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To retrospectively evaluate the efficacy and safety of all transscleral cyclophotocoagulation (TCP) treatments performed during a 5-year period.Medical records of all patients, who had undergone TCP treatment between 2010 and 2014 at Umeå University Hospital, Sweden, were evaluated. Clinical data including intraocular pressure (IOP), visual acuity (VA), number of topical glaucoma medications, use of oral acetazolamide, retreatments and complications during a 2-year follow-up were registered. Global success was defined as IOP 6-18 mmHg with or without glaucoma medication.Three hundred patients underwent TCP during the time period. Mean IOP at baseline was 29.3 ± 11.0 (mean ± standard deviation) mmHg (n = 297) with a mean reduction of 11.5 (±12.0) mmHg at 1 year (n = 258; p 0.001) and 12.6 (±12.0) mmHg at 2-year follow-up (n = 245; p 0.001). Global success at 2 years was 64%, achieved by a mean of 1.2 treatments (n = 257). The number of topical glaucoma medications at baseline was 3.1 (±1.0; n = 296) and was reduced by 0.9 (±1.0) medications at 2 years (n = 244; p 0.001). Use of oral acetazolamide decreased from 30% (n = 90) at baseline to 5.3% (n = 13) at 2 years. In eyes with Snellen VA ≥ 0.1, the mean VA at baseline was 0.55 (±0.3) logarithm of the minimum angle of resolution (logMAR; n = 132) and 1.1 (±0.9) logMAR (n = 76) at 2 years (p 0.001). No cases of phthisis bulbi were found.This study displays a substantial and long-term reduction of IOP following TCP with a decrease in topical and oral glaucoma medications. The treatment appears to be safe but the decrease in VA during follow-up is a concern that needs further evaluation.

Objective: The discovery of a posture-dependent effect on the difference between intraocular pressure (IOP) and intracranial pressure (ICP) at the level of lamina cribrosa could have important impl ...

To compare in a randomized, controlled trial topical 1.5% dexamethasone γ-cyclodextrin nanoparticle eye drops (DexNP) with posterior subtenon injection of triamcinolone acetonide in diabetic macular oedema (DME).In this prospective, randomized, controlled trial, 22 eyes of 22 consecutive patients with DME were randomized to (i) topical treatment with DexNP ×3/day (4 weeks), ×2/day (4 weeks) and ×1/day (4 weeks) or (ii) one posterior subtenon injection of 20 mg triamcinolone acetonide. Study visits were at baseline and 4, 8, 12 and 16 weeks.The logMAR (Snellen) visual acuity (mean ± SD) improved significantly with DexNP from 0.41 ± 0.3 (Snellen 0.39) to 0.32 ± 0.25 (0.48) and 0.30 ± 0.26 (0.50) at 4 and 8 weeks, respectively. One-third of the DexNP group improved more than 0.3 logMAR units. For triamcinolone, logMAR changed significantly from 0.42 ± 0.28 (0.38) at baseline to 0.32 ± 0.29 (0.48) at 4w and 0.33 ± 0.37 (0.47) at 12w. The central macular thickness (CMT) decreased significantly with DexNP from 483 ± 141 μm to 384 ± 142 μm at 4w and 342 ± 114 μm at 8w. For triamcinolone, CMT decreased significantly at all time-points: 494 ± 94 μm, 388 ± 120, 388 ± 145, 390 ± 136 and 411 ± 104 μm at 0, 4, 8, 12 and 16 weeks, respectively. There was a modest increase in intraocular pressure (IOP) at all time-points with DexNP while no increase was seen with triamcinolone. Serum cortisol was affected by both treatments.Topical DexNP significantly improve visual acuity and decrease macular thickness in patients with DME. The effect is similar to that from subtenon triamcinolone. A modest increase in IOP was seen with the nanoparticle eye drops, but IOP normalized after the discontinuation of treatment.

In recent years, Applanation Resonance Tonometry (ART) has been suggested for intraocular pressure (IOP) measurements. The manual version of ART (ART(manual) ) has been further developed, and to improve usability, an automatic servo-controlled prototype (ART(servo) ) has been proposed. The aim of this study was to assess the limits of agreement (LoA) of ART(manual) and ART(servo) as compared with the reference method, Goldmann Applanation Tonometry (GAT).This was a prospective single-centre study on 152 eyes from 77 subjects. It was designed according to International Standard Organization's (ISO) requirements for tonometers (ISO 2001). Intraocular pressure was measured six times/method in a standardized order. The ART technique has two available analysis procedures: a dynamic one that measures IOP during the indentation phase and a static one that causes a Goldmann-like measurement during two seconds of full applanation. The 95% LoA was defined as ±1.96 × standard deviation of difference against GAT.Mean IOP for GAT was 19.1 mmHg (range: 10-37 mmHg). The 95% LoA of ART(manual) was ±4.5 mmHg for both dynamic and static analyses. The 95% LoA of ART(servo) was ±5.7 mmHg for dynamic and ±4.9 mmHg for static analyses.This study confirms that the ART methodology is feasible. The further developed ART(manual) fulfilled the ISO standard with both the dynamic and the static analysis techniques. ART(servo) with static analysis was close to fulfilling the standard but failed to do so in the highest IOP range. ART(servo) has the potential to greatly improve usability if further development is completed.

To compare intraocular pressure (IOP) measurements by Pascal, ICare and Goldmann applanation tonometry (GAT), to evaluate the effects of central corneal thickness (CCT) and curvature on IOP measurement and to estimate the intra-observer variability.A prospective, single-centre study of 150 eyes with a wide range of pressures. Six masked IOP measurements/method; corneal thickness and curvature were studied for each eye. GAT was the reference.IOPPascal and IOPICare correlated with IOPGAT (r = 0.91, 0.89). Mean ICare measurement exceeded GAT by 2 mmHg. Pascal measured higher than GAT at low IOPs and lower at high IOPs. For every 10 mmHg increase in IOP above 31 mmHg, Pascal measured 2 mmHg lower than GAT and vice versa. CCT was correlated significantly with IOPGAT (r = 0.23) and IOPICare (r = 0.43) but not with IOPPascal (P = 0.12). CCT was correlated with age. In a subgroup (50 years), ICare and the difference between IOPGAT and IOPPascal were affected significantly by the CCT, whereas IOPGAT and IOPPascal were not. Corneal curvature was correlated significantly with IOPGAT (r = -0.27) and IOPPascal (r = -0.26) but not with IOPICare (P = 0.60). Intra-observer variability within each set of six measurements was approximately 2 mmHg, irrespective of method.This study showed a reasonable overall correlation and concordance between the IOP obtained with the three instruments. None of the methods were completely independent of the biomechanical properties of the cornea. ICare showed a significant dependency upon CCT, whereas GAT and Pascal showed a significant dependency on corneal curvature. All methods showed intra-observer variability, which leaves room for further improvement of methods.

PURPOSE: To explore the possibility of estimating the prevalence of open-angle glaucoma (OAG) on the west coast of Iceland using a clinical retrospective material, and to compare that estimate with ...

Purpose To measure the volume flow rate of the ophthalmic artery (OA). A phase contrast magnetic resonance imaging (PCMRI) protocol was developed to assess volume flow rate of OA in healthy young (HY) and elderly (HE). Methods The study was performed with a 3-Tesla scanner on HY (n=51,28females,age=64-80ys) and HE (n=51,28females,age=21-30ys). The OA were localized by a 3D time of flight (3DTOF) sequence. To measure the volume flow rate, a 2D PCMRI sequence was optimized to reach a spatial resolution of 0.35mm/pixel. Based on 3DTOF data, the flow measurement was perpendicular to OA. Mean volume flow rate (Qmean), resistive index (RI), arterial volume change (ΔV) and symmetry index (SI) were computed from the volume flow rate curve. Accuracy of MRI measures was studied using a vessel-phantom (O=1.4mm). Six constant flow rates (5.54-34.41mL/min) were used as reference. Results Phantom investigation showed good agreement between the reference and MRI measurements with a percentage error 0.05). Conclusion Volume flow rate measurement of OA vessels using PCMRI is possible. Contrary to color Doppler imaging, PCMRI technique does not alter IOP during the measurements. This method may provide a precise description of the dynamics of the volume flow rate of OA during the cardiac cycle.

Purpose The purpose of this study was to evaluate the effect of repetitive applanation tonometry measurements on IOP and aqueous humor volume in the anterior chamber. Methods This is an ongoing study where four healthy volunteers have participated so far. Consecutive repeated series of six measurements with Goldmann applanation tonometry (GAT) and applanation resonance tonometry (ART) were made alternately on both eyes for one hour. Using an Oculus Pentacam, the anterior chamber of the left eye was photographed before the measurements and then consecutively for 20 min. Finally, one additional measurement was performed with both GAT and ART. Results In this abstract we present the results from the first four subjects. The results show that there was a significant reduction in IOP on the right eye both with GAT and ART. After one hour of measurements, IOP was reduced by 5.5 mmHg (range 4.3-7.2 mmHg) for GAT and 3.1 mmHg (range 1.0-4.1 mmHg) for ART. The decrease in aqueous humour volume after IOP measurements was less than 10 % for all subjects. Conclusion Although Bechrakis showed as early as 1966 that repetitive measurements result in significant IOP reduction, the mechanism behind this is still matter of debate. Our preliminary results confirm the occurrence of IOP reduction after repetitive measurements, but indicate that it could not be explained by the decrease in volume of the anterior chamber.