Abstract
Purpose
To investigate the effects of dehydration and fasting on the intraocular pressure (IOP) and corneal biomechanics during Ramadan in healthy subjects.
Methods
A total of 36 healthy fasting male volunteers with a mean age of 32.7 ± 5.1 years (range 28–38 years) were enrolled in the study. A Reichert Ocular Response Analyzer (ORA) was used to measure the corneal resistance factor (CRF), corneal hysteresis (CH), Goldman-correlated IOP (IOPg), and corneal-compensated IOP (IOPcc), additionally IOP with Goldmann applanation tonometer (IOP-GAT) was taken. All measurements were recorded at 8:00 am and 4:00 p.m. during Ramadan and during a 1-month follow-up after Ramadan was over.
Results
Statistical analysis demonstrated no difference in the ORA measurements including CH, CRF, IOPcc, and IOPg; CCT and CV values between fasting and non-fasting periods or within a single day (diurnal changes). Nine volunteers (25% of total subjects) were excluded because eyedrops were believed to disrupt the Ramadan fast consequently IOP-GAT could not be measured from these subjects. No statistically significant difference was noted between IOP-GAT and IOPg measurements of twenty-seven subjects at the different periods and time points.
Conclusions
Our results reveal that fasting during Ramadan does not profoundly affect corneal biomechanics and IOP values in healthy volunteers without ocular diseases such as glaucoma. When planning corneal refractive surgery and determining IOP, the ORA measurements can be done safely during a Ramadan fast. Moreover, ORA may be a better alternative for patients that refuse IOP measurement via GAT for examining the accuracy of IOP during fasting. Further studies are needed to better understand the role of these parameters on corneal disease and glaucoma during fasting.
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References
Kerimoglu H, Ozturk B, Gunduz K et al (2010) Effect of altered eating habits and periods during Ramadan fasting on intraocular pressure, tear secretion, corneal and anterior chamber parameters. Eye (Lond) 24:97–100
Dadeya S, Kamlesh Shibal F et al (2002) Effect of religious fasting on intra-ocular pressure. Eye (Lond) 16:463–465
Kayikcioglu O, Guler C (2000) Religious fasting and intraocular pressure. J Glaucoma 9:413–414
Indriss BA, Anas BM, Hicham T (2008) Influence of fasting during Ramadan on intra-ocular pressure. Ann Saudi Med 28:61
Assadi M, Akrami A, Beikzadeh F et al (2011) Impact of Ramadan fasting on intraocular pressure, visual acuity and refractive errors. Singap Med J 52:263–266
Baser G, Cengiz H, Uyar M et al (2014) Diurnal alterations of refraction, anterior segment biometrics, and intraocular pressure in long-time dehydration due to religious fasting. Semin Ophthalmol 19:1–6
Inan UU, Yücel A, Ermis SS et al (2002) The effect of dehydration and fasting on ocular blood flow. J Glaucoma 11:411–415
Kayikcioğlu O, Erkin EF, Erakgün T (1999) The influence of religious fasting on basal tear secretion and tear break-up time. Int Ophthalmol 22:67–69
Nowroozzadeh MH, Mirhosseini A, Meshkibaf MH et al (2012) Effect of Ramadan fasting in tropical summer months on ocular refractive and biometric characteristics. Clin Exp Optom 95:173–176
Koktekir BE, Bozkurt B, Gonul S et al (2014) Effect of religious fasting on tear osmolarity and ocular surface. Eye Contact Lens 40:239–242
Bhan A, Browning AC, Shah S et al (2002) Effect of corneal thickness on intraocular pressure measurements with the pneumotonometer, Goldmann applanation tonometer, and Tono-Pen. Invest Ophthalmol Vis Sci 43:1389–1392
Medeiros FA, Weinreb RN (2006) Evaluation of the influence of corneal biomechanical properties on intraocular pressure measurements using the ocular response analyzer. J Glaucoma 15:364–370
Luce DA (2005) Determining in vivo biomechanical properties of the cornea with an ocular response analyzer. J Cataract Refract Surg 31:156–162
Moreno-Montanes J, Maldonado MJ, Garcia N et al (2008) Reproducibility and clinical relevance of the ocular response analyzer in nonoperated eyes: corneal biomechanical and tonometric implications. Invest Ophthalmol Vis Sci 49:968–974
Congdon NG, Broman AT, Bandeen-Roche K et al (2006) Central corneal thickness and corneal hysteresis associated with glaucoma damage. Am J Ophthalmol 141:868–875
De Moraes CV, Hill V, Tello C et al (2012) Lower corneal hysteresis is associated with more rapid glaucomatous visual field progression. J Glaucoma 21:209–213
Fontes BM, Ambro´sio R Jr, Jardim D et al (2010) Corneal biomechanical metrics and anterior segment parameters in mild keratoconus. Ophthalmology 117:673–679
Ambrósio R Jr, Dawson DG, Salomão M et al (2010) Corneal ectasia after LASIK despite low preoperative risk: tomographic and biomechanical findings in the unoperated, stable, fellow eye. J Refract Surg 26:906–911
Kotecha A (2007) What biomechanical properties of the cornea are relevant for the clinician? Surv Ophthalmol 52:109–114
Leiper JB, Molla AM, Molla AM (2003) Effects on health of fluid restriction during fasting in Ramadan. Eur J Clin Nutr 57:30–38
Hatami-Marbini H, Rahimi A (2016) Interrelation of hydration, collagen cross-linking treatment, and biomechanical properties of the cornea. Curr Eye Res 41:616–622
Sarici AM, Elgin CY, Dikkaya F (2015) Effect of fasting on corneal biomechanical and structural parameters. Curr Eye Res 15:1–5
Oltulu R, Satirtav G, Ersan I et al (2016) The effect of dehydration and fasting on corneal biomechanical properties and intraocular pressure. Eye Contact Lens 42(6):392–394
Brucculeri M, Hammel T, Harris A et al (1999) Regulation of intraocular pressure after water drinking. J Glaucoma 8:111–116
Danesh-Meyer HV, Papchenko T, Tan Y-W et al (2008) Medically controlled glaucoma patients show greater increase in intraocular pressure than surgically controlled patients with the water drinking test. Ophthalmology 115:1566–1570
Bogdan A, Bouchareb B, Touitou Y (2001) Ramadan fasting alters endocrine and neuroendocrine circadian patterns. Meal-time as a synchronizer in humans? Life Sci 68:1607–1615
Goldberg I, Clement CI (2010) The water drinking test. Am J Ophthalmol 150(4):447–449
Kumar N, Jivan S (2007) Ramadan and eyedrops: the muslim perspective. Ophthalmology 114:2356–2360
Doughty MJ, Zaman ML (2000) Corneal thickness and its impact on intraocular pressure measures. A review and metaanalysis approach. Surv Ophthalmol 44:367–408
Ehlers N, Branson T, Sperling S (1975) Applanation tonometry and corneal thickness. Acta Ophthalmol 53:34–43
Liu J, Roberts CJ (2005) Influence of corneal biomechanical properties on intraocular pressure measurement: quantitative analysis. J Cataract Refract Surg 31:146–155
Harada Y, Naoi N (2004) Corneal elasticity as a measure of intraocular pressure: a controlled clinical examination. Kobe J Med Sci 50:141–152
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Uysal, B.S., Duru, N., Ozen, U. et al. Impact of dehydration and fasting on intraocular pressure and corneal biomechanics measured by the Ocular Response Analyzer. Int Ophthalmol 38, 451–457 (2018). https://doi.org/10.1007/s10792-017-0479-5
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DOI: https://doi.org/10.1007/s10792-017-0479-5