Use of a novel telemetric sensor to study interactions of intraocular pressure and ganglion-cell function in glaucoma

(1) To test the feasibility of simultaneous steady-state pattern electroretinogram (ssPERG) and intraocular pressure (IOP) measurements with an implanted IOP sensor. (2) To explore the scope of this approach for detecting PERG changes during IOP manipulation in a model of lateral decubitus positioning (LDP; lateral position).

15 healthy controls and 15 treated glaucoma patients participated in the study. 8 patients had an IOP sensor (Eyemate-IO, Implandata Ophthalmic Products GmbH) in the right eye (GLA_IMP) and 7 had no sensor and with glaucoma in the left eye. (1) We compared PERGs with and without simultaneous IOP read-out in GLA_IMP. (2) All participants were positioned in the following order: sitting1 (S1), right LDP (LD_R), sitting2 (S2), left LDP (LD_L) and sitting3 (S3). For each position, PERG amplitudes and IOP were determined with rebound tonometry (Icare TA01i) in all participants without the IOP sensor.

Electromagnetic intrusions of IOP sensor read-out onto ssPERG recordings had, due to different frequency ranges, no relevant effect on PERG amplitudes. IOP and PERG measures were affected by LDP, for example, IOP was increased during LD_R versus S1 in the lower eyes of GLA_IMP and controls (5.1±0.6 mmHg, P_0.025=0.00004 and 1.6±0.6 mmHg, P_0.025=0.02, respectively) and PERG amplitude was reversibly decreased (-25±10%, P_0.025=0.02 and -17±5%, P_0.025, respectively).

During LDP, both IOP and PERG changed predominantly in the lower eye. IOP changes induced by LDP may be a model for studying the interaction of IOP and ganglion-cell function.