Faschinger C, Mossböck G
Universitäts-Augenklinik, Medizinische Universität Graz, Auenbruggerplatz 4, 8036, Graz, Österreich.
Ophthalmologe. 2010 Oct;107(10):918-22. doi: 10.1007/s00347-010-2198-4.
For many years researchers have been striving for a non-invasive 24 h continuous method of ambulatory intraocular pressure monitoring. A wireless device with a contact lens sensor is now on the market for clinical use, which is not a quantitative measurement of the intraocular pressure but is at least a recording of qualitative changes. These changes of corneal curvature due to changes of the intraocular pressure result in a distinct profile which gives information about fluctuations of the intraocular pressure, the behaviour during supine sleeping time and the 24 h efficacy of glaucoma therapy. We investigated the practicability and tolerability of this device.
The sensor is embedded in a soft silicone contact lens and consists of 4 strain gauges. Additionally there is an antenna made out of gold and a microchip. A second antenna is fixed around the eye which sends impulses to the microchip and receives data from the microchip. The data are sent to a recorder via a wire. Measurements are made for 90 s every 8.5 min resulting in 144 measurements within 24 h. Of the 4 strain gauges 2 sense changes in the corneal curvature due to changes of the intraocular pressure. This device was used in 11 patients with ocular hypertension or glaucoma.
The result of the 24 h continuous measurement is a pressure profile which may be flat, fluctuating and with no, some or many spikes. We describe 2 examples of profiles from patients with glaucoma. The changes in the profiles were mostly during the sleeping hours in a supine position. Due to the lack of validation of the results it is not known if intermittent spikes are true spikes or artefacts. Practicability was simple and tolerability was reported to be good by all patients.
For the first time a practicable, well tolerated, non-invasive device for continuous 24 h monitoring of changes of the corneal curvature due to changes of the intraocular pressure is available. It is not a direct measurement of the intraocular pressure. The resulting profile gives additional information about the behaviour of the intraocular pressure, especially during out-of-office times and night times. Disadvantages are the high cost of the contact lens sensor and the lack of validation of the results and reproducibility in patients.
多年来，研究人员一直在努力寻求一种非侵入性的24小时动态眼压监测方法。一种带有隐形眼镜传感器的无线设备现已上市用于临床，它并非眼压的定量测量，但至少能记录定性变化。眼压变化导致的角膜曲率变化会产生独特的曲线，可提供有关眼压波动、仰卧睡眠时间的表现以及青光眼治疗24小时疗效的信息。我们研究了该设备的实用性和耐受性。
传感器嵌入软硅胶隐形眼镜中，由4个应变片组成。此外，还有一个由金制成的天线和一个微芯片。另一个天线固定在眼睛周围，向微芯片发送脉冲并从微芯片接收数据。数据通过电线发送到记录器。每8.5分钟测量90秒，24小时内进行144次测量。4个应变片中，有2个可感知因眼压变化引起的角膜曲率变化。该设备用于11例高眼压或青光眼患者。
24小时连续测量的结果是一个压力曲线，可能是平坦的、波动的，且有无、一些或许多尖峰。我们描述了2例青光眼患者的曲线示例。曲线变化大多发生在仰卧位的睡眠时间。由于结果缺乏验证，尚不清楚间歇性尖峰是真正的尖峰还是伪像。实用性简单，所有患者均报告耐受性良好。
首次有了一种可行、耐受性良好的非侵入性设备，可用于连续24小时监测因眼压变化引起的角膜曲率变化。它不是眼压的直接测量方法。所得曲线可提供有关眼压行为的额外信息，尤其是在非工作时间和夜间。缺点是隐形眼镜传感器成本高，且结果缺乏验证以及在患者中的可重复性。
