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Andrew G. Iwach, M.D. Associate Clinical Professor University of California, San Francisco San Francisco, California. Media Briefing Update on IOP Continuous Monitoring Technologies. I have the following financial interests or relationships to disclose: Consultant AcuMEMS
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Andrew G. Iwach, M.D.Associate Clinical ProfessorUniversity of California, San FranciscoSan Francisco, California Media Briefing Update on IOP Continuous Monitoring Technologies
I have the following financial interests or relationships to disclose: Consultant AcuMEMS Carl Zeiss Meditec Clarity Medical Systems IRIDEX Lumenis, Inc. Lecture Fees Alcon Laboratories, Inc. Carl Zeiss Meditec IRIDEX ISTA Pharmacuticals Lumenis, Inc. Merck U.S. Human Health Pfizer Ophthalmics Financial Disclosure
Devers Eye Institute Portland, Oregon • Dr. Downs created an implantable IOP transducer system • Measures IOP a minimum of 500 times per second • Around the clock, for as long as two years • Sensor Adaptation of a commercial system used for drug safety studies in cardiovascular applications • Implanted in nonhuman primates so far EyeNet June 2011
Courtesy of J. Crawford Downs, PhD A: Photograph of a typical T30F total implant system showing the battery/transmitter module, radio frequency (RF) ring antenna for on/off, transmission antenna, a pressure transducer, and two ECG electrodes plus ground B: Photograph of the extra-orbital surface of our custom IOP transducer housing that is secured within a ¼-inch hole in the lateral orbital wall with bone screws C: A 23-gauge silicone tube delivers aqueous from the anterior chamber to a fluid reservoir on the intraorbital side of the transducer (partially hidden from view in B); The tube (with appropriate slack to allow for eye movement) is trimmed, inserted into the anterior chamber, sutured to the sclera using theintegral scleral tube anchor plate, and covered with a scleral patchgraft (not shown) Downs et al.: Invest Ophthalmol Vis Sci.2011;52:7365–7375
Courtesy of J. Crawford Downs, PhD Downs et al.: Invest Ophthalmol Vis Sci.2011;52:7365–7375
Comments from J. Crawford Downs, PhD • IOP goes up 4-12 mmHg every time you blink or move your eyes • IOP spikes are higher in stiffer eyes and at higher basal IOP’s • IOP is extremely variable throughout the day on the second-to-second, minute-to-minute, and hour-to-hour timescales • IOP shows diurnal variation, although the pattern is NOT repeatable from day-to-day • In light of these data, one wonders whether snapshot IOP measurements in the clinic are reflective of true IOP on any timescale
Glaucoma Center of San Francisco www.GlaucomaSF.com
Glaucoma Center of San Francisco www.GlaucomaSF.com