Lageabhängigkeit des Augeninnendruckes bei Glaukompatienten

Enders, Philip; Stern, Claudia; Schrittenlocher, Silvia; Händel, Alexander; Jordan, Jens; Cursiefen, Claus; Dietlein, Thomas S.

doi:10.1007/s00347-020-01113-6

Cited by 6 publications

(6 citation statements)

References 57 publications

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“…It is well-known that in glaucomatous and in nonglaucomatous eyes the IOP can increase in the supine position. 28–30 Especially for patients with glaucoma, an elevated body position can lower the IOP. 31 To what extent such non-gas–dependent mechanisms could also play a role in IOP increases after DMEK has not yet been investigated.…”

Section: Discussionmentioning

confidence: 99%

Influence of Body Position on Intraocular Pressure After Descemet Membrane Endothelial Keratoplasty: A Prospective Randomized Trial

Händel

Siebelmann

Lüke

et al. 2022

Cornea

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The purpose of this study was to analyze the influence of patient positioning on intraocular pressure (IOP) after Descemet membrane endothelial keratoplasty (DMEK) in pseudophakic patients treated for Fuchs endothelial corneal dystrophy.Methods: Forty patients were included in this prospective, singleblinded, randomized controlled clinical trial. Patients received a YAG iridotomy 1 day before surgery and an 80% anterior chamber tamponade [20% concentration of sulfur hexafluoride (SF6)]. Postoperative positioning was either supine (group 1) or seated (group 2, at least 30 degrees upper-body high position). IOP was measured with iCare.Results: There was no statistically significant difference in IOP postoperatively [group 1 vs. group 2-after 1h: 13.9 mm Hg (64.2 mm Hg) versus 13.6 mm Hg (64.1 mm Hg) (P = 1.00); after 2h: 13.9 mm Hg (65.4 mm Hg) versus 15.3 mm Hg (64.6 mm Hg) (P = 0.370); after 4h: 13.8 mm Hg (64.2 mm Hg) versus 15.2 mm Hg (64.2 mm Hg) (P = 0.401]. In group 1, 10% of patients showed IOP decompensations well above 30 mm Hg, and in group 2, there were no IOP decompensations. Seated position led to relative risk reduction of 100% and absolute risk reduction of 10% regarding IOP decompensations. The number of patients needed to position seated to prevent 1 additional IOP decompensation was 10. Rebubbling rates, best spectacle-corrected visual acuity, and reduction of corneal thickness were comparable between the 2 groups in the follow-up period up to 1 month. Conclusions:After DMEK in pseudophakic eyes with 80% anterior chamber tamponade, positioning patients with at least 30 degrees elevation of the upper body up immediately after surgery until bedtime prevents IOP decompensations.

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Section: Discussionmentioning

confidence: 99%

Influence of Body Position on Intraocular Pressure After Descemet Membrane Endothelial Keratoplasty: A Prospective Randomized Trial

Händel

Siebelmann

Lüke

et al. 2022

Cornea

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“…There is no association in principle between raised intraocular pressure (IOP) and optic disc size [19]. However, Enders et al showed the positional dependence of the IOP in glaucoma patients and in another study they found a significant association between the peripapillary vascular density measured by SD-OCT angiography and the BMO measurements obtained on SD-OCT in glaucoma patients [25]. In the normal databases the measurement algorithms are based on, there is only a small number of extremely large or small optic discs [4].…”

Section: Discussionmentioning

confidence: 99%

“…der SD-OCT-Angiografie und den gemessenen BMO-Werten im SD-OCT bei Glaukompatienten dar [25]. In den in Messalgorithmen zugrunde liegenden Normdatenbanken findet sich nur eine kleine Anzahl von extrem großen bzw.…”

Section: Diskussionunclassified

“…Grundsätzlich besteht kein Zusammenhang zwischen einem erhöhten Augeninnendruck (IOD) und der Papillengröße 19 . Enders et al konnten jedoch bei Glaukompatienten die Lageabhängigkeit des IOD nachweisen und stellten in einer weiteren Studie einen signifikanten Zusammenhang der peripapillär gemessenen Gefäßdichte in der SD-OCT-Angiografie und den gemessenen BMO-Werten im SD-OCT bei Glaukompatienten dar 25 . In den in Messalgorithmen zugrunde liegenden Normdatenbanken findet sich nur eine kleine Anzahl von extrem großen bzw.…”

Section: Diskussionunclassified

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Glaucoma Diagnostic Testing: The Influence of Optic Disc Size

Scheuble

Petrak

Brinkmann

2021

Klin Monbl Augenheilkd

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Background There are various imaging techniques for the assessment of the optic disc in glaucoma patients. However, anatomically conspicuous, large or small optic discs can be quite challenging for an examiner. Objective The Bruchʼs membrane opening (BMO) by spectral domain optical coherence tomography (SD-OCT) is a modern approach for the quantitative measures of retinal nerve fibre layer (RNFL). The study focuses on comparison analysis of the BMO method and the widely used Heidelberg retina tomograph (HRT) method – in terms of detection of glaucoma for different optic disc sizes. Methods 216 Patients examinations during glaucoma consultation hours. Macro- (Ma) and micro-optic discs (Mi) detected by HRT are analysed via BMO analysis in SD-OCT. Correlation between BMO area and optic disc measured by HRT has been investigated and examined in terms of severity of visual field defect (MD [dB]). Results The results of study show that for micro and macro-optic discs there is a modest correlation between the size of optic disc measured by BMO and the size of optic disc measured by HRT by applying funduscopic examination (correlation rate r = 0,53; Mi: n = 111, Ma: n = 105). For micro-optic discs with a very small BMO area (< 1.5 mm2), there is a significant tendency (linear trend test p < 0.05) towards deeper visual field defects (MD < − 5 dB). Conclusion The BMO parameter of SD-OCT allows an assessment of glaucoma for a large range of optic disc sizes. BMO area and optic disc size measured by HRT are not correlated. Micro optic discs with a small BMO area lead to a higher risk of deep visual field defects.

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“…This causes compression of ganglion cell axon as well as affects their blood supply resulting in impaired axoplasmic flow and poor perfusion of the optic nerve head with consequent death of these axons seen as cupping in optic nerve head during fundus examination [10][11] . Studies had shown that IOP fluctuates with change in posture with glaucomatous eyes having greater IOP elevation than non-glaucomatous eyes during changes in such body positions (from sitting to a horizontal position) [12][13][14] .…”

Section: Introductionmentioning

confidence: 99%

Comparing posture induced intraocular pressure variations in normal subjects and glaucoma patients

Onyekachi¹,

Arinze²,

Ogbu³

et al. 2021

Int J Ophthalmol

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AIM: To compare the posture-induced variations in intraocular pressure (IOP) between the primary open angle glaucoma (POAG) and non-glaucomatous eyes. METHODS: A case-controlled age matched study was conducted in 55 successive newly diagnosed POAG and 56 non-glaucomatous patients seen in glaucoma clinic and general outpatient eye clinic in the Alex Ekwueme University Teaching Hospital, Abakaliki. The IOPs of eligible correspondents were measured with Perkin's hand-held tonometer in the sitting, supine flat and supine with pillow positions respectively. Measurement of IOP in each position was done after 15min of assuming such posture. RESULTS: The IOP difference between the sitting and supine flat position was significantly higher in the POAG than non-glaucoma subjects (7.68±2.08 vs 4.03±0.13 mm Hg, P<0.001). The IOP difference between the sitting and supine with pillow positions was 2.61±1.49 mm Hg for POAG and 1.44±0.70 mm Hg in non-glaucoma (P<0.001), while difference between supine flat and supine with pillow positions was 5.07±2.24 mm Hg in POAG and 2.59±0.66 mm Hg in non-glaucomatous patients (P<0.001). CONCLUSION: Greater variations in posture induced IOP occurred in POAG patients than non-glaucomatous. The posture induced IOP variation is lowest in the sitting position and highest in the supine flat position. Evaluation of posture induced IOP changes may be an important tool in the management of glaucoma.

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Lageabhängigkeit des Augeninnendruckes bei Glaukompatienten

Cited by 6 publications

References 57 publications

Influence of Body Position on Intraocular Pressure After Descemet Membrane Endothelial Keratoplasty: A Prospective Randomized Trial

Influence of Body Position on Intraocular Pressure After Descemet Membrane Endothelial Keratoplasty: A Prospective Randomized Trial

Glaucoma Diagnostic Testing: The Influence of Optic Disc Size

Comparing posture induced intraocular pressure variations in normal subjects and glaucoma patients

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