Theoretical Assessment of the Risk of Ocular Hypotony in Patients With Intravitreal Gas Bubbles Who Travel Through Subsea Tunnels

Rashidi, Neda; Thomas, Vineet S.; Amini, Rouzbeh

doi:10.1167/tvst.8.1.4

Cited by 3 publications

(3 citation statements)

References 30 publications

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“…Unlike previously reported mathematical models [13-15,33], we developed our app based on the assumption that the patient with intravitreous gas or air would be traveling immediately from one place to another. Therefore, the abovementioned compensation mechanisms were not incorporated into the app design.…”

Section: Discussionmentioning

confidence: 99%

“…Vitreoretinal surgeons sometimes need to have better communication with their postoperative patients when intravitreous gas or air is present [7-12]. The mathematical models of eyes with intravitreal gas bubbles developed by Amini et al [13-15] and Wong et al [16] were significant and inspired vitreoretinal surgeons to gain an in-depth understanding of the impact of altitude-induced IOP changes. However, there has not been any easily available reference tool for both surgeons and patients to get a preliminary estimation of the risk of volume expansion and IOP elevation when traveling to a place at a higher altitude.…”

Section: Introductionmentioning

confidence: 99%

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Development and Testing of a Mobile Phone App for Risk Estimation of Gas Volume Expansion and Intraocular Pressure Elevation in Patients With Intravitreous Gas or Air Tamponade: Interobserver Assessment Study

Zhang

et al. 2019

JMIR Mhealth Uhealth

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Background Pars plana vitrectomy (PPV) with intravitreous tamponade of gas or air has been widely used for a series of vitreoretinal diseases. It is estimated that 100,000 patients per year undergo PPV globally, and half of them were subsequently tamponaded with gas or air. According to Boyle’s law (P 1 V 1 =P 2 V 2 ), patients with an intravitreous remnant of gas or air will be under high risk of intraocular pressure (IOP) elevation and subsequent vision loss owing to the expanded intravitreous gas or air when traveling post operation to a place with a significantly higher altitude. We always explain to patients why postoperative travel is potentially risky. Emergency cases of elevated IOP caused by postoperative traveling would sometimes come to surgeons. However, there have been few disease education or reference tools for both the surgeons and patients to have better communication. Objective The aim of this study was to introduce and evaluate a mobile phone app developed by surgeons (the authors) for preliminary risk estimation of volume expansion and IOP elevation in patients with intravitreous gas or air when traveling to a place of higher altitude. Methods The app was developed on the iOS and Android operating systems. Boyle’s law (P 1 V 1 =P 2 V 2 ) was the theoretical basis of the app. Intravitreous gas or air volume and altitude values were independent factors to deduce the risk report. Consecutive patients underwent vitrectomy, and those with an intravitreous remnant of gas or air were recruited. The surgeons judged the vertical height of the fluid/gas interface through the dilated pupil; the patients were instructed to judge it according to their visual field when looking straight ahead and line it out on a chart included in the app. Finally, all the patients were required to fill a Likert scale–based questionnaire with 2 main items to evaluate the participants’ user experience and attitudes toward the app. Results A total of 50 patients were included (30 males and 20 females). All patients could independently operate the app to complete the test. The median heights of the fluid/gas interface independently judged by the surgeon and patients were 40% (range: 10%-75%) and 41% (range: 9%-78%), respectively ( P =.63). The median altitude of the participants’ destinations was 150.0 m (range: 0-3490 m). The Bland-Altman analysis revealed a good agreement between the surgeons’ and patients’ judgments (bias of −0.3%), with 95% limits of agreement of −5.8% to 5.3%. Overall, the Likert scale revealed a positive attitude from the patients toward the app. Conclusions The app is reliable for patients to have preliminary risk estimation of intrav...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Development and Testing of a Mobile Phone App for Risk Estimation of Gas Volume Expansion and Intraocular Pressure Elevation in Patients With Intravitreous Gas or Air Tamponade: Interobserver Assessment Study

Zhang

et al. 2019

JMIR Mhealth Uhealth

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show abstract

“…1,2 Invasive methods, like injections and ocular implants, can only be used sparingly because they incur increasing risks of retinal detachment, cataracts, and intraocular pressure destabilization when used repeatedly. [2][3][4][5][6] Topical treatment would prevent these risks but is currently not feasible due to slow corneal uptake, which results in B90% loss of the therapeutic. [7][8][9][10][11][12] Both delivery modes suffer from fast clearance and low retinal targeting.…”

Section: Introductionmentioning

confidence: 99%