Effect of High Altitude Exposure on Intraocular Pressure Using Goldmann Applanation Tonometry.
Willmann, Gabriel, Kai Schommer, Maximilian Schultheiss, M. Dominik Fischer, Karl-Ulrich Bartz-Schmidt, Florian Gekeler, and Andreas Schatz. Effect of high altitude exposure on intraocular pressure using Goldmann applanation tonometry. High Alt Med Biol. 18:114-120, 2017.


OBJECTIVE
The aim of the study was to quantify changes of intraocular pressure (IOP) during exposure to 4559 m using the state-of-the-art method of Goldmann applanation tonometry for IOP measurement and to detect correlations between IOP and acute mountain sickness (AMS) in a prospective manner.


METHODS
IOP was measured using a Goldmann applanation tonometer AT 900®(Haag-Streit, Switzerland) and central corneal thickness (CCT) with the anterior segment module of a Spectralis™ HRA+OCT®device (Heidelberg Engineering, Germany) at baseline and high altitude. Assessment of AMS was performed using the Lake Louise and AMS-C questionnaires, and Pearson's correlation coefficient was calculated for association between IOP and AMS.


RESULTS
Raw IOP values at high altitude were not significantly changed compared to baseline. IOP adjusted to the increase in CCT at high altitude, which is known to alter IOP levels, showed a significant reduction for corrected IOP values on day 3 of exposure (morning -2.1 ± 1.2 mmHg; evening -2.3 ± 1.1 mmHg; p < 0.05). No correlation of IOP with AMS or clinical parameters (heart rate and SpO2) at high altitude was noted.


CONCLUSIONS
IOP showed a significant reduction of IOP levels when corrected for increased CCT values at high altitude. Furthermore, the prospective measurement of IOP is not useful in diagnosing AMS or for the prediction of more severe high altitude related illnesses as the decrease in IOP and symptoms of AMS do not correlate during altitude exposure.
1 Department of Ophthalmology, Katharinenhospital Stuttgart , Stuttgart, Germany .|2 Centre for Ophthalmology, University of Tübingen , Tübingen, Germany .
Gabriel
G
Willmann
3 Medizinischer Dienst der Krankenversicherungen , MDK Baden-Württemberg, Mannheim, Germany .
Kai
K
Schommer
2 Centre for Ophthalmology, University of Tübingen , Tübingen, Germany .|4 Department of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE) , Hamburg, Germany .
Maximilian
M
Schultheiss
2 Centre for Ophthalmology, University of Tübingen , Tübingen, Germany .
M Dominik
MD
Fischer
2 Centre for Ophthalmology, University of Tübingen , Tübingen, Germany .
Karl-Ulrich
KU
Bartz-Schmidt
1 Department of Ophthalmology, Katharinenhospital Stuttgart , Stuttgart, Germany .|2 Centre for Ophthalmology, University of Tübingen , Tübingen, Germany .
Florian
F
Gekeler
1 Department of Ophthalmology, Katharinenhospital Stuttgart , Stuttgart, Germany .|2 Centre for Ophthalmology, University of Tübingen , Tübingen, Germany .
Andreas
A
Schatz
D000064:Acclimatization / Q000502:physiology*; D000328:Adult; D000531:Altitude; D000532:Altitude Sickness / Q000503:physiopathology*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014065:Tonometry, Ocular / Q000379:methods*
acute mountain sickness; eye; high altitude; intraocular pressure; optic nerve