Association of rs 10038177 and rs 1971050 Polymorphism of WDR 36 Gene with Clinical Profile in POAG Patients

Aim: To study WDR36 gene polymorphism (rs10038177 , rs1971050) and its association with clinical parameters in patients of primary open angle glaucoma. Methods: A cross sectional study conducted on 105 cases of POAG to study its association with WDR36 gene polymorphisms (rs 10038177, rs 1971050). The study subjects underwent complete ophthalmic examination, slit lamp examination, IOP measurement by Goldmann’s Applanation Tonometer, gonioscopy, fundus evaluation by 90D lens. RNFL thickness was measured using cirrus 500 OCT by Carl Zeiss. Peripheral blood samples were collected in EDTA-anticoagulant tubes, then DNA was extracted using the genomic DNA extraction and genotyped by PCR-RFLP by using (AluI) enzyme.Data analysis by SPSS, version 21.0. Chi-square and Independent sample ‘t’-tests used for comparison. Results: The association of genotypic expression of rs10038177 polymorphism with different clinical variables in POAG patients, and the mean IOP (31.66 + 5.88) and CDR (0.72+ 0.15) for heterozygous genotype TC was significantly higher as compared to homozygous de33eeeee4(p<0.05) while in rs1971050 polymorphism, Diabetic history was significantly higher in genotype TC(60%)(p=0.012) as compared to genotype TT (19.1%). Conclusion: Our study shows that WDR 36 polymorphism (rs10038177) and (rs1971050) have an association with higher IOP and RNFL thinning which could be the underlying factors in pathogenesis and progression of POAG.

Assessment of temporal and spatial distribution patterns of aerosol produced by air-puff non-contact tonometer

Purpose To assess the distribution pattern of aerosol in the aspect of time and direction during the intraocular pressure (IOP) measurement by air-puff non-contact tonometer (NCT) and further offer references for protection from coronavirus disease-19 (COVID-19) in the routine ophthalmic examination. Method A single-center observational study was conducted in the ophthalmology clinics of Peking University Third Hospital. Two air quality detectors were equipped to assess the generated particulate matter (PM) concentration simultaneously within 30 s after IOP measurement in the outpatient hall. Detector A was fixed next to the NCT as a reference, while Detector B was fixed 1 meter away. The participants were divided into two groups depending on the position of Detector B. The generation of aerosol was compared within different groups and time intervals. Results 144 participants were enrolled in the final analysis. At a 1 m distance from the NCT, the PM2.5 concentration significantly increased at the 30 s ( Z = 2.898, Bonferroni-corrected P = 0.038) while the PM10 concentration increased immediately after the IOP measurement ( Z = 2.967, Bonferroni-corrected P = 0.030). The PM2.5 and PM10 concentrations at 1 m were significantly higher immediately ( Z = −2.183, P = 0.029; Z = −2.502, P = 0.012) and 30 s ( Z = −2.021, P = 0.043; Z = −2.071, P = 0.038) after the IOP measurements when the Detector B was vertical to the air jet on the lateral side. Conclusions NCT may produce aerosol after the IOP measurement by air-puff. The generated PM2.5 had a prolonged existence compared with PM10 at a 1 m distance. The lateral side of the air-puff direction may be of higher exposure risk to aerosol.

Ocular Response Analyzer versus Goldmann Applanation Tonometer for Measurement of Intra-Ocular Pressure

Background Goldmann applanation tonometry (GAT) has been the gold standard for intraocular pressure(IOP) measurement ,since its appearance in clinical practice around 50 years ago.(1) In spite of being almost unchallenged, the last few years have become a sustained search for a new standard method for IOP measurement,. One such recently marketed instrument is the Ocular Response Analyzer (ORA), which able to detect the corneal biomechanics. Aim of the Work is to compare the IOP measurement estimated by Goldmann applanation tonometer to that of ORA and detect the effect of state of refraction, corneal topography and central corneal thickness (CCT) on these measurements. Patients and Methods This cross-sectional study was done from March 2018 to October 2018 on 65 eyes of patients visiting the outpatient clinic. Results The mean GAT IOP was 15.938 ± 6.041 while the mean ORA (IOPcc) and (IOPg) were 19.711 ± 7.59 and 17.242 ± 7.35 mm Hg respectively. There is a strong positive relationship between GAT IOP & ORA IOPg measurement (r = 0.880 – p = &lt;0.001*). Also finding a weak yet significant correlation between IOPg and CCT (r = 0.385, p = 0.001). None of the pressure measurements was affected by refraction or corneal curvature significantly. Conclusion In conclusion, our results suggest that mean IOPs obtained by ORA were significantly higher than that of GAT with different influencing factors that are not completely understood. caution has to be sought when using the ORA, the values obtained ought not to be used interchangeably with the values obtained by 1 GAT, despite the presence of a positive correlation between these values. This underlines the importance of using one and only method of evaluation of the IOP for every patient in successive follow-up visits.

Comparison among TonoVet, TonoVet Plus, Tono-Pen Avia Vet, and Kowa HA-2 portable tonometers for measuring intraocular pressure in dogs

Background and Aim: Tonometers are an important instrument for measuring intraocular pressure (IOP) in the diagnosis of glaucoma or uveitis. This study aimed to compare the accuracy of the main types of tonometers with different IOP measurement methodologies in dogs: TonoVet and TonoVet Plus (rebound), Tono-Pen Avia Vet (applanation), and Kowa HA-2 (Goldmann applanation). Materials and Methods: IOP was measured in 152 eyes of 76 dogs. A postmortem study was performed by comparing manometry and tonometry values and calculating the correlation coefficient (r2), in vivo real IOP (manometry) among the tonometers was compared, and an outpatient study was conducted with healthy eyes and eyes with signs of glaucoma and uveitis. Results: In the postmortem study, the values of r2 in descending order were Kowa (0.989), TonoVet Plus (0.984), TonoVet (0.981), and Tono-Pen Avia Vet (0.847). The IOP values in mmHg in the in vivo study were as follows: Aneroid manometer (16.8±2.5.7), TonoVet (18.1±2.9), TonoVet Plus (20.6±2.3), Tono-Pen Avia Vet (17.1±2.5), and Kowa (16.1±1.7); in outpatient clinics: TonoVet (16.8±3.8), TonoVet Plus (19.2±2.9), Tono-Pen Avia Vet (16.2±2.4), and Kowa (15.0±1.3); glaucoma: TonoVet (30.2±3.5), TonoVet Plus (35.0±6.1), Tono-Pen Avia Vet (29.5±4.2), and Kowa (23.9±5.0); and uveitis: TonoVet (14.2±1.4), TonoVet Plus (17.6±1.9), Tono-Pen Avia Vet (13.7±2.1), and Kowa (12.6±1.7). Conclusion: There was a strong correlation between IOP values and manometry in all the tonometers. The highest values were obtained with TonoVet Plus and the lowest with Kowa HA-2. All tonometers accurately measured IOP in dogs, including the latest TonoVet Plus, which showed an excellent correlation coefficient.

Changes in Iridocorneal Angle Configuration and Intraocular Pressure during Smartphone Use under Room Light

Purpose: To investigate changes in intraocular pressure (IOP) and iridocorneal angle (ICA) configuration during smartphone use under room light. Methods: We included healthy adults aged 19-35 years with no ophthalmological abnormalities. All read text on a smartphone for 6 minutes under room light. IOP was measured via rebound tonometry at baseline and at 2, 4, and 6 minutes. ICA images were obtained via anterior segment optical coherence tomography after each IOP measurement. After 6 minutes, participants stopped reading text and rested for 2 minutes. IOP was then measured again. Results: The IOP significantly increased at 2, 4, and 6 minutes of reading compared to baseline (p < 0.001) but recovered to baseline after 2 minutes of rest (p = 1.000). The anterior chamber depth decreased significantly, and the anterior chamber angle width increased after 6 minutes of smartphone reading (both p < 0.05). Conclusions: IOP increased when reading smartphone text under room light but the ICA did not change. Prolonged smartphone reading is inappropriate for a patient at risk of glaucoma or glaucoma progression. Such patients should be cautioned.

A study to compare intraocular pressure using Perkins and Schiotz tonometer with respect to Goldmann applanation tonometer as a gold standard in a tertiary health care centre, Navi Mumbai

To compare IOP measurement of Perkin’s tonometer and Schiotz tonometer with respect to Goldmann applanation tonometer (GAT).100 eyes of 50 patients aged 18 to 65 years presenting to Ophthalmology OPD were selected by randomization and detailed general and ophthalmic examination was done. IOP was measured using applanation tonometers (Perkin’s and GAT) and indentation tonometer (Schiotz tonometer) in that order. The study population included 38 male eyes and 62 female eyes; 50 right eyes and 50 left eyes. There was a statistically highly significant difference seen for the values between the groups (p&#60;0.01) with higher values in IOP measured by GAT followed by IOP measured by Perkin’s tonometer and least in IOP measured by Schiotz tonometer.There was a statistically non significant difference seen for the values between Perkin’s tonometer and GAT (p&#62;0.05). While there was a statistically highly significant difference seen for the values between GAT and Schiotz tonometer (p&#60;0.01).There was a statistically non significant difference seen for the IOP values between right eye and left eye. There was a statistically non significant difference seen for the IOP values between males and females. Measurement of IOP with Perkin’s was closer to the values obtained by GAT. Perkin’s being portable, easy to use and precise tonometer than Schiotz tonometer, can be considered as an excellent substitute to GAT, for large scale examination, if cost is not a concern.

THE EFFECTS OF OXIDATIVE STRESS ON THE EYES OF SPRAGUE–DAWLEY RATS

An imbalance between oxidants and antioxidants in favor of the oxidants, potentially leading to damage, is termed as ‘oxidative stress’. Some studies indicate that reactive oxygen species (ROS) may increase in resistance of the aqueous humor drainage or induce the rearrangement of human trabecular meshwork and result in glaucoma finally. An eight-week d-galactose injection was used to mimic high oxidative stress rats. Behavior tests, fundus images, anterior chamber depth, anterior chamber diameter (ACDia) and pupil diameter (PD) were investigated. Intraocular pressure (IOP) measurement and serum were taken for antioxidant capability of superoxide dismutase (SOD) and the amount of nitric oxide (NO). After perfusion, Müller’s cells and astrocyte, microglial and inducible Nitric Oxide Synthase (iNOS) were labeled. The activities of SOD were decreased after induction. The spatial memory ability and muscular endurance were impaired through Morris water maze (MWM) and weight-loaded forced swimming test. These results demonstrated that oxidative stress was exacerbated by d-galactose. The IOP was gradually increased in the third week after d-galactose induction. Immunohistochemical stains showed that the density of Müller’s cells, astrocytes and microglia increased in d-galactose group. Microglia mostly became active. These data indicate that oxidative stress may result in the impairment of behavior, increase of Müller’s cells, astrocyte and microglia which is induced by d-galactose. The correlation between oxidative stress and elevation of IOP should be further studied. These may involve in the pathologies of aging or other neurodegenerative disease.

One Year Outcomes and Stability of a Novel Scleral Anchored Intraocular Lens

Purpose. To assess one year results and stability of the implantation of a scleral anchored intraocular lens (IOL). Design. Interventional prospective case series. Methods. Sixty eyes of 60 patients affected by either aphakia or IOL dislocation were included in this study. Patients underwent vitrectomy, scleral fixation of the IOL, and, if present, dislocated IOL removal. Patients were evaluated preoperatively and at 1, 3, 6, and 12 months after surgery by best-corrected distance visual acuity (BCVA) assessment, intraocular pressure (IOP) measurement, corneal specular microscopy, and optical coherence tomography (OCT) of both the macula and anterior segment. Results. At twelve months, mean BCVA significantly improved ( p < 0.0001 ), and none of the patients experienced a decrease of visual acuity. A 10% decrease of endothelial cell count occurred after surgery. Cystoid macular edema occurred in three patients (5%). A transient increase of intraocular pressure was noted in 7 cases (12%). At one month, horizontal and vertical IOL tilt was 1.04 ± 0.87 and 0.74 ± 0.71 degrees, respectively, and did not significantly change in the follow-up ( p > 0.05 ). None of the patients had decentration or dislocation of scleral-fixated IOL during the follow-up. Conclusion. Implantations of scleral plug fixated IOL provide good visual results, low complication rate, and excellent stability of the lens until one-year follow-up.

A CLINICAL STUDY ON LENS INDUCED GLAUCOMA IN PATIENTS ATTENDING GOVERNMENT GENERAL HOSPITAL,SRIKAKULAM.

AIM: To determine the prevalence and visual outcomes after cataract surgery in different LIG patients METHODS:In this prospective study 50 patients were taken into study. Detailed history was taken and slit lamp examination was done & IOP was recorded by AT. All the patients were treated preoperatively appropriately. Patients were operated with SICS with PC IOL implantation and Peripheral Iridectomy.During follow up a detailed Ocular examination was done including Refraction using snellens chart and IOP measurement with AT. RESULTS: Among 50 patients 21(42%)were male patients and 29(58%)were female. Maximum patients had Phacomorphic Glaucoma accounting 72% (36patients) and Phacolytic Glaucoma 24%. Highest percentage was among 40-49mmHg (52%) followed by 30-39mmHg (36%) and >50mmHg (10%). Highest patients were between 10-19mmHg (76%). Visual acuity on admission, highest patients were seen in HM positive (64%) followed by PL+(32%). Even No PL were also seen (4%). On follow up after 6weeks ,majority were seen between 6/12- 6/18(52%) CONCLUSION: LIG is an important vision-threatening disease presenting as a painful red eye. It is remaining as one of the important cause of Blindness not only because of Senile cataract but even after cataract surgery due to Glaucoma caused by neglected cataractous lens.Hence, importance should be given for timely surgery for better visual outcome .