May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
In vivo Optic Nerve Head Change Due to Artificially Increased Intraocular Pressure
Author Affiliations & Notes
  • K. A. Townsend
    UPMC Eye Center, Ophthalmology and Visual Science Research Center, Dept. of Ophthalmology, Eye and Ear Institute, Univ of Pittsburgh Medical Ctr, Pittsburgh, Pennsylvania
  • L. Kagemann
    UPMC Eye Center, Ophthalmology and Visual Science Research Center, Dept. of Ophthalmology, Eye and Ear Institute, Univ of Pittsburgh Medical Ctr, Pittsburgh, Pennsylvania
    Dept. of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania
  • G. Wollstein
    UPMC Eye Center, Ophthalmology and Visual Science Research Center, Dept. of Ophthalmology, Eye and Ear Institute, Univ of Pittsburgh Medical Ctr, Pittsburgh, Pennsylvania
  • A. Sajjad
    Dept. of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania
  • R. A. Bilonick
    UPMC Eye Center, Ophthalmology and Visual Science Research Center, Dept. of Ophthalmology, Eye and Ear Institute, Univ of Pittsburgh Medical Ctr, Pittsburgh, Pennsylvania
  • H. Ishikawa
    UPMC Eye Center, Ophthalmology and Visual Science Research Center, Dept. of Ophthalmology, Eye and Ear Institute, Univ of Pittsburgh Medical Ctr, Pittsburgh, Pennsylvania
    Dept. of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania
  • J. Xu
    UPMC Eye Center, Ophthalmology and Visual Science Research Center, Dept. of Ophthalmology, Eye and Ear Institute, Univ of Pittsburgh Medical Ctr, Pittsburgh, Pennsylvania
  • K. Sung
    UPMC Eye Center, Ophthalmology and Visual Science Research Center, Dept. of Ophthalmology, Eye and Ear Institute, Univ of Pittsburgh Medical Ctr, Pittsburgh, Pennsylvania
  • M. L. Gabriele
    UPMC Eye Center, Ophthalmology and Visual Science Research Center, Dept. of Ophthalmology, Eye and Ear Institute, Univ of Pittsburgh Medical Ctr, Pittsburgh, Pennsylvania
    Dept. of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania
  • J. S. Schuman
    UPMC Eye Center, Ophthalmology and Visual Science Research Center, Dept. of Ophthalmology, Eye and Ear Institute, Univ of Pittsburgh Medical Ctr, Pittsburgh, Pennsylvania
    Dept. of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania
  • Footnotes
    Commercial Relationships  K.A. Townsend, None; L. Kagemann, None; G. Wollstein, Carl Zeiss Meditec, Inc., F; Optovue, F; A. Sajjad, None; R.A. Bilonick, None; H. Ishikawa, None; J. Xu, None; K. Sung, None; M.L. Gabriele, None; J.S. Schuman, Alcon, F; Allergan, F; Carl Zeiss Meditec, Inc., F; Merck, F; Optovue, F; Heidelberg Engineering, F; Carl Zeiss Meditec, Inc., P; Alcon, R; Allergan, R; Carl Zeiss Meditec, Inc., R; Merck, R; Heidelberg Engineering, R.
  • Footnotes
    Support  NIH RO1-EY013178-8, P30-EY008098; Eye and Ear Foundation (Pittsburgh, PA); Research to Prevent Blindness.
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 3671. doi:https://doi.org/
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    • Get Citation

      K. A. Townsend, L. Kagemann, G. Wollstein, A. Sajjad, R. A. Bilonick, H. Ishikawa, J. Xu, K. Sung, M. L. Gabriele, J. S. Schuman; In vivo Optic Nerve Head Change Due to Artificially Increased Intraocular Pressure. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3671. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : Transient increases in intraocular pressure (IOP) have been shown ex-vivo to increase cupping of the optic nerve head (ONH) and peripapillary displacement. The purpose of this study was to use confocal scanning laser ophthalmoscopy (CSLO) and spectral domain optical coherence tomography (SDOCT) to observe in-vivo changes in the ONH under transient IOP increase.

Methods: : In 6 healthy subjects, IOP was raised with a ring over the eyelids connected to a pulley system where weight was added to increase the pressure by the ring. Weight ranged from 0 to 500g in 100g intervals. At each of the weights, Goldmann applanation tonometry, corneal topography (Pentacam; Oculus, Lynnwood, WA), CSLO (HRT3; Heidelberg Engineering, Heidelberg, Germany) and SDOCT raster scan (Bioptigen, Durham, NC) were acquired. Topographic Change Analysis (TCA) was used to identify areas of change, and mixed effects models were fit to standard HRT3 parameters with IOP and reference plane as explanatory factors. SDOCT images were observed for disc shape changes and to measure maximum cup depth.

Results: : Pentacam found no significant change in astigmatism power and axis or central corneal thickness. IOP across subjects ranged from 13±2.7mmHg baseline to 43±6.9mmHg with 500g. TCA showed change clusters on various vessels in all eyes in consistent locations for each subject, with cluster size and amount of change increasing with increasing IOP. Clusters of depression near the disc margin extending into the disc, and areas of topographic increase in the peripapillary region occurred in 5 of 6 subjects. IOP was negatively and statistically significantly associated with HRT rim volume globally and in more sectors than any other parameter. SDOCT presented widening and deepening of the cup with IOP increase, as well as posterior bending of Bruch’s membrane ends. SDOCT cup depth had to be modeled quadratically; as IOP increased, cup depth initially increased, then decreased.

Conclusions: : TCA results indicate vascular changes at higher IOP. SDOCT qualitative results and HRT parameter model quantitative results suggest posterior bowing of the disc and peripapillary region are occurring.

Clinical Trial: : www.clinicaltrials.gov NCT00343746

Keywords: intraocular pressure • optic nerve • imaging/image analysis: clinical 
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