Dampening of Diurnal Intraocular Pressure Fluctuation by Combined Trabeculotomy and Sinusotomy in Eyes With Open-angle Glaucoma

Matsuoka, Masato; Andõ, Akira; Minamino, Keizo; Matsuyama, Kayako; Shima, Chieko; Matsumura, Miyo; Nishimura, Tetsuya

doi:10.1097/ijg.0b013e31824479e6

Cited by 11 publications

(7 citation statements)

References 19 publications

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“…Filtering surgery has been shown to produce a flattening of the nocturnal IOP curve. 29 In the present study, when patients with previous trabeculectomy or ab-interno trabeculotomy were included in the analysis, no significant effect of medications on 24-h rhythms was seen. However, when we eliminated the overriding effect of glaucoma surgery by excluding the three patients with previous surgery from the analysis, the medication effect became significant.…”

Section: Discussionmentioning

confidence: 50%

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Effect of glaucoma medications on 24‐hour intraocular pressure‐related patterns using a contact lens sensor

Mansouri

Medeiros

Weinreb

2015

Clinical Exper Ophthalmology

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Background To study the circadian intraocular pressure-related (IOP) effects of ocular hypotensive medications using a contact lens sensor (CLS). Design University-based prospective, randomized, crossover trial. Participants Twenty-three patients with primary open-angle glaucoma Methods Patients underwent ambulatory recording of IOP-related patterns for 24 hours in one eye during 3 monthly sessions using a CLS. Patients were untreated in session 1 (S1), were randomized to one of 4 classes of glaucoma drops for S2, and had a prostaglandin analog add-on for S3. Outcome measures Changes in IOP-related patterns were defined using 1) slopes from wake/sitting to sleep/supine, 2) cosinor rhythmometry modeling, and 3) area under receiver operating curve (AUC) of sleep period. Results Mean patient age was 63.8±11.8 years. Positive linear slopes were seen from wake/sitting to sleep/supine at S1 (17.1±14.2 mVeq/h) and S2 (5.5±23.9 mVeq/h) and negative slopes at S3 (−1.9±29.4 mVeq/h) (S1 to S2, p=0.01; S1 to S3, p=0.02). In the prostaglandin group, slopes changed significantly with introduction of drops (S1 to S2, p<0.024) while they did not in a mixed group combining the 3 other classes (S1 to S2, p=0.060). Overall, cosinor amplitudes were 98.4±46.5 mVeq (S1), 113.0±35.6 mVeq (S2), and 109.6±58.3 mVeq (S3) (S1–S2, p=0.23; S1–S3, p=0.66; S2–S3, p=0.93). AUC was 91.8±63.0 mVeq (S1), 76.3±102.7mVeq (S2), and 19.9±135.8 mVeq (S3). Differences between sessions were not statistically significant (S1–S2, p=0.541; S1–3, p=0.083; S2–S3, p=0.092). Conclusions Prostaglandin analogs but not other medications seem to flatten the IOP-related increase at transition of the wake/sitting to the sleep/supine period but do not seem to have an effect on acrophase and amplitude.

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Section: Discussionmentioning

confidence: 50%

“…Filtering surgery has been shown to produce a flattening of the nocturnal IOP curve . In the present study, when patients with previous trabeculectomy or ab‐interno trabeculotomy were included in the analysis, no significant effect of medications on 24‐h rhythms was seen.…”

Section: Discussionmentioning

confidence: 54%

Effect of glaucoma medications on 24‐hour intraocular pressure‐related patterns using a contact lens sensor

Mansouri

Medeiros

Weinreb

2015

Clinical Exper Ophthalmology

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“…Matsuoka et al [ 161 ] investigated the effect of combined trabeculotomy and sinusotomy on the 24-h IOP characteristics in treated patients with open-angle glaucoma [ 161 ]. The authors analyzed 14 eyes of 8 patients with office-hour IOP <17 mmHg who exhibited IOP peaks >20 mmHg outside office hours.…”

Section: -H Efficacy Of Surgerymentioning

confidence: 99%

24-h Efficacy of Glaucoma Treatment Options

et al. 2016

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Current management of glaucoma entails the medical, laser, or surgical reduction of intraocular pressure (IOP) to a predetermined level of target IOP, which is commensurate with either stability or delayed progression of visual loss. In the published literature, the hypothesis is often made that IOP control implies a single IOP measurement over time. Although the follow-up of glaucoma patients with single IOP measurements is quick and convenient, such measurements often do not adequately reflect the untreated IOP characteristics, or indeed the quality of treated IOP control during the 24-h cycle. Since glaucoma is a 24-h disease and the damaging effect of elevated IOP is continuous, it is logical that we should aim to understand the efficacy of all treatment options throughout the 24-h period. This article first reviews the concept and value of diurnal and 24-h IOP monitoring. It then critically evaluates selected available evidence on the 24-h efficacy of medical, laser and surgical therapy options. During the past decade several controlled trials have significantly enhanced our understanding on the 24-h efficacy of all glaucoma therapy options. Nevertheless, more long-term evidence is needed to better evaluate the 24-h efficacy of glaucoma therapy and the precise impact of IOP characteristics on glaucomatous progression and visual prognosis.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-016-0302-0) contains supplementary material, which is available to authorized users.

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“…These findings are reasonable and may help explain the reduced progression rates that have been observed after surgery [ 185 ]. More recently, Matsuoka et al [ 186 ] studied the 24-h effect of combined trabeculotomy/sinusotomy in glaucoma patients. After the procedure, the diurnal IOP curves were flattened without a significant nocturnal rise.…”

Section: -H Iop Evidence: How Can It Change Treatment Patterns and mentioning

confidence: 99%

Diurnal and 24-h Intraocular Pressures in Glaucoma: Monitoring Strategies and Impact on Prognosis and Treatment

et al. 2018

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The present review casts a critical eye on intraocular pressure (IOP) monitoring and its value in current and future glaucoma care. Crucially, IOP is not fixed, but varies considerably during the 24-h cycle and between one visit and another. Consequently, a single IOP measurement during so-called office hours is insufficient to characterize the real IOP pathology of a patient with glaucoma. To date IOP remains the principal and only modifiable risk factor for the development and progression of glaucoma. Only by evaluating IOP characteristics (mean, peak and fluctuation of IOP) at diagnosis and after IOP-lowering interventions can we appreciate the true efficacy of therapy. Unfortunately, a major limiting factor in glaucoma management is lack of robust IOP data collection. Treatment decisions, advancement of therapy and even surgery are often reached on the basis of limited IOP evidence. Clearly, there is much room to enhance our decision-making and to develop new algorithms for everyday practice. The precise way in which daytime IOP readings can be used as predictors of night-time or 24-h IOP characteristics remains to be determined. In practice it is important to identify those at-risk glaucoma patients for whom a complete 24-h curve is necessary and to distinguish them from those for whom a daytime curve consisting of three IOP measurements (at 10:00, 14:00 and 18:00) would suffice. By employing a staged approach in determining the amount of IOP evidence needed and the rigour required for our monitoring approach for the individual patient, our decisions will be based on more comprehensive data, while at the same time this will optimize use of resources. The patient’s clinical picture should be the main factor that determines which method of IOP monitoring is most appropriate. A diurnal or ideally a 24-h IOP curve will positively impact the management of glaucoma patients who show functional/anatomical progression, despite an apparently acceptable IOP in the clinic. The potential impact of nocturnal IOP elevation remains poorly investigated. The ideal solution in the future is the development of non-invasive methods for obtaining continuous, Goldmann equivalent IOP data on all patients prior to key treatment decisions. Moreover, an important area of future research is to establish the precise relationship between 24-h IOP characteristics and glaucoma progression.

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Dampening of Diurnal Intraocular Pressure Fluctuation by Combined Trabeculotomy and Sinusotomy in Eyes With Open-angle Glaucoma

Abstract: The diurnal [INCREMENT]IOPs are dampened by LOT+SIN in glaucoma patients with controlled IOPs during regular office hours. These results indicate that these surgical procedures can be used for the treatment of open-angle glaucoma patients.

Cited by 11 publications

References 19 publications

Effect of glaucoma medications on 24‐hour intraocular pressure‐related patterns using a contact lens sensor

Effect of glaucoma medications on 24‐hour intraocular pressure‐related patterns using a contact lens sensor

24-h Efficacy of Glaucoma Treatment Options

Diurnal and 24-h Intraocular Pressures in Glaucoma: Monitoring Strategies and Impact on Prognosis and Treatment

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