Department of Ophthalmology, Otto von Guericke University, Magdeburg, Germany.
Department of Ophthalmology, University Medical Centre Groningen, Groningen, The Netherlands.
Br J Ophthalmol. 2023 Oct;107(10):1425-1431. doi: 10.1136/bjophthalmol-2021-320508. Epub 2022 Jun 14.
BACKGROUND: Patients with glaucoma on topical glaucoma medication are often affected by dry eye symptoms and thus likely to rub or squeeze their eyelids. Here, we telemetrically measure peak intraocular pressure (IOP) during eyelid manoeuvres and eyelid rubbing. METHODS: Eleven patients with primary open-angle glaucoma (POAG) previously implanted with a telemetric IOP sensor (Eyemate-IO) were instructed to look straight ahead for 1 min as a baseline measurement. Next, 6 repeats of blinking on instruction with 10 s intervals in between were performed. In addition, 5 repeats of eyelid closure (n=9), eyelid squeezing and eyelid rubbing (n=7) were performed with 15 s intervals in between. IOP was recorded via an external antenna placed around the study eye. Average peak IOP increases from baseline were analysed and tested against zero (no change) with one-sample t-tests. RESULTS: For eyelid rubbing, the average peak ∆ IOP increase (mean±SEM) was 59.1±9.6 mm Hg (p<0.001) from baseline. It was 42.2±5.8 mm Hg (p<0.0001) for eyelid squeezing, 3.8±0.6 mm Hg (n=9, p<0.01) for eyelid closure and 11.6±2.4 mm Hg (p<0.001) for voluntary blinking. No IOP change except for a short irregularity in the ocular pulse was observed during involuntary blinking. CONCLUSION: Eyelid manoeuvres in patients with POAG elicited brief increases in IOP that were particularly large with squeezing and rubbing. Further investigation of the potential implications for glaucoma progression is warranted.
背景:接受局部青光眼药物治疗的青光眼患者常受干眼症症状影响,从而可能揉搓或挤压其眼睑。在此,我们通过遥测技术测量眼睑动作和眼睑摩擦期间的眼内压(IOP)峰值。
方法:11 名先前植入遥测 IOP 传感器(Eyemate-IO)的原发性开角型青光眼(POAG)患者被指示直视 1 分钟作为基线测量。接下来,每 10 秒指示重复眨眼 6 次。此外,在 15 秒间隔之间进行 5 次眼睑闭合(n=9)、眼睑挤压和眼睑摩擦(n=7)。IOP 通过放置在研究眼周围的外部天线进行记录。通过单样本 t 检验分析并针对零(无变化)测试从基线开始的平均峰值 IOP 增加量。
结果:对于眼睑摩擦,平均峰值 ∆IOP 增加量(平均值±SEM)为 59.1±9.6 mmHg(p<0.001),与基线相比。眼睑挤压为 42.2±5.8 mmHg(p<0.0001),眼睑闭合为 3.8±0.6 mmHg(n=9,p<0.01),自愿眨眼为 11.6±2.4 mmHg(p<0.001)。除了眼球脉冲的短暂不规则外,在非自愿眨眼期间未观察到 IOP 变化。
结论:POAG 患者的眼睑动作会引起短暂的 IOP 升高,特别是在挤压和摩擦时升高幅度较大。进一步研究这种变化对青光眼进展的潜在影响是必要的。
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