Ventilation Manipulation for Glaucoma
Recruiting in Palo Alto (17 mi)
Overseen byKanwal Nischal, MD,FRCOphth
Age: < 18
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Pittsburgh
Disqualifiers: Altered cerebral autoregulation, increased intracranial pressure, pulmonary hypertension, others
No Placebo Group
Approved in 1 Jurisdiction
Trial Summary
What is the purpose of this trial?This study is to investigate the relationship between arterial carbon dioxide (CO2) concentration and vitreous pressure on the choroidal volume by integrated intraoperative OCT imaging under eye exams under anesthesia.
Will I have to stop taking my current medications?
The trial information does not specify whether participants need to stop taking their current medications.
What data supports the effectiveness of the treatment Ventilation Manipulation for Glaucoma?
Research shows that mechanical ventilation can affect intraocular pressure (IOP), with high pressure ventilation increasing IOP significantly. This suggests that manipulating ventilation could potentially influence eye pressure, which is relevant for glaucoma management.
12345How is ventilation manipulation different from other treatments for glaucoma?
Ventilation manipulation, which involves techniques like mechanical ventilation and positive pressure ventilation, is unique for glaucoma as it focuses on altering air pressure to potentially influence eye pressure, unlike traditional treatments that often involve surgery or medications to directly reduce eye pressure.
678910Eligibility Criteria
This clinical trial is for children from newborns up to 8 years old who are already scheduled for an eye exam under anesthesia due to ophthalmologic reasons. It's not suitable for kids over 8, those with conditions affecting brain blood flow regulation, increased pressure inside the skull, or any issues the anesthesiologist thinks could cause problems.Inclusion Criteria
My child needs an eye exam under anesthesia for an eye condition.
My child is between newborn and 8 years old.
Exclusion Criteria
I am over 8 years old.
Children with altered cerebral autoregulation, increased intracranial pressure, or any other condition deemed appropriate by the anesthesiologist.
Children who are not having an eye exam under anesthesia
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
1-2 weeks
Treatment
Manipulation of end tidal carbon dioxide in subjects to measure intraocular pressure and choroidal thickness
1 day
1 visit (in-person)
Follow-up
Participants are monitored for safety and effectiveness after treatment
2 weeks
Participant Groups
The study is examining how changing the amount of carbon dioxide (CO2) in a child's breath affects the thickness of part of their eye called the choroid. This will be done using special imaging during an eye exam while they're under anesthesia.
1Treatment groups
Experimental Treatment
Group I: Observational GroupExperimental Treatment1 Intervention
Manipulation of end tidal carbon dioxide in subjects
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
University of Pittsburgh Medical CenterPittsburgh, PA
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Who Is Running the Clinical Trial?
University of PittsburghLead Sponsor
References
Intraocular pressure and mechanical ventilation. [2019]Mechanical ventilation increases superior vena cava pressure and should theoretically increase episcleral venous pressure and intraocular pressure (IOP). A Keeler Pulsair Non Contact Tonometer was used to measure the IOP's of six subjects with no history of glaucoma or ocular hypertension. At 30 min of supine mechanical ventilation of tidal volume with low (7 to 15 cm H2O) peak inspiratory pressures, the IOP's were no different than at the end of a 30-min control period of supine spontaneous ventilation. However, using high (60 cm H2O) peak inspiratory pressures for 1 min after tidal volume ventilation, IOP's were 32.7% higher than at the end of the supine spontaneous ventilation control period (p
The effects of non-invasive mechanic ventilator modes on intraocular pressure in COPD patients with hypercapnic respiratory failure. [2020]Chronic obstructive pulmonary disease (COPD) is not fully reversible disease that is characterized by progressive restricting airflow. Non-invasive mechanical ventilation (NIMV) treatment can be used in COPD patients who had type 2 respiratory failure. This study aimed to determine the effect of BPAP S/T and AVAPS modes on intraocular pressure (IOP), central corneal thickness (CCT) in 40 type 2 respiratory failure patients with COPD.
Bi-level positive airway pressure ventilation reduces the oxygen cost of breathing in long-standing post-polio patients on invasive home mechanical ventilation. [2005]Today, patients with chronic respiratory failure are commonly treated with non-invasive bi-level positive airway pressure ventilation, supporting spontaneous breathing. However, in conformity with previous clinical routine, many post-polio patients with chronic respiratory failure are still treated with invasive (i.e. via a tracheostomy) controlled mechanical ventilation (CMV). The aim of the study was to investigate the effect of invasive bi-level positive airway pressure ventilation on the work of breathing compared with that during the patients' ordinary CMV and spontaneous breathing without mechanical support.
Intraocular pressure during mechanical ventilation with different levels of positive end-expiratory pressure. [2019]To determine the effect of positive end-expiratory pressure (PEEP) on intraocular pressure.
Effect of non-invasive positive pressure ventilation (NIPPV) on mortality in patients with acute cardiogenic pulmonary oedema: a meta-analysis. [2023]Non-invasive positive pressure ventilation (NIPPV), using continuous positive airway pressure (CPAP) or bilevel ventilation, has been shown to reduce the need for invasive mechanical ventilation in patients with acute cardiogenic pulmonary oedema. We assessed additional benefits of NIPPV in a meta-analysis.
[Experience in the surgical treatment of neovascular diabetic glaucoma]. [2006]A new operation for neovascular glaucoma, filtrating vitrectomy, is described. The operation is based on creation of a permanent microfistula in the posterior chamber of the eye and simultaneous replacement of the viscous vitreous body with the isotonic saline. Filtrating vitrectomy was performed in 46 eyes with neovascular diabetic glaucoma. The intraocular pressure was normalized completely without medication in 70 per cent cases in the early postoperative period and in 66 per cent cases in the long term (12-39 months) period.
The Blitz Anesthesia Technique in Non-English Speaking Patients Undergoing Glaucoma Surgery. [2022]To describe a less invasive method of providing anesthesia in non-English speaking patients undergoing glaucoma surgery.
Noninvasive glaucoma procedures: current options and future innovations. [2018]Noninvasive glaucoma procedures (NIGPs) represent a new dawn in the management of glaucoma. They try to fill the gap between the shortcoming of invasive glaucoma surgeries and antiglaucoma medications. NIGPs were introduced as an adjunct or alternative treatments for glaucoma. Some of these procedures have shown good efficacy with few serious complications. Hence, they are now used as both primary and adjunctive therapy for glaucoma. The most common NIGPS involve laser and ultrasound technologies. Currently, the portfolio of NIGPs includes argon laser trabeculoplasty, selective laser trabeculoplasty, and micropulse diode laser trabeculoplasty. More recent innovations include therapeutic ultrasound for glaucoma, ultrasonic circular cyclocoagulation, and deep wave trabeculoplasty.
[Sinusotrabeculectomy with regulated filtration in the treatment of secondary glaucoma]. [2018]A new method for surgical treatment of secondary glaucoma (neovascular, postuveal, traumatic, and aphakic) is described. The aims of the new method are as follows: regulation of ophthalmic tone in the postoperative period, pain relief, organ preservation, stabilization of the process, and creation of reliable routes of intraocular fluid discharge with formation of a stable diffuse functional pad. Seven patients (8 eyes) aged 13-70 years were operated on and followed up for up to 6 months. Preliminary results are presented. Positive shifts were observed in all cases.
Surgical outcomes of 23-gauge transconjunctival pars plana vitrectomy combined with lensectomy for glaucomatous eyes with extremely shallow anterior chamber and cataract. [2018]Glaucoma combined with an extremely shallow anterior chamber and cataracts remains as a complex condition to deal with. And the emergence of microincision vitrectomy surgery (MIVS) system may provide an ideal option for the treatment of that. We report a clinical study of surgical outcomes of 23-gauge transconjunctival pars plana vitrectomy (PPV) combined with lensectomy in the treatment of glaucomatous eyes with extremely shallow anterior chamber and cataract.