A simple method for evaluation of aqueous humor dynamics “A weight on-off test” in patients with glaucom

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Hiroshi Ohguro
Department of Ophthalmology, Sapporo Medical University School of Medicine
Megumi Watanabe
Department of Ophthalmology, Sapporo Medical University School of Medicine
Shuichiro Inatomi
Department of Ophthalmology, Sapporo Medical University School of Medicine
Kazushi Umeda
Department of Ophthalmology, Sapporo Medical University School of Medicine
Ikuyo Ohguro
Department of Ophthalmology, Sapporo Medical University School of Medicine

Abstract

Purpose:To evaluate aqueous humor (AH) dynamics in patients with glaucoma through a newly developed method termed the “Weight on-off test”

Methods: Patients: primary open angle glaucoma (POAG)(n=124), primary angle closure glaucoma (n=16), Pseudoexfoliation syndrome(n=17), or senile cataract (n=93) without other eye diseases. For evaluation of AH dynamics, a 50 g weight was placed onto the eye of a subject in a supine position for 5 min and then removed. Intraocular pressure (IOP) was measured before and immediately after removal, and thereafter every minute until IOP returned to baseline. Based upon IOP changes (decreases during the weight on and recovery after removal), we defined AH outflow resistance: IOP drop rate (IOPdrop) (%) = (P0-Pe) – (P5-Pe) / (P0-Pe) x 100 (P0: IOP at baseline, Pe: assumed episcleral venous pressure, P5: IOP at 5 min) and AH outflow resistance index (Raq out)= 100 - IOP drop, and AH production: IOP recovery time (IOPrec) (min) reached to baseline IOP, and AH production index (Paq) was an IOP increase rate during the IOPrec by least squares method.

Results:AH outflow resistance was significantly higher in glaucoma subjects than the control. AH production in glaucoma subjects was slightly increased compared to that in control. In POAG, prostaglandin-analogues (PG) caused a significant delay of AH production (IOPrec).

Conclusions: The current data suggests that a “Weight on-off test” may be simple and useful for estimating AH dynamics in patients with glaucoma and provides a better understanding of glaucoma etiology as well as its pharmacology.

Article Details

How to Cite
OHGURO, Hiroshi et al. A simple method for evaluation of aqueous humor dynamics “A weight on-off test” in patients with glaucom. Medical Research Archives, [S.l.], n. 3, june 2015. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/227>. Date accessed: 16 dec. 2024.
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Keywords
aqueous humor ; glaucoma ; intraocular pressure ; tonography
Issue
No 3 (2015)
Section
Research Articles

The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.

 

References

1. Shields, MB. An overview of glaucoma. In: Shields MB, editor. Textbook of glaucoma. 4th. ed. Baltimore, Maryland:Williams & Wilkins;1988;1-2.
2. Quigley HA. Number of people with glaucoma worldwide. Br J Ophthalmol. 1996;80(5):389–93.
3. Collaborative Normal-Tension Glaucoma Study Group. The effectiveness of intraocular pressure reduction in the treatment of normal-tension glaucoma. Am J Ophthalmol. 1998;126:498-505.
4. The AGIS Investigators. The Advanced Glaucoma Intervention Study (AIGIS):7. The relationship between control of intraocular pressure and visual field deterioration. Am J Ophthalmol. 2000;130:429-40.
5. Kass MA, Heuer DK, Higginbotham EJ, Johnson CA, Keltner JL, Miller JP, et al. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol. 2002;120:701-13.
6. Goel M, Picciani RG, Lee RK, Bhattacharya SK. Aqueous humor dynamics:a review. Open Ophthalmol J. 2010;3(4):52-9.
7. Whitson JT. Glaucoma:a review of adjunctive therapy and new management strategies. Expert Opin Pharmacother. 2007;8:3237-49.
8. Mark HH. Aqueous humor dynamics in historical perspective. Surv Ophthalmol. 2009;55(1):89-100.
9. Toris CB, Yablonski ME, Wang YL, Camras CB. Aqueous humor dynamics in the aging human eye. Am J Ophthalmol. 1999;127(4):407-12.
10. Morrison JC, Acott TS. Anatomy and physiology of aqueous humor outflow. In: Glaucoma - Science and Practice. New York: Thieme Medical Publishers Inc; 2003;34-41.
11. Gong H, Tripathi RC, Tripathi BJ. Morphology of the aqueous outflow pathway. Microsc Res Tech. 1996;33(4):336–67.
12. Alm A, Nilsson SF. Uveoscleral outflow-a review. Exp Eye Res. 2009;88(4):760–8.
13. Toris CB. Pharmacotherapies for glaucoma. Curr Mol Med. 2010;10:824-40.
14. Brubaker RF. Goldmann's equation and clinical measures of aqueous dynamics. Exp Eye Res. 2004;78:633-637.
15. Civan MM, Brubaker RF. Clinical measurements of aqueous dynamics: implications for addressing glaucoma. In: Civan MM ed. The Eye's Aqueous Humor. New York: Academic Press. 1998;233-284.
16. Brubaker RF. Measurement of aqueous flow by fluorophotometry. In: Ritch R, Shields MB, Krupin T, editors. The Glaucomas. St. Louis: Mosby; 1989. 337-44.
17. Wheeler NC, Lee DA, Cheng Q, Ross WF, Hadjiaghai L. Reproducibility of intraocular pressure and outflow facility measured by pneumatic tonography and Schiotz tonography. J Ocul Pharmacol Ther. 1998 Feb;14(1):5-13.
18. Becker B, Shaffer RN, Kolker AE, Hetherington J. Becker – Shaffer’s Diagnosis and Therapy of the Glaucomas. 1983; 5th ed. Mosby St. Louis.
19. Green K. Techniques of intraocular pressure determination. Lens Eye Toxic Res. 1990;7(3-4):485-9.
20. Gensler HM. An evaluation of the Schiotz tonometer in glaucoma screening programs. Am J Optom Arch Am Acad Optom. 1967 Oct;44(10):634-41.
21. Selvadurai D, Hodge D, Sit AJ. Aqueous humor outflow facility by tonography does not change with body position. Invest Ophthalmol. 2010;51(3):1453-1457.
22. Feghali JG, Azar DT, Kaufman PL. Comparative aqueous outflow facility measurements by pneumatonography and Schiotz tonography. Invest Ophthalmol. 1986;27(12):1776-1780.
23. Moses RA, Grodzki WJ Jr. Constant-pressure tonography based on the electronic Schiotz tonometer. Invest Ophthalmol. 1972;11（7）:585-592.
24. Novack GD. Trabecular outflow facility determined by fluorophotometry in human subjects. Exp Eye Res. 1989;48:621-625.
25. Daniel JT, Richard FB. Immediate effect of epinephrine on aqueous formation in the normal human eye as measured by fluophotometry. Invest Ophthalmol. 1980;19（3）:256-266.
26. Pierscionek BK, Asejczyk-Widlicka M, Schachar RA. The effect of changing intraocular pressure on the corneal and scleral curvatures in the fresh porcine eye. Br J Ophthalmol. 2007 Jun;91(6):801-3
27. Justin AW, Aurélie E, Joel SS. Characterization of Uveoscleral Out flow in Enucleated Porcine Eyes Perfused under Constant Pressure. Invest Ophthalmol. 2004 Sep;45(9):3203-3206.
28. Johnson CS, Mian SI, Moroi S, et al, Role of corneal elasticity in damping of intraocular pressure. Invest Ophthalmol. 2007;48(6):2540-2544.
29. Friedenwald JS. Contribution to the theory and practice of tonometry. Am J Ophthalmol 1937;20:985-1024.
30. Ytteborg J. The effect of intraocular pressure on rigidity coefficient in the human eye. Acta Ophthalmol. 1960;38:548-561.
31. Ytteborg J. Further investigations of factors influencing size of rigidity coefficient. Acta Ophthalmol. 1960;38:643-657.
32. Eisenlohr JE, Langham ME, Maumenee AE. Manometric studies of the pressure-volume relationship in living and enucleated eyes of individual human subjects. Br J Ophthalmol. 1962;46:536-548.
33. Pallikaris IG, Kymionis GD, Ginis HS, et al. Ocular rigidity in living human eyes. Invest Ophthalmol. 2005;46(2):409-414.
34. LYTTON H. Compression of the aqueous outlets. Br J Ophthalmol. 1956 Feb;40(2):104-7.
35. Stepanik J. Determining resistance to aqueous outflow by compression of the eyeball. Am J Ophthalmol. 1966 Jul;62(1):89-94.
36. E. M. Evans, M. Klein. A bulbar suction test for glaucoma. Br J Ophthalmol. 1959;43(8):494-498.
37. Calbert IP, Michael CQ. Impression tonometry and the effect of eye volume variation. Br J Ophthalmol. 1960;44(3):149-163.
38. Tranquilino AP. Bulbar Compression test with applanation tonometry clinical observations in ocular rigidity change. J Natl Med Assoc. 1964;56(9):498-500.
39. HH. The effect of external compression of the eye on intraocular pressure. I. Its variations with magnitude of compression and with age. Invest Ophthalmol.
1963;2(10):591-598.
40. Langham ME, Leydhecker W, Krieglstein G, Waller W. Pneumatonographic studies on normal and glaucomatus eyes. Adv Ophthalmol. 1976;32:108-33.
41. Kozobolis VP, Paschalis EI, Labiris G, Foudoulakis NC, Konstantinidis A, Koukoula SC. Tonography assessment using quantitative and qualitative analysis of the aqueous humor outflow mechanism. Eur J Ophthalmol. 2012 Sep-Oct;22(5):726-33.
42. Mansour FA. Adnan HH. The effect of external compression of the eye on intraocular pressure II. Recovery:Tonographic changes and the influence of pharmacologic agents. Invest Ophthalmol. 1963;2（10）:599-606.
43. Vassilios PK, Eleftherios IP, Nikitas CF, et al. The digital aqueous humor outflow meter:an alternative tool for screening of the human eye outflow facility. Clin Ophthalmol. 2010;4:937-45.