Andrew G. Iwach, M.D.Associate Clinical Professor

University of California, San FranciscoSan Francisco, California

Media BriefingUpdate 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 DisclosureFinancial Disclosure

June 2011 Issue

EyeNet June 2011

• 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

Devers Eye InstitutePortland, Oregon

Downs et al.: Invest Ophthalmol Vis Sci.2011;52:7365–7375

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 groundB: 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 screwsC: 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)

Courtesy of J. Crawford Downs, PhD

Downs et al.: Invest Ophthalmol Vis Sci.2011;52:7365–7375

Courtesy of 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

Comments from J. Crawford Downs, PhD

Now Entering A Different Dimension…

Source: www.sensimed.ch

Source: www.sensimed.ch

www.sensimed.ch

www.sensimed.ch

www.sensimed.ch

Glaucoma Center of San Francisco

www.GlaucomaSF.com

Glaucoma Center of San Francisco

www.GlaucomaSF.com