Before interpreting corneal biomechanical parameters, it seems important to adjust the measured data for their underlying influencing factors. Glaucoma patients with lower adjusted CH and CRF probably have more advanced disease and should, therefore, be treated more aggressively and monitored more carefully and frequently.
ABSTRACT.Purpose: To evaluate the nocturnal blood pressure (BP) dipping-pattern in patients with manifest primary open-angle glaucoma (POAG) and to find possible associations with the severity of visual field damage. Methods: A number of 314 patients suffering from POAG were consecutively enrolled in this cross-sectional hospital-based study. Each patient had diurnal intraocular pressure (IOP) measurements, 24-hr BP monitoring and computerized perimetry with the Humphrey 30-2 SITA Standard program. Inclusion criteria were a mean IOP of less than 15 mmHg with fluctuations of less than 5 mmHg and a visual acuity of at least 20/40. One eye was randomly selected. Based on the night-day BP ratio, a mean arterial nocturnal BP drop of less than 10% was considered as non-dipping, between 10% and 20% as physiological dipping and of more than 20% as over-dipping. Results: Glaucoma patients with daytime systemic normotension on the average had more visual field loss in the over-dipper group (MD = À 16.6 dB, IQR = À18.9 to À2.7 dB) than glaucoma patients with daytime systemic hypertension, who had less visual field defects in the over-dipper group (MD = À3.9 dB, IQR = À6.2 to À1.9 dB) (p = 0.004). This result was also found taking age, glaucoma duration, visual acuity, gender, systemic and topical medication as covariates into account. Conclusions: To judge the nocturnal BP situation of an individual patient, it is important to do this in relation to the daytime BP level. Twenty-four-hour BP evaluation might be important for all patients with POAG, as nocturnal BP could be a modifiable risk factor for glaucoma severity and progression.Key words: 24-hr ambulatory blood pressure -nocturnal blood pressure dipping -nocturnal safety range -ocular perfusion pressure -open-angle glaucoma -systemic hypertension -visual field severity Acta Ophthalmol. 2015: 93: e621-e626
A significant amount of research effort is being carried out by the research community to increase the scope and usefulness of wireless sensor networks; to optimise life time by developing energy efficient power management, self-organising, medium access and routing protocols; and to reduce the cost of sensing nodes so that dense and robust deployment is possible. Though much has already been achieved, currently the cost of commercially available wireless sensor nodes is considerable and the wide applicability of proposed or existing protocols is still under investigation. One essential problem associated with cost or wide applicability of protocols is that sensor networks are application-specific. Protocols and in-network algorithms are optimised for particular sensing tasks. On the other hand, in research environments researchers would like to experiment not with a single application but with many applications. Considering the not-so-cheap sensing nodes available on the market and the management overhead of deploying wireless sensor networks, it is not economical or efficient to dedicate wireless sensor networks just to a single application, not at present at any rate. We therefore propose a middleware that enables researchers to experiment with multiple applications while providing them with essential in-network functionalities to satisfy individual application's requirements. The middleware cleanly separates sensing from network management so that application developers can obtain data from the wireless sensor networks without having to deal with management concerns.
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