Valsalva Maneuver

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Leslie D. Montgomery - One of the best experts on this subject based on the ideXlab platform.

Julian M. Stewart - One of the best experts on this subject based on the ideXlab platform.

Jin Wook Jeoung - One of the best experts on this subject based on the ideXlab platform.

  • age dependent variation of lamina cribrosa displacement during the standardized Valsalva Maneuver
    Scientific Reports, 2019
    Co-Authors: Yong Woo Kim, Michaël J. A. Girard, Jean Martial Mari, Dong Hyun Lee, Young Kook Kim, Ki Ho Park, Hyung Bin Lim, Jin Wook Jeoung
    Abstract:

    Based on biomechanical theory, lamina cribrosa (LC) displacement, the key component of progressive glaucomatous change, is presumed to be dependent on intraocular pressure (IOP) as well as tissue stiffness of LC. In the performance of the Valsalva Maneuver, both IOP and cerebrospinal fluid pressure can increase. The present study investigated the age-dependent variation of LC displacement during the standardized Valsalva Maneuver in healthy subjects. Sixty-three (63) eyes (age range: 20-76 years) were prospectively underwent IOP measurement and Cirrus HD-OCT optic disc scans before and during the standardized Valsalva Maneuver. During the standardized Valsalva Maneuver, the IOP significantly increased from 13.2 ± 2.9 mmHg to 18.6 ± 5.2 mmHg (P < 0.001). The maximal LC depth significantly decreased in the younger age groups (age: 20 s to 40 s) but not in the older age groups (age: over 50). The BMO distance did not change significantly. Younger age (P = 0.009), a smaller increase of IOP during the Valsalva Maneuver (P = 0.002), and greater baseline maximal LC depth (P = 0.013) were associated with more anterior displacement of the LC during the standardized Valsalva Maneuver. Taken together, age as well as translaminar pressure dynamics seems to play a crucial role in LC biomechanics.

  • Age-Dependent Variation of Lamina Cribrosa Displacement During the Standardized Valsalva Maneuver.
    Scientific reports, 2019
    Co-Authors: Yong Woo Kim, Michaël J. A. Girard, Jean Martial Mari, Dong Hyun Lee, Hyung Bin Lim, Young Kook Kim, Ki Ho Park, Jin Wook Jeoung
    Abstract:

    Based on biomechanical theory, lamina cribrosa (LC) displacement, the key component of progressive glaucomatous change, is presumed to be dependent on intraocular pressure (IOP) as well as tissue stiffness of LC. In the performance of the Valsalva Maneuver, both IOP and cerebrospinal fluid pressure can increase. The present study investigated the age-dependent variation of LC displacement during the standardized Valsalva Maneuver in healthy subjects. Sixty-three (63) eyes (age range: 20-76 years) were prospectively underwent IOP measurement and Cirrus HD-OCT optic disc scans before and during the standardized Valsalva Maneuver. During the standardized Valsalva Maneuver, the IOP significantly increased from 13.2 ± 2.9 mmHg to 18.6 ± 5.2 mmHg (P 

  • Anterior Displacement of Lamina Cribrosa during Valsalva Maneuver in Young Healthy Eyes.
    PloS one, 2016
    Co-Authors: Yong Woo Kim, Michaël J. A. Girard, Jean Martial Mari, Jin Wook Jeoung
    Abstract:

    PURPOSE To investigate lamina cribrosa (LC) displacement during the Valsalva Maneuver in young healthy eyes using enhanced depth imaging (EDI) spectral-domain optical coherence tomography (SD-OCT). METHODS Forty-eight eyes of 48 young healthy volunteers (age range: 20-34 years) underwent intraocular pressure (IOP) measurement by Goldmann applanation tonometry as well as Cirrus HD-OCT scans before and during the Valsalva Maneuver. The optic nerve head (ONH) parameters (average retinal nerve fiber layer thickness, rim area, disc area, average C/D ratio, vertical C/D ratio, cup volume), anterior LC depth (LCD), subfoveal and peripapillary choroidal thickness, and neural canal opening diameter were measured on compensated OCT and compared during Valsalva challenge. The subjects were asked to take a five-minute break after each Valsalva Maneuver. RESULTS During the Valsalva Maneuver, the IOP significantly increased, from 12.7 ± 3.0 mmHg to 16.0 ± 3.2 mmHg (P 0.05). CONCLUSIONS The Valsalva Maneuver induced anterior displacement of the LC, but did not alter the choroidal thickness or ONH morphology. The data describe the positional characteristics of the LC in response to the Valsalva Maneuver in young healthy eyes.

  • Anterior Displacement of Lamina Cribrosa during Valsalva Maneuver in Young Healthy Eyes
    PLoS ONE, 2016
    Co-Authors: Yong Woo Kim, Michaël J. A. Girard, Jean Martial Mari, Jin Wook Jeoung
    Abstract:

    Purpose To investigate lamina cribrosa (LC) displacement during the Valsalva Maneuver in young healthy eyes using enhanced depth imaging (EDI) spectral-domain optical coherence tomography (SD-OCT). Methods Forty-eight eyes of 48 young healthy volunteers (age range: 20-34 years) underwent intraocular pressure (IOP) measurement by Goldmann applanation tonometry as well as Cirrus HD-OCT scans before and during the Valsalva Maneuver. The optic nerve head (ONH) parameters (average retinal nerve fiber layer thickness, rim area, disc area, average C/D ratio, vertical C/D ratio, cup volume), anterior LC depth (LCD), subfoveal and peripapillary choroidal thickness, and neural canal opening diameter were measured on compensated OCT and compared during Valsalva challenge. The subjects were asked to take a five-minute break after each Valsalva Maneuver. Results During the Valsalva Maneuver, the IOP significantly increased, from 12.7 +/- 3.0 mmHg to 16.0 +/- 3.2 mmHg (P < 0.001), while the LCD sharply decreased, from 463.4 +/- 118.8 mu m to 427.3 +/- 106.4 mu m (P < 0.001). The subfoveal choroidal thickness (300.7 +/- 90.6 vs. 309.6 +/- 93.5 mu m), peripapilllary choroidal thickness (152.2 +/- 55.4 vs. 150.8 +/- 49.3 mu m), neural canal opening diameter (1651.8 +/- 204.2 vs. 1651.0 +/- 217.6 mu m), and all of the ONH parameters did not change significantly (all P > 0.05). Conclusions The Valsalva Maneuver induced anterior displacement of the LC, but did not alter the choroidal thickness or ONH morphology. The data describe the positional characteristics of the LC in response to the Valsalva Maneuver in young healthy eyes.

Yong Woo Kim - One of the best experts on this subject based on the ideXlab platform.

  • age dependent variation of lamina cribrosa displacement during the standardized Valsalva Maneuver
    Scientific Reports, 2019
    Co-Authors: Yong Woo Kim, Michaël J. A. Girard, Jean Martial Mari, Dong Hyun Lee, Young Kook Kim, Ki Ho Park, Hyung Bin Lim, Jin Wook Jeoung
    Abstract:

    Based on biomechanical theory, lamina cribrosa (LC) displacement, the key component of progressive glaucomatous change, is presumed to be dependent on intraocular pressure (IOP) as well as tissue stiffness of LC. In the performance of the Valsalva Maneuver, both IOP and cerebrospinal fluid pressure can increase. The present study investigated the age-dependent variation of LC displacement during the standardized Valsalva Maneuver in healthy subjects. Sixty-three (63) eyes (age range: 20-76 years) were prospectively underwent IOP measurement and Cirrus HD-OCT optic disc scans before and during the standardized Valsalva Maneuver. During the standardized Valsalva Maneuver, the IOP significantly increased from 13.2 ± 2.9 mmHg to 18.6 ± 5.2 mmHg (P < 0.001). The maximal LC depth significantly decreased in the younger age groups (age: 20 s to 40 s) but not in the older age groups (age: over 50). The BMO distance did not change significantly. Younger age (P = 0.009), a smaller increase of IOP during the Valsalva Maneuver (P = 0.002), and greater baseline maximal LC depth (P = 0.013) were associated with more anterior displacement of the LC during the standardized Valsalva Maneuver. Taken together, age as well as translaminar pressure dynamics seems to play a crucial role in LC biomechanics.

  • Age-Dependent Variation of Lamina Cribrosa Displacement During the Standardized Valsalva Maneuver.
    Scientific reports, 2019
    Co-Authors: Yong Woo Kim, Michaël J. A. Girard, Jean Martial Mari, Dong Hyun Lee, Hyung Bin Lim, Young Kook Kim, Ki Ho Park, Jin Wook Jeoung
    Abstract:

    Based on biomechanical theory, lamina cribrosa (LC) displacement, the key component of progressive glaucomatous change, is presumed to be dependent on intraocular pressure (IOP) as well as tissue stiffness of LC. In the performance of the Valsalva Maneuver, both IOP and cerebrospinal fluid pressure can increase. The present study investigated the age-dependent variation of LC displacement during the standardized Valsalva Maneuver in healthy subjects. Sixty-three (63) eyes (age range: 20-76 years) were prospectively underwent IOP measurement and Cirrus HD-OCT optic disc scans before and during the standardized Valsalva Maneuver. During the standardized Valsalva Maneuver, the IOP significantly increased from 13.2 ± 2.9 mmHg to 18.6 ± 5.2 mmHg (P 

  • Anterior Displacement of Lamina Cribrosa during Valsalva Maneuver in Young Healthy Eyes.
    PloS one, 2016
    Co-Authors: Yong Woo Kim, Michaël J. A. Girard, Jean Martial Mari, Jin Wook Jeoung
    Abstract:

    PURPOSE To investigate lamina cribrosa (LC) displacement during the Valsalva Maneuver in young healthy eyes using enhanced depth imaging (EDI) spectral-domain optical coherence tomography (SD-OCT). METHODS Forty-eight eyes of 48 young healthy volunteers (age range: 20-34 years) underwent intraocular pressure (IOP) measurement by Goldmann applanation tonometry as well as Cirrus HD-OCT scans before and during the Valsalva Maneuver. The optic nerve head (ONH) parameters (average retinal nerve fiber layer thickness, rim area, disc area, average C/D ratio, vertical C/D ratio, cup volume), anterior LC depth (LCD), subfoveal and peripapillary choroidal thickness, and neural canal opening diameter were measured on compensated OCT and compared during Valsalva challenge. The subjects were asked to take a five-minute break after each Valsalva Maneuver. RESULTS During the Valsalva Maneuver, the IOP significantly increased, from 12.7 ± 3.0 mmHg to 16.0 ± 3.2 mmHg (P 0.05). CONCLUSIONS The Valsalva Maneuver induced anterior displacement of the LC, but did not alter the choroidal thickness or ONH morphology. The data describe the positional characteristics of the LC in response to the Valsalva Maneuver in young healthy eyes.

  • Anterior Displacement of Lamina Cribrosa during Valsalva Maneuver in Young Healthy Eyes
    PLoS ONE, 2016
    Co-Authors: Yong Woo Kim, Michaël J. A. Girard, Jean Martial Mari, Jin Wook Jeoung
    Abstract:

    Purpose To investigate lamina cribrosa (LC) displacement during the Valsalva Maneuver in young healthy eyes using enhanced depth imaging (EDI) spectral-domain optical coherence tomography (SD-OCT). Methods Forty-eight eyes of 48 young healthy volunteers (age range: 20-34 years) underwent intraocular pressure (IOP) measurement by Goldmann applanation tonometry as well as Cirrus HD-OCT scans before and during the Valsalva Maneuver. The optic nerve head (ONH) parameters (average retinal nerve fiber layer thickness, rim area, disc area, average C/D ratio, vertical C/D ratio, cup volume), anterior LC depth (LCD), subfoveal and peripapillary choroidal thickness, and neural canal opening diameter were measured on compensated OCT and compared during Valsalva challenge. The subjects were asked to take a five-minute break after each Valsalva Maneuver. Results During the Valsalva Maneuver, the IOP significantly increased, from 12.7 +/- 3.0 mmHg to 16.0 +/- 3.2 mmHg (P < 0.001), while the LCD sharply decreased, from 463.4 +/- 118.8 mu m to 427.3 +/- 106.4 mu m (P < 0.001). The subfoveal choroidal thickness (300.7 +/- 90.6 vs. 309.6 +/- 93.5 mu m), peripapilllary choroidal thickness (152.2 +/- 55.4 vs. 150.8 +/- 49.3 mu m), neural canal opening diameter (1651.8 +/- 204.2 vs. 1651.0 +/- 217.6 mu m), and all of the ONH parameters did not change significantly (all P > 0.05). Conclusions The Valsalva Maneuver induced anterior displacement of the LC, but did not alter the choroidal thickness or ONH morphology. The data describe the positional characteristics of the LC in response to the Valsalva Maneuver in young healthy eyes.

Ronald D Miller - One of the best experts on this subject based on the ideXlab platform.

  • massive suprachoroidal hemorrhage during pars plana vitrectomy associated with Valsalva Maneuver
    American Journal of Ophthalmology, 2001
    Co-Authors: Aryeh L Pollack, Richard H Mcdonald, Robert N Johnson, Pravin U Dugel, James C Folk, Gilbert M Grand, Michael H Lambert, Steven D Schwartz, Ronald D Miller
    Abstract:

    Abstract PURPOSE: To report the intraoperative occurrence of massive intraocular suprachoroidal hemorrhage associated with Valsalva Maneuver. METHODS: Retrospective, multicenter study of patients who developed massive choroidal hemorrhage associated with Valsalva Maneuver during vitrectomy. RESULTS: Massive intraoperative suprachoroidal hemorrhage in seven patients (seven eyes) involved three men and four women with a median age of 52 years (range, 26 to 82 years). General anesthesia was used in six of seven cases. Coughing or “bucking” on the endotracheal tube during general anesthesia or severe coughing during the one vitrectomy performed under local anesthesia was associated with massive suprachoroidal hemorrhage. In five of seven eyes, this occurred near the end of surgery, after air-fluid exchange but before sclerotomy closure. Scleral plugs were immediately placed, and sclerotomy closure was performed exigently. Immediate posterior sclerotomy was performed on five of seven eyes; an additional patient underwent posterior sclerotomy postoperatively. After median follow-up of 18 months (range, 3 to 36 months), final visual acuity was no light perception in four eyes, light perception in one eye, 20/250 in one eye, and 20/20 in one eye. Four eyes became phthisical. CONCLUSIONS: Valsalva Maneuver during pars plana vitrectomy may result in massive suprachoroidal hemorrhage with disastrous visual consequences. Precautionary measures to prevent coughing or “bucking” on the endotracheal tube during general anesthesia, or a prolonged episode of coughing during local anesthesia, may prevent this potentially devastating complication.

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