Willmann Gabriel, Schommer Kai, Schultheiss Maximilian, Fischer M Dominik, Bartz-Schmidt Karl-Ulrich, Gekeler Florian, Schatz Andreas
1 Department of Ophthalmology, Katharinenhospital Stuttgart , Stuttgart, Germany .
2 Centre for Ophthalmology, University of Tübingen , Tübingen, Germany .
High Alt Med Biol. 2017 Jun;18(2):114-120. doi: 10.1089/ham.2016.0115. Epub 2017 Mar 23.
Willmann, Gabriel, Kai Schommer, Maximilian Schultheiss, M. Dominik Fischer, Karl-Ulrich Bartz-Schmidt, Florian Gekeler, and Andreas Schatz. Effect of high altitude exposure on intraocular pressure using Goldmann applanation tonometry. High Alt Med Biol. 18:114-120, 2017.
The aim of the study was to quantify changes of intraocular pressure (IOP) during exposure to 4559 m using the state-of-the-art method of Goldmann applanation tonometry for IOP measurement and to detect correlations between IOP and acute mountain sickness (AMS) in a prospective manner.
IOP was measured using a Goldmann applanation tonometer AT 900 (Haag-Streit, Switzerland) and central corneal thickness (CCT) with the anterior segment module of a Spectralis™ HRA+OCT device (Heidelberg Engineering, Germany) at baseline and high altitude. Assessment of AMS was performed using the Lake Louise and AMS-C questionnaires, and Pearson's correlation coefficient was calculated for association between IOP and AMS.
Raw IOP values at high altitude were not significantly changed compared to baseline. IOP adjusted to the increase in CCT at high altitude, which is known to alter IOP levels, showed a significant reduction for corrected IOP values on day 3 of exposure (morning -2.1 ± 1.2 mmHg; evening -2.3 ± 1.1 mmHg; p < 0.05). No correlation of IOP with AMS or clinical parameters (heart rate and SpO) at high altitude was noted.
IOP showed a significant reduction of IOP levels when corrected for increased CCT values at high altitude. Furthermore, the prospective measurement of IOP is not useful in diagnosing AMS or for the prediction of more severe high altitude related illnesses as the decrease in IOP and symptoms of AMS do not correlate during altitude exposure.
威尔曼、加布里埃尔、凯·朔默、马克西米利安·舒尔特海斯、M. 多米尼克·菲舍尔、卡尔 - 乌尔里希·巴茨 - 施密特、弗洛里安·盖克勒和安德烈亚斯·沙茨。使用戈德曼压平眼压计测量高海拔暴露对眼压的影响。《高海拔医学与生物学》。2017年第18卷:第114 - 120页。
本研究的目的是使用测量眼压的先进方法——戈德曼压平眼压计,量化在海拔4559米暴露期间眼压(IOP)的变化,并前瞻性地检测眼压与急性高原病(AMS)之间的相关性。
在基线和高海拔时,使用戈德曼压平眼压计AT 900(瑞士哈格 - 施特赖特公司)测量眼压,并使用Spectralis™ HRA + OCT设备(德国海德堡工程公司)的前段模块测量中央角膜厚度(CCT)。使用路易斯湖问卷和AMS - C问卷对急性高原病进行评估,并计算眼压与急性高原病之间关联的皮尔逊相关系数。
与基线相比,高海拔时的原始眼压值没有显著变化。已知海拔升高会改变眼压水平,对高海拔时因中央角膜厚度增加而调整后的眼压进行分析,结果显示在暴露第3天校正后的眼压值显著降低(早晨 -2.1±1.2 mmHg;晚上 -2.3±1.1 mmHg;p < 0.05)。未发现高海拔时眼压与急性高原病或临床参数(心率和血氧饱和度)之间存在相关性。
在高海拔时,当对因中央角膜厚度增加而升高的眼压值进行校正后,眼压水平显著降低。此外,前瞻性测量眼压对于诊断急性高原病或预测更严重的高原相关疾病并无帮助,因为在海拔暴露期间眼压降低与急性高原病症状之间不存在相关性。