Multipressure Dial Goggle Effects on Circumpapillary Structure and Microvasculature in Glaucoma Patients

Kamalipour, Alireza; Moghimi, Sasan; Inpirom, Veronica R; Mahmoudinezhad, Golnoush; Weinreb, Robert N.

doi:10.1016/j.ogla.2022.05.004

Cited by 3 publications

(8 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This data also implies that there is a decrease in the pressure differential across the optic nerve head known as the trans-laminar pressure differential, which has been further supported by a recent study using OCT-A in which they demonstrated an increase in retinal microcirculation following a short-term reduction in IOP with the MPD. 19 The safety data in this report support the safety profile and non-invasive nature of the device and corroborate prior work evaluating the safety of the MPD. [15][16][17] As previously mentioned, a prior study by Shafer et al 17 explored the impact of applying negative pressure with the MPD on both retrobulbar and intraocular pressure in cadaver subjects.…”

Section: Discussionsupporting

confidence: 84%

“…The clinically relevant effect of the system is the reduction in IOP relative to atmospheric pressure and to the retro-orbital pressure. This data also implies that there is a decrease in the pressure differential across the optic nerve head known as the trans-laminar pressure differential, which has been further supported by a recent study using OCT-A in which they demonstrated an increase in retinal microcirculation following a short-term reduction in IOP with the MPD 19 …”

Section: Discussionsupporting

confidence: 56%

See 1 more Smart Citation

Negative Pressure Application via a Multi-Pressure Dial to Lower IOP in Patients with Suspected Glaucoma or Open Angle Glaucoma

Samuelson

Ferguson

Brubaker

et al. 2023

Journal of Glaucoma

View full text Add to dashboard Cite

Précis: The multi-pressure dial applies localized periocular negative pressure to safely and effectively lower IOP and represents the first non-invasive, non-pharmacologic device for IOP reduction. Objective: To evaluate the safety and effectiveness of the Multi-Pressure Dial (MPD) system, a device that applies periocular negative pressure to lower intraocular pressure (IOP). Setting: 6 investigational sites, United States. Design: Prospective, assessor-masked, randomized controlled trial. Methods: Subjects with suspected glaucoma, ocular hypertension (OHTN), and open angle glaucoma (OAG) with baseline IOP ≥13 mmHg and ≤32 mmHg were enrolled. One eye of each subject was randomized to receive negative pressure application; the fellow eye served as a control. The study eye negative pressure setting was programmed for 60% of the baseline IOP. The primary effectiveness endpoint was the proportion of study eyes versus control eyes achieving an IOP reduction ≥20% at Day 90. Secondary endpoints included the proportion of eyes achieving an IOP reduction ≥25% at Day 90 as well as the proportion of eyes achieving an IOP reduction ≥20% at Days 30 and 60. Results: 116 eyes of 58 subjects completed the study. At the Day 90 visit, 89.7% (n=52) of study eyes versus 3.4% (n=2) of control eyes achieved an IOP reduction ≥20% (P<0.001). At Day 90, 77.6% (n=45) of study eyes achieved a ≥25% IOP reduction compared to 1.7% (n=1) of control eyes (P<0.001). The most commonly reported adverse events were lid (17.2% study eye, 7.8% control eye) and periorbital edema (14.1% study eye, 10.9% control eye). Conclusions: This trial demonstrates that the MPD safely and effectively lowers IOP in a group of patients that included glaucoma suspects, OHTN, and patients with OAG.

show abstract

Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 56%

Negative Pressure Application via a Multi-Pressure Dial to Lower IOP in Patients with Suspected Glaucoma or Open Angle Glaucoma

Samuelson

Ferguson

Brubaker

et al. 2023

Journal of Glaucoma

View full text Add to dashboard Cite

show abstract

“…Kamalipour et al, recently evaluated the impact of the negative pressure goggles on retinal and ONH perfusion. 17 This study examined 24 subjects with open angle glaucoma, using OCTA to determine the impact of negative pressure on measurements of perfused capillary density (PCD) and retinal nerve fiber layer (RNFL) thickness. Prior studies examining the relationship between IOP and retinal perfusion have demonstrated increased retinal blood flow following sustained lowering of IOP using laser doppler flowmetry 26 and dynamic alteration in blood flow during vitrectomy using and intraocular transducer 27 , with increased flow associated with decreased IOP.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…While changes in atmospheric pressure occur mostly in specialized conditions (e.g., diving, altitude changes), alteration in atmospheric pressure around the eye has been proposed as a novel treatment of glaucoma to non-invasively reduce IOP. [17][18][19] Based on this potential impact of atmospheric pressure on IOP, interest has developed in evaluating the application of goggles that apply negative pressure to the ocular surface simulating a drop in atmospheric pressure to provide a potential non-invasive therapeutic option to reduce IOP in glaucoma [16][17][18][19][20][21][22] . Computational studies have suggested that this approach should lower IOP due to scleral expansion acutely and decrease episcleral pressure over longer periods.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Effect of Negative Pressure on IOP in the Living Human Eye

Fazio

Bianco

Karuppanan

et al. 2022

Preprint

View full text Add to dashboard Cite

PurposeTo quantify the effect of negative pressure applied to the anterior surface of the eye on absolute IOP.SubjectsParticipants, and/or Controls. Three eyes from three research-consented brain-dead organ donors.MethodsAir-tight goggles connected to a negative pressure (NP) pump (Mercury Multi-pressure Dial (MPD); Equinox Ophthalmic, Inc., CA) were tested on three research consented brain-dead organ donors. The MPD was set to generate a vacuum of −20mmHg. A baseline IOP of 10, 20, and 30mmHg was sequentially set by adjusting the height of a balanced salt solution bottle connected to the cornea through a 20G needle. IOP was manually annotated at time = 0s, right before turning on the vacuum pump; after a few seconds with the vacuum pump ON; at 60s; at 120s, right before turning the pump OFF; at 240s with the pump OFF (recovery). Three repetitions per each test at varying baseline IOP were taken for a total of nine series of measures per eye.Main Outcome MeasuresIOP change with exposure to NP.ResultsEye1 and 3 showed an immediate reduction in IOP at all baselines immediately following activation of the MPD NP pump; Eye2 showed an opposite response to NP. Eye1 and 3 showed a reduction in IOP at all baselines with NP pump ON for 60s and 120s, while Eye 2 showed a consistent increase in IOP. After 120s from turning NP OFF (time=240s), IOP partially recovered to its baseline in all eyes.ConclusionsThis study is the first to evaluate changes in manometrically-measured intracameral IOP due to NP applied to the ocular surface in living conditions. The inconsistent response of IOP following exposure to negative pressure warrants further investigations on the mechanism underlaying IOP lowering by NP.

show abstract

Displacement of the Lamina Cribrosa With Acute Intraocular Pressure Increase in Brain-Dead Organ Donors

Girkin,

Garner,

Gardiner

et al. 2023

Invest. Ophthalmol. Vis. Sci.

View full text Add to dashboard Cite

Purpose To examine deformations of the optic nerve head (ONH) deep tissues in response to acute elevation of intraocular pressure (IOP). Methods Research-consented brain-dead organ donors underwent imaging by spectral domain optical coherence tomography (OCT). OCT imaging was repeated while the eye was sequentially maintained at manometric pressures of 10, 30, and 50 mm Hg. Radial scans of the ONH were automatically segmented by deep learning and quantified in three dimensions by a custom algorithm. Change in lamina cribrosa (LC) depth and choroidal thickness was correlated with IOP and age by linear mixed-effect models. LC depth was computed against commonly utilized reference planes. Results Twenty-six eyes from 20 brain-dead organ donors (age range, 22–62 years; median age, 43 years) were imaged and quantified. LC depth measured against a reference plane based on Bruch's membrane (BM), BM opening, and an anterior sclera canal opening plane showed both a reduction and an increase in LC depth with IOP elevation. LC depth universally increased in depth when measured against a sclera reference plane. Choroidal (−0.5222 µm/mm Hg, P < 0.001) and retinal nerve fiber layer thickness (−0.0717 µm/mm Hg, P < 0.001) significantly thinned with increasing IOP. The magnitude of LC depth change with IOP was significantly smaller with increasing age ( P < 0.03 for all reference planes). Conclusions LC depth changes with IOP reduce with age and are significantly affected by the reference plane of choice, which highlights a need for standardizing LC metrics to properly follow progressive remodeling of the loadbearing tissues of the ONH by OCT imaging and for the definition of a reference database.

show abstract

Multipressure Dial Goggle Effects on Circumpapillary Structure and Microvasculature in Glaucoma Patients

Cited by 3 publications

References 43 publications

Negative Pressure Application via a Multi-Pressure Dial to Lower IOP in Patients with Suspected Glaucoma or Open Angle Glaucoma

Negative Pressure Application via a Multi-Pressure Dial to Lower IOP in Patients with Suspected Glaucoma or Open Angle Glaucoma

The Effect of Negative Pressure on IOP in the Living Human Eye

Displacement of the Lamina Cribrosa With Acute Intraocular Pressure Increase in Brain-Dead Organ Donors

Contact Info

Product

Resources

About