +/- 2.42 mm Hg) was statistically significant (P = 0.007). The IBD patients were classified as group I, IOP less than or equal to 19 mm Hg in both eyes, and group II, IOP greater than or equal to 20 mm Hg in either eye. Twelve of the 54 patients (22.2%) and none of the controls had IOP greater than or equal to 20 mm Hg (P less than 0.001). Seventeen of the 54 patients (31.5%) were characterized as "steroid responders" (IOP of greater than or equal to 20 mm Hg, change in IOP of greater than or equal to 6 mm Hg between visits, or difference in IOP of greater than or equal to 6 mm Hg between the two eyes). When the dose of prednisone was reduced to 0-10 mg/day 30 days or more before measurement, 9 steroid responders showed a decrease in IOP to within 2 SD of the mean control IOP; 7 of the 9 showed a decrease in IOP of greater than or equal to 6 mm Hg. These observations indicate that while prednisone is a causative factor in increasing the IOP, susceptibility to average doses of prednisone is highly variable, and patients need to be monitored on an individual basis. Because IBD is a chronic disorder that requires prolonged corticosteroid treatment, these children are at risk of developing steroid-induced glaucoma. Careful ophthalmologic monitoring of pediatric IBD patients, as well as of other pediatric patients who receive corticosteroid therapy, is recommended.

Adolescent↗

Systemic blood pressure and intraocular pressure relationship.

The relationship between intraocular pressure (IOP) and arterial blood pressure (BP) was analyzed in response to two pressor agents (norepinephrine and angiotensin II) and two depressor agents (methacholine and isoproterenol) in pentobarbital anesthetized cats. Both IOP and BP were measured manometrically in the same animals. Intravenous norepinephrine and angiotensin II produced dose-dependent increases, whereas intravenous methacholine and isoproterenol produced dose-dependent decreases of both BP and IOP. The IOP response to methacholine was biphasic, with an initial decrease followed by an increase above the pre-drug level. In some experiments a cannula loop was inserted into a carotid artery in order to separate the direct ocular effect of drugs on IOP from that contributed by the changes in systemic BP. Intravenous administration of norepinephrine and angiotensin II produced a larger increase in IOP on the side where drugs were delayed by the loop. Conversely, methacholine produced a larger fall in IOP on the cannulated side while the effect of isoproterenol was essentially unchanged. In other experiments injections were made directly into the ocular arterial blood supply. Norepinephrine and angiotensin II produced a decrease in IOP, methacholine produced a rise of IOP and isoproterenol was not active by this route. The present findings indicate that IOP is largely influenced by arterial BP changes in the acute phase and that the IOP response to drugs is the algebraic sum of effects on systemic BP and their direct ocular effects.

Angiotensin II↗

Nocturnal blood pressure and intraocular pressure measurement in glaucoma patients and healthy controls.

Daytime and nocturnal intraocular pressure (IOP) values and systemic blood pressure (BP) values were compared in 60 non-glaucomatous controls, 54 glaucoma patients with normal visual field, and 46 glaucoma patients with visual field loss. The daytime IOP was measured with a Goldmann applanation tonometer and the nocturnal IOP with a Bio-Rad-Tono-Pen 2. The BP was measured with either a mercury manometer or with a Meditech ABPM-02 Ambulatory Blood Pressure Monitor, which took BP readings at 60 minute intervals. A tendency towards increasing IOP and decreasing BP was detected in the non-glaucomatous controls, within normal limits, and pathological changes of IOP and BP were observed with a significantly high occurrence (5% > P > 2%; Pearson's chi 2-test) in the glaucoma group with visual field loss.

Age Distribution↗

Does the change of anterior chamber depth or/and episcleral venous pressure cause intraocular pressure change in postural variation?

PURPOSE: Previous studies have found that the intraocular pressure (IOP) variation from postural change is due to the obstruction of aqueous outflow by an increase in episcleral venous pressure. This study investigated if any shift of anterior lens position from postural variation would be another contributing factor. METHODS: Thirty-three Chinese subjects were recruited with their IOP and anterior chamber depth (ACD) measured in the sitting, supine, and prone postures. The IOP was measured using a Pulsair 2000 noncontact tonometer and ACD with a Nidek US-2000 EchoScan unit. RESULTS: The highest IOP was obtained in the prone position and this value was significantly different from the IOP obtained in other postures, whereas there was no significant difference in ACD. CONCLUSIONS: Because no significant variation in ACD was demonstrated, the prone and supine IOP variation could be due to something other than the change in lens position. However, a higher IOP in the prone position rather than in the supine position also suggests that it is not merely the episcleral venous pressure causing the IOP change. Investigation of the entire iris profile at different postures would be more informative in future studies.

Adult↗

Single intraocular pressure measurements and diurnal intraocular pressure profiles.

PURPOSE: To evaluate the probability of a single intraocular pressure measurement to be the highest measurement within a diurnal intraocular pressure profile. DESIGN: Hospital-based clinical, observational study. METHODS: The study included 3,025 day-and-night intraocular pressure profiles measured on 1,072 eyes of 547 Caucasian glaucoma patients or glaucoma suspects. Applanation tonometry was performed at 7 am, noon, 5 pm, 9 pm, and midnight. RESULTS: Intraocular pressure measurements were highest at 7 am, noon, 5 pm, 9 pm, and midnight, respectively, in 20.4%, 17.8%, 21.3% 13.9%, and 26.7% of the profiles, respectively. The measurement taken at 7 am was significantly (P < .001) closest to the maximal value of the profile. CONCLUSIONS: Any single intraocular pressure measurement taken between 7 am and 9 pm has a higher than 75% chance to miss the highest point of a diurnal curve. Intraocular pressure may be measured at different times of the day to have the best chance of observing the maximal value.

Circadian Rhythm↗

Socioeconomic status, systolic blood pressure and intraocular pressure: the Tanjong Pagar Study.

BACKGROUND: Lower socioeconomic status (SES) is associated with higher morbidity and mortality in many countries. Present evidence suggests that glaucoma has similar risk factors to major chronic diseases such as cardiovascular disease. This study investigates the association between SES and intraocular pressure (IOP), an important risk factor for glaucoma. METHODS: The Tanjong Pagar Study was a population-based cross-sectional survey of Chinese people aged 40-79 years, who were randomly selected from the Singapore electoral register. Of the 2000 people selected, 1717 were considered eligible and 1090 were examined in clinic and included in the present study. IOP was measured using applanation tonometry. SES was assessed using a standardised questionnaire; education and income were used as the main explanatory variables. The effect of systolic blood pressure (SBP) was also examined. RESULTS: Participants with lower levels of education and income had higher mean IOP (both p<0.01). These associations remained after adjusting for age and central corneal thickness, a strong independent predictor. SBP was strongly associated with both SES and IOP (both p<0.01). Adjusting for SBP attenuated the association between SES and IOP. CONCLUSION: Participants with lower education and income have a higher mean IOP. This effect may be mediated, in part, by an association of education and income with SBP. This is the first study to suggest that there is a social gradient in the distribution of the only major modifiable risk factor for glaucoma. Increasing similarities exist between the causation models of chronic diseases and that of glaucoma.

Adult↗

Neovascular glaucoma and intraocular pressure: II. Reduction of intraocular pressure--our 5-year experience.

The paper reports the results obtained with reduction of intraocular pressure in 38 eyes of 38 patients with acute neovascular glaucoma. Cyclocryocoagulation alone was made in 12 eyes, 26 eyes were treated by transscleral panretinal cryocoagulation combined with cyclocryocoagulation. In eyes treated by cyclocryocoagulation alone the intraocular pressure less than 26 mmHg was on 5th day after operation in 41.6%, on 10th day in 66.7%. However, this effect was transient in one-third of the patients, and no effect was found in one-third of eyes. In eyes treated by transscleral panretinal cryocoagulation combined with cyclocryocoagulation, the intraocular pressure less than 26 mmHg by 3 days after operation was recorded in 50%, by 10 days in 76.9%. Postoperative hypotension developed in 27%. It is concluded that intraocular pressure in neovascular glaucoma is better managed by transscleral panretinal cryocoagulation with concurrent cyclocryocoagulation than by cyclocryocoagulation alone.

Cryosurgery↗

A study of the effects of four concentrations of D-timolol, 0.25% L-timolol, and placebo on intraocular pressure on patients with raised intraocular pressure.

The intraocular pressure lowering effect in 30 patients with raised intraocular pressure and open angles following a single application in a randomised double-masked fashion of four concentrations of D-timolol (0.25%, 0.5%, 1.0%, and 2.0%), 0.25% L-timolol, and placebo are presented. The percentage reduction in intraocular pressure after four hours following single-drop instillation range from 20% to 25% in the D-timolol group, 32% in the L-timolol group, and only 8% in the placebo group of treated eyes.

Adolescent↗

Diurnal variations in intraocular pressure in the albino rabbit: relationship to morning intraocular pressure.

Intraocular pressure (IOP) measurements were carried out in 88 adult male New Zealand white rabbits. IOP of each rabbit was measured in the morning (8.00-9.00 h), at noon (12.00-13.00 h) and in the afternoon (16.00-17.00 h) on 6 separate days. A linear relationship was found between the noon IOP and the morning IOP: noon IOP = 0.77 morning IOP + 4.37; r = 0.950. This regression line intersects the line of IOP equality (morning IOP = noon IOP) at morning IOP = 19 mm Hg. Thus, in animals with morning IOP < 19 mm Hg, there was an increase in IOP between the morning and noon readings whereas animals with a higher morning IOP (20-30 mm Hg) showed a progressive decrease in the morning-noon IOP. This observed relationship explains the disparity among previously published IOP diurnal curves for rabbits. It is suggested that future studies of IOP changes should present IOP values and not only relative changes in IOP (delta IOP or percent change in IOP).

Animals↗

Low intraocular pressure and postural changes in intraocular pressure in patients with Hansen's disease.

We found intraocular pressures of less than 7 mm Hg in 11 of 72 patients (15%) with early Hansen's disease. Furthermore, significant postural changes in intraocular pressure (greater than 30%) occurred in 43 of 72 patients (60%). This loss of intraocular pressure homeostasis, which results from reduced aqueous humor production or increased uveoscleral outflow with reduced local adrenergic control in the ciliary body-iris-trabecular meshwork region, suggests that early autonomic neuropathy of the eye may occur in Hansen's disease. The only predictive value for significant postural change in intraocular pressure was the presence of immunologically unstable disease.

Homeostasis↗