Intraocular Pressure During ECT: New Study From Belgium in JECT

 Out on PubMed, from researchers in Belgium, is this case report in JECT:

Lateralized Raise in Intraocular Pressure During Electroconvulsive Therapy: A Tonometry Pilot Study.

Vandeurzen J, Vansteelandt K, Lemmens S, Sienaert P.J ECT. 2022 Aug 9. doi: 10.1097/YCT.0000000000000879. Online ahead of print.PMID: 35969842



The abstract is copied below:

Objective: The aim of this study was to evaluate intraocular pressure (IOP) changes during and after electroconvulsive therapy.

Methods: In 20 patients, IOP was measured using a handheld iCare tonometer before, during, and up to 15 minutes after the seizure. Electrode placement was either right unilateral (RUL) or bilateral (BL). Statistical analyses were done at baseline, during, and 15 minutes after the seizure.

Results: In the RUL group (n = 14), the IOP in the left eye increased from 14.8 mm Hg before the seizure to 27.8 mm Hg during the seizure (P = 0.0001) and decreased to 14.0 mm Hg after the seizure (P = 0.0002). The IOP in the right eye increased from 15.4 mm Hg before the seizure to 34.4 mm Hg during the seizure (P = 0.0001) and decreased to 16.0 mm Hg after the seizure (P = 0.0002).In the BL group (n = 6), the IOP in the left eye increased from 13.0 mm Hg before the seizure to 26.3 mm Hg during the seizure (P = 0.1250) and decreased to 14.5 mm Hg after the seizure (P = 0.250). In the right eye, the IOP increased from 13.3 mm Hg before the seizure to 28.4 mm Hg during the seizure (P = 0.1250) and decreased to 13.7 mm Hg after the seizure (P = 0.25).When the results were compared between the 2 electrode placements, the difference in IOP between the right and left eye was higher in the RUL group during (RUL 6.7 mm Hg vs BL 2.0 mm Hg, P = 0.0231) and after (RUL 2.1 mm Hg vs BL -0.8 mm Hg, P = 0.0492) the seizure.

Conclusions: RUL stimulation with electroconvulsive therapy causes a rise in IOP that is partially lateralized, ipsilateral to the side of stimulation.

The pdf is here.

And from the text:





This is a fascinating study showing the expected transient increase in IOP with ECT; the finding of greater rise in IOP in the right eye with RUL stimulation is interesting, as are the speculations about possible mechanisms of action.
While the clinical implications of this study are likely very limited, any increased knowledge of the physiological effects of ECT is most welcome.
A full read, mostly for ECT physiology nerds and ophthalmologists, is about 10 minutes.
Kudos to Dr. Sienaert and colleagues for this little gem.



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