Circadian intraocular pressure patterns in healthy subjects, primary open angle and normal tension glaucoma patients with a contact lens sensor

Abstract

ABSTRACT.Purpose: To examine the circadian intraocular pressure (IOP) patterns in healthy subjects, in primary open angle and normal tension glaucoma (POAG; NTG) using a contact lens sensor (CLS; Sensimed Triggerfish, Lausanne, Switzerland). Methods: This was an observational, nonrandomized study. Ten healthy subjects (Group 1, 10 eyes) and 20 glaucomatous patients [20 eyes, 10 with POAG (Group 2) and 10 with NTG (Group 3)] were enrolled. All patients were controlled with prostaglandin analogues. The 24-hr IOP pattern was the main outcome. The morning (6AM-11AM), afternoon/evening (noon-11PM) and night (midnight-5AM) subperiod patterns, peaks and prolonged peaks (>1 hr) were secondary outcomes. Results: Mean 24-hr IOP pattern showed a nocturnal acrophase in all groups. Patterns were significantly different among groups (p = 0.02), with highest nocturnal IOP values in POAG. Prolonged peaks were more common in patients with glaucoma (70%) than in healthy subjects (33.3%) (p < 0.001). Significant differences were found for Groups 2 and 3 in the morning versus afternoon/evening (p = 0.019 and p = 0.035, Bonferroni correction), morning versus night (p = 0.005 and p < 0.0001) and afternoon/evening versus night periods comparisons (p < 0.0001 for both groups). In Group 1, patterns significantly differed in the morning versus night and afternoon/evening versus night period comparisons (p < 0.0001). Conclusions: Continuous 24-hr IOP monitoring with the CLS revealed a nocturnal acrophase in healthy subjects and, more markedly, in glaucoma. Because the diurnal IOP profile seems not to predict the nocturnal rhythm, the circadian IOP pattern should be evaluated in clinical practice. These findings may be worthwhile for the management of glaucoma.

Postural and diurnal fluctuations in intraocular pressure across the spectrum of glaucoma

“…Recently, 24 h IOP monitoring has received attention in an attempt to characterise the dynamic changes of IOP especially during sleep 23 24. Mansouri and Shaarawy23 studied patients with glaucoma progression despite normal IOPs during clinic hours who underwent ‘24 h IOP monitoring’ with the contact lens sensor, and found that the peak ‘IOP’ occurred in 69% of patients during the nocturnal/sleep period.…”

Estimation of 24-Hour Intraocular Pressure Peak Timing and Variation Using a Contact Lens Sensor

“…Recently, a wireless contact lens sensor (CLS, Triggerfish; Sensimed, Lausanne, Switzerland) has been developed for monitoring 24-hour IOP at home without the need of awakening subjects during sleep [10], [11]. Several reports have demonstrated good tolerability of the CLS for 24-hour recordings, but the clinical applications of the CLS need to be investigated [12]-[19]. By design, the CLS detects the circumferential change in the corneoscleral curvature that is under the influence of IOP.…”

Interaction between diurnal variations of intraocular pressure, pachymetry, and corneal response to an air puff: Preliminary evidence

“…Glaucoma patients do not follow this circadian pattern and have more IOP variability. 13 In conclusion, the corneal deformation response to an air puff is dependent on IOP and pachymetry and not only on the biomechanical properties of the cornea. Therefore, this deformation by itself cannot be considered a parameter that accurately characterizes the biomechanical behavior of a specific cornea.…”

“…This agrees with results in studies of IOP variability in the circadian cycle in healthy subjects. 13 However, a larger number of patients is required to confirm this observation. In addition, the study should consider different types of corneas, not only healthy ones.…”