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[The alteration of the human ERG in light- and darkadapted state under normal and increased intraocular pressure (author's transl)].

Electroretinograms of 19 human eyes in light- and darkadapted state under normal and increased intraocular pressure (increased by a spring pressure dynamometer) were recorded (Pm = (Ps + Pd)/2). On physiological intraocular pressure the a-wave showed a low increase in amplitude after 25 min of dark adaptation, the b-wave a great one. After increasing the intraocular pressure no significant influence of the state of adaptation to the magnitude of the a- and b-wave could be found.

Adaptation, Ocular↗

Comparison of effects of topical ibopamine and epinephrine on the circadian rhythm of intraocular pressure of the rabbit eye as measured by telemetry.

The purpose of this study was to measure the effect of topical ibopamine and epinephrine on intraocular pressure in undisturbed rabbits. Six pigmented rabbits were outfitted with a telemetric transducer system connected via catheter to the vitreous cavity of one eye for continuous monitoring of intraocular pressure. After entrainment to a 12 hour light, 12 hour dark cycle and after stabilization of the circadian rhythm of intraocular pressure, the animals were tested with 2% ibopamine and 2% epinephrine. Each drug was instilled during the light phase and during the dark phase of the circadian cycle. When administered during the light phase, both drugs caused a transient pressure rise followed by prolonged hypotension. When administered during the dark phase, neither drug caused a pressure rise but both drugs caused prolonged hypotension. It was concluded that ibopamine and epinephrine cause identical intraocular pressure changes in the normal rabbit eye. The effect was dependent on the timing of administration during the circadian cycle. Since ibopamine is a pro-drug of deoxyepinephrine (N-methyl dopamine, epinine), its effects are assumed to be due to this metabolite, a metabolite that is structurally similar to epinephrine.

Animals↗

Comparison of the effect of sodium hyaluronate (Ophthalin) and hydroxypropylmethylcellulose (HPMC-Ophtal) on corneal endothelium, central corneal thickness, and intraocular pressure after phacoemulsification.

PURPOSE: To prospectively evaluate the effects of 2% hydroxypropyl-methylcellulose (HPMC-Ophtal) and sodium hyaluronate 1% (Ophthalin) on intraocular pressure, corneal thickness, and endothelial cell loss in small incision cataract surgery with implant. METHODS: A total of 110 patients undergoing routine phacoemulsification with implant received either 2% hydroxypropyl methylcellulose or sodium hyaluronate 1% as ophthalmic viscosurgical device. Pre- and postoperative slitlamp examination, intraocular pressure measurement (preoperatively and at 1-4 hours, 1 day, and 7 days postoperatively), ultrasonic pachymetry (preoperatively and at 1 week, 4-6 weeks, and 12 weeks post operatively), and corneal endothelial cell count (preoperatively and 12 weeks postoperatively) were performed. Data were analyzed using two-way analysis of variance. RESULTS: All measurements were comparable between the two groups preoperatively. Intraocular pressure was significantly lower in the Ophthalin group at 1 day post operatively, while no significant difference was found between the two groups on the 1-4 hours and 7 days examination. The central corneal thickness was not significantly different between the two groups at any postoperative visit . However, the mean cell density demonstrated a significant fall of 11.76% for Ophthalin and 4.27% for HPMC-Ophtal at 12 weeks post-operatively, the difference between the two being significant (p=0.009). CONCLUSIONS: 2% Hydroxypropyl methylcellulose, compared with sodium hyaluronate 1%, is superior in protecting the corneal endothelial cells, has the same effect on central corneal thickness, and is associated with slightly higher intraocular pressure 1 day post operatively. It compares favorably with sodium hyaluronate 1% and can be used as an effective and cheaper alternative in routine small incision cataract surgery with implant.

Anterior Chamber↗

Effects of short term increase of intraocular pressure on optic disc cupping.

AIMS: To evaluate the effect of acute elevation of intraocular pressure (IOP) on optic disc cupping. METHODS: 10 emmetropic and 10 myopic volunteers were included in this study. The cup area (CA) and cup volume (CV) of the optic disc were determined with the Heidelberg retina tomograph (HRT). After baseline determinations, a suction cup was used to increase the intraocular pressure (IOP) to 20-25 mm Hg above the baseline and HRT images were obtained. RESULTS: Baseline IOP was 13.5 (SD 1.3) nim Hg and 12.6 (2.6) mm Hg in the emmetropic and myopic groups, respectively. The IOP was elevated to 35.4 (3.3) mm Hg and 34.4 (2.5) mm Hg in the emmetropic and myopic groups, respectively. When compared with their baseline values, the cupping variables (CA and CV) were significantly increased (p < 0.05) during the suction treatment in both emmetropic and myopic subjects. CONCLUSION: There was a significant enlargement in the optic disc cupping during the artificial increment of intraocular pressure in both emmetropic and myopic eyes. In non-glaucomatous eyes the optic nerve head has a partially dynamic topography dependent upon the level of IOP.

Adult↗

Peribulbar anaesthesia: the role of local anaesthetic volumes and Thiomucase in motor block and intraocular pressure.

Peribulbar anaesthesia is a useful regional anaesthesia and akinesia technique for eye surgery. We studied changes in muscular akinesia and intraocular pressure under peribulbar anaesthesia caused by different volumes of 0.75% bupivacaine with or without the addition of Thiomucase (chondroitin sulphatase) in patients undergoing cataract surgery. A total of 120 patients were randomly allocated into four groups: group 1, bupivacaine 5 mL; group 2, bupivacaine 5 mL plus Thiomucase 10 U mL-1; group 3, bupivacaine 9 mL; group 4, bupivacaine 9 mL plus Thiomucase 10 U mL-1. We assessed: (1) akinesia according to mobility in the four quadrants of the eyeball and the palpebral opening using a scoring system between 0 (total akinesia) and 10 (full movement); and (2) intraocular pressure before, immediately after and 15 min after peribulbar anaesthesia. A significantly better motor blockade was observed in groups 2, 3 and 4 than in group 1 (P < 0.05). Thiomucase increased the quality of motor blockade in group 2, but not in group 4. Intraocular pressure increased by 5-10 mmHg in comparison with baseline values and, after 15 min application of Honan's balloon, decreased by 8-10 mmHg in comparison with baseline values, with no significant differences between groups. Thiomucase can improve the motor block if a lower volume of local anaesthetic is used. The administration of 5 or 9 mL volumes or the addition of Thiomucase decreases the the intraocular pressure in a similar way.

Aged↗

Effect of intracameral and intravitreal injection of calcitonin gene-related peptide on the intraocular pressure and outflow facility of aqueous humor in the rabbit.

After intracameral injection calcitonin gene-related peptide has been demonstrated to break the blood aqueous barrier and increase intraocular pressure in rabbits. However in cats, calcitonin gene-related peptide decreases intraocular pressure by increasing the outflow facility of aqueous humor. In the present study, the effect of intracameral injection of calcitonin gene-related peptide on the outflow facility in rabbits has been investigated and the intraocular pressure and outflow facility were measured following intravitreal administration of calcitonin gene-related peptide. The results demonstrate that in spite of the apparent pseudofacility component caused by a breakdown of the blood aqueous barrier also the true trabecular outflow is probably increased in the rabbit eye after intracameral injection of calcitonin gene-related peptide. The intravitreal administration of calcitonin gene-related peptide leaves the blood aqueous barrier intact and causes an increase in the outflow facility of aqueous humor with a concomitant long-lasting decrease in intraocular pressure.

Animals↗

The efficacy of the combination of l-moprolol and dipivefrin in reducing the intraocular pressure in primary open-angle glaucoma or in ocular hypertension.

BACKGROUND: In this double-blind prospective trial the efficacy of lowering the intraocular pressure of l-moprolol given alone and in combination with dipivefrin was tested. METHODS: Twenty-seven patients with primary open-angle glaucoma or ocular hypertension were randomly assigned to receive twice-daily l-moprolol eye drops or dipivefrin eye drops for 4 weeks; in a second phase of the trial, the combination of the two drugs was administered for 4 weeks. RESULTS: The results of this study indicated that l-moprolol and dipivefrin had an equivalent effect in lowering the intraocular pressure. The association of the two drugs caused a further reduction of intraocular pressure which was significant only in the group previously treated with dipivefrin alone. CONCLUSION: This trial demonstrated that the combination of l-moprolol and dipivefrin is an effective and safe treatment for elevated intraocular pressure.

Adrenergic beta-Antagonists↗

Intraocular pressure elevation following Nd:YAG laser posterior capsulotomy.

Intraocular pressures (IOP) and tonographic outflow facilities were measured following neodymium (Nd): YAG laser posterior capsulotomy in 13 pseudophakic and 8 aphakic eyes. Mean intraocular pressure (IOP) peaked by three hours with a mean increase of 13 mmHg, remained elevated by 5 mmHg at 24 hours but returned to baseline by one week. Fourteen eyes (67%) had greater than or equal to 10 mmHg elevation and eight (38%) had greater than or equal to 40 mmHg maximum IOP. All the patients who eventually demonstrated a greater than or equal to 10 mmHg elevation within six hours of the capsulotomy initially had an IOP elevation greater than or equal to 5 mmHg at one hour. The mean outflow facility was reduced from 0.18 microl/min/mmHg before capsulotomy to 0.08 microl/min/mmHg (55%, P less than 0.0001) at four hours and was still decreased at 0.13 microl/min/mmHg (27%, P less than 0.05) at one week. Seventy-five percent of aphakic and 15% of pseudophakic patients had maximum IOP greater than or equal to 40 mmHg (P less than 0.01). Measurements should be performed one hour postlaser in all patients for IOP and three to four hours in aphakic patients, glaucomatous patients, patients receiving greater than or equal to 200 mjoules total laser energy, and patients with greater than or equal to 5 mmHg elevation at one hour in order to detect and treat significant IOP elevations.

Cataract Extraction↗

Effects of topically applied bupranolol on the intraocular pressure. Effects on the untreated eye.

Topically applied bupranolol, a beta-adrenergic blocking agent, has been shown to have a marked effectiveness in lowering the intraocular pressure of the normal and glaucomatous eyes. The effects were not only seen in the treated eyes but also in the untreated, contralateral eyes. The contralateral response was independent of the ongoing diurnal variation of the intraocular pressure. Instillation of the drug into the nasal cavity induced decrease of the intraocular pressure in both eyes, the extent of which was comparable to the contralateral response induced by ocular instillation. These observations suggest that the contralateral response is caused by systemically absorbed drug, probably due to the action on the central locus regulating the intraocular pressure. Instillation of pilocarpine did not show any similar contralateral response.

Absorption↗

Brain death and intraocular pressure.

The authors report on the behavior of the intraocular pressure of 20 patients who had sustained severe head injury. The 8 patients who retained normal intraocular pressure all survived. The 12 patients who developed intraocular hypotony all suffered brain death. Although optic disc edema was not noted in any brain-dead patients, we did find signs of fundus ischemia in most.

Adolescent↗

Ocular autonomic dysfunction and intraocular pressure in leprosy.

We examined 241 leprosy patients and 135 age-matched healthy controls in central South Korea, measuring intraocular pressure in the supine and the upright positions and measuring the size of the pupils in darkness as an indication of ocular autonomic dysfunction. The mean intraocular pressure was significantly lower in the patients and the mean size of pupils was significantly smaller in the patients than in the controls. However, there was no correlation between pupil size and intraocular pressure in our patients. Our findings show that leprosy patients have ocular autonomic dysfunction, but do not support previous speculation that this dysfunction is the primary cause for low intraocular pressure in leprosy.

Adult↗

The effect of different doses of ketamine on intraocular pressure in anesthetized children.

BACKGROUND: When used for induction of anesthesia, ketamine usually increases intraocular pressure (IOP). However, the effect of low doses of ketamine, which are used for parental separation in children, is unknown. We studied the effect of two different doses of ketamine on IOP in anesthetized children. METHODS: Forty children age 1 to 6 years who met American Society of Anesthesiologists physical status I criteria scheduled to undergo surgery were randomly selected to receive either an induction dose (6 mg/kg) or a low dose (3 mg/kg) of ketamine intramuscularly. Anesthesia was induced and maintained with halothane, and ketamine was injected 10 minutes after induction. Intraocular pressure was measured using a Perkins applanation tonometer before ketamine administration and every 5 minutes thereafter for 20 minutes by an observer who was unaware of the ketamine dose used. 10.8 +/- 2.2 mm Hg to 12.6 +/- 2.8 mm Hg at 5 minutes and 11.9 +/- 2.5 mm Hg at 10 minutes after administration of ketamine in the induction-dose group. There was no significant change in IOP after administration of ketamine in the low-dose group. Intraocular pressure was significantly higher in the induction-dose group compared to the low-dose group at 5 minutes after administration of ketamine. More patients in the induction-dose group had postoperative airway obstruction and sedation than in the low-dose group. CONCLUSIONS: In children anesthetized with halothane, ketamine had a dose-dependent effect on IOP, with 6 mg/kg of the drug causing a small increase in IOP at 5 to 10 minutes and 3 mg/kg not altering the IOP. The higher dose of ketamine also was associated with an increased incidence of postoperative complications.

Anesthesia, Inhalation↗

Intraocular pressure measurement with the Tono-Pen through soft contact lenses.

We evaluated a miniaturized digital and electronic tonometer, the Tono-Pen, for accuracy of intraocular pressure measurement in the presence of a contact lens. In the manometric study, the Tono-Pen was used to measure a known intraocular pressure, ranging from 10 mm Hg to 60 mm Hg in a cadaver eye over soft contact lenses with different powers and a plano-T bandage lens. There was significant bias in pressure measurement over all contact lenses except for the plano-T, which had no bias at any level. In the clinical study, the intraocular pressures of 40 eyes in 20 normal patients were measured with and without a plano-T contact lens in place. Analysis of variance showed no significant interactive effect between the right and left eyes, with or without the lens. There was no significant difference in the Tono-Pen measurement of intraocular pressure over a plano-T contact lens compared with no lens.

Analysis of Variance↗

The quantitative effect of Healon on early postoperative intraocular pressure after extracapsular cataract extraction with implantation of a posterior chamber lens.

In a prospective, randomized and masked study the quantitative effect of sodium hyaluronate (Healon) on early postoperative intraocular pressure after cataract surgery was evaluated. At the end of planned extracapsular cataract extraction with implantation of posterior chamber lens, 0.1 ml or 0.2 ml of Healon was injected into the anterior chamber. The intraocular pressure was measured preoperatively, 3-6 h and 24 h postoperatively. All patients received topical timolol at the end of surgery. The results were compared to eyes operated with identical techniques where Healon was aspirated at the end of surgery. Three to six hours postoperatively a significant drop in mean intraocular pressure from preoperative pressure occurred when Healon was aspirated, but no statistical differences in mean intraocular pressure appeared when 0.1 ml or 0.2 ml of Healon was injected. The frequencies of pressure rise above 30 mmHg show no differences among the groups. Twenty-four hours postoperatively a significant pressure elevation from mean preoperative pressure occurred when 0.1 ml or 0.2 ml Healon was injected compared to the group were Healon was aspirated at the end of surgery. Similar results are seen when pressure rise above 30 mmHg are concerned.

Adult↗

Effect of melatonin on intraocular pressure.

We studied the effect of orally administered melatonin on intraocular pressure in humans. We suppressed serum melatonin levels by exposing our subjects to bright light. Our experiments suggest that melatonin lowers intraocular pressure in man. This may prove to be a therapeutically useful agent since melatonin appears to be relatively free of side effects and is effective in small quantities.

Administration, Oral↗

Relationship between intraocular pressure and obesity in Japan.

BACKGROUND: Some cross-sectional studies have suggested that age, systolic blood pressure and obesity are positively related to intraocular pressure (IOP), but few longitudinal studies have examined this relationship. This study was carried out to evaluate the association between intraocular pressure and obesity by cross-sectional and longitudinal analyses in a large Japanese population. METHODS: Data were collected from annual health examinations between 1989 and 1997 and reviewed retrospectively. Subjects of the cross-sectional analysis were 70 139 males and females aged 14-94 years. Among these subjects, 25 216 males and females who had undergone IOP measurements more than three times were analysed longitudinally. The association between IOP and obesity was examined cross-sectionally and longitudinally. RESULTS: Cross-sectional analysis: The mean IOP at the last visit was 11.6 mmHg. The IOP decreased gradually with age and was significantly higher in males than in females in almost all age groups. Body mass index (BMI) significantly correlated with IOP after controlling for age, gender and blood pressure. Longitudinal analysis: There was a significant association between longitudinal change in IOP and change in weight. This relationship remained significant after controlling for initial BMI, initial blood pressure, change in blood pressure, gender and age. CONCLUSION: This study showed a significant association between IOP and obesity in both cross-sectional and longitudinal analysis. These findings suggest that obesity is an independent risk factor for increase in IOP.

Adolescent↗

Retinal circulation during a spontaneous rise of intraocular pressure.

The retinal haemodynamic changes occurring in an eye with a spontaneous elevation of intraocular pressure were investigated by bidirectional laser Doppler velocimetry and monochromatic fundus photography. At an intraocular pressure of 47 mmHg the blood velocity and volumetric blood flow rate were significantly smaller and arterial blood velocity pulsatility was significantly greater than normal. The corresponding 88% reduction in perfusion pressure was accompanied by a 67% reduction in total retinal blood flow, indicating that autoregulation is not efficient at this level of intraocular pressure. An Octopus visual field examination obtained immediately following blood flow measurements suggested that the central retina can preserve a fairly good function under a total retinal blood flow rate of about one-third of the normal value.

Adult↗