Peak Intraocular Pressure and Glaucomatous Progression in Primary Open-Angle Glaucoma

Konstas, Anastasios G. P.; Quaranta, Luciano; Mikropoulos, Dimitrios G.; Nasr, M. B.; Russo, Andrea; Jaffee, Harris A.; Stewart, Jeanette A.; Stewart, William C.

doi:10.1089/jop.2011.0081

Cited by 78 publications

(59 citation statements)

References 17 publications

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“…These results are not consistent with other studies investigating the role of peak IOP established with single IOP measurements over a long-term follow-up, in which peak IOP was not found to be an independent risk factor for progression. [41][42][43] To date only one previous study 44 analyzed retrospectively the effect of 24-hour peak IOP on long-term progression in POAG. In that study 24-hour peak IOP was documented to be an independent risk factor for progression, and a 24-hour peak IOP below 18 mm Hg ensured a 78% nonprogression rate in treated POAG patients after 5 years of follow-up.…”

Section: Discussionmentioning

confidence: 99%

Long-term 24-hour Intraocular Pressure Control With Travoprost Monotherapy in Patients With Primary Open-angle Glaucoma

Riva

Katsanos

Floriani

et al. 2014

Journal of Glaucoma

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Purpose: The aim of the study was to evaluate the long-term 24-hour intraocular pressure (IOP) efficacy of travoprost monotherapy in primary open-angle glaucoma patients.Patients and Methods: A total of 36 previously untreated primary open-angle glaucoma patients were enrolled in this 5-year study.Patients underwent an untreated 24-hour IOP evaluation. Subsequently all patients were assigned to topical therapy with travoprost 0.004% eye-drops preserved with benzalkonium chloride (Travatan, Alcon Laboratories Inc., Fort Worth, TX) administered once in the evening (8:00 PM) in both eyes. All patients were then scheduled for a 24-hour IOP assessment approximately 12 months after the baseline visit. This schedule of follow-up was maintained for the whole duration of the trial. The predetermined range of target IOP reduction selected in this cohort of patients ranged between 20% and 30%.Results: A total of 34 patients completed all phases of the investigation. The mean survival time was 57.3 ± 2.0 months and the cumulative survival rate was 0.82 ± 0.6 at 60 months. Travoprost reduced the mean 24-hour IOP from 23.4 ± 1.7 mm Hg at baseline to 16.8 ± 2.4 mm Hg (28.4%), 16.8 ± 2.5 mm Hg (28.1%), 16.8 ± 2.4 mm Hg (28.5%), 16.7 ± 2.5 mm Hg (28.6%), and 16.9 ± 2.4 mm Hg (27.8%), respectively at the end of the first, second, third, fourth, and fifth year follow-up. No drug-related serious adverse events were registered during the study.Conclusions: The present study demonstrated the long-term 24-hour efficacy of travoprost for the treatment of primary open-angle glaucoma.Key Words: open-angle glaucoma, prostaglandin analogue, circadian intraocular pressure, travoprost (J Glaucoma 2014;23:535-540) R eduction of intraocular pressure (IOP) is the only currently available, evidence-based management strategy in patients affected with primary open-angle glaucoma (POAG). Most POAG patients will require lifelong medical therapy to avoid visual loss. The decision to select medical therapy options relies primarily on the efficacy of the available medications in various therapeutic trials. Sadly, most published studies only evaluate the short-term, daytime efficacy of medical therapy.Prostaglandin analogues have become a popular firstline therapy option for lowering IOP in POAG owing to their superior 24-hour efficacy, 1-6 convenient once-a-day administration, 5 and favorable systemic safety profile. 7 Travoprost is a synthetic prostaglandin F2a analogue that exerts its IOP-lowering effect through the prostaglandin FP receptors situated at the ciliary muscle 8 and the trabecular meshwork. 9 Travoprost is increasingly becoming a popular first-line monotherapy option for POAG patients 10 as there is cumulative evidence suggesting good quality of shortterm 24-hour IOP control with low fluctuation, especially with evening administration. 11-13 However, although several controlled studies have demonstrated the daytime short-term efficacy of travoprost monotherapy, [14][15][16] little is currently known about its long-term efficacy.As POA...

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Section: Discussionmentioning

confidence: 99%

Long-term 24-hour Intraocular Pressure Control With Travoprost Monotherapy in Patients With Primary Open-angle Glaucoma

Riva

Katsanos

Floriani

et al. 2014

Journal of Glaucoma

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“…These variations are the result of complex interactions between external environmental stimuli and the biologic IOP rhythm. Although previous studies have implicated peak IOP as a major contributor to glaucoma progression, 7,8 data on the time course of IOP rhythms and their reproducibility in glaucoma patients remain scarce. Evidence suggests that reproducibility of several daytime IOP measurements with GAT is only moderate at best in glaucoma patients.…”

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confidence: 99%

Analysis of Continuous 24-Hour Intraocular Pressure Patterns in Glaucoma

Mansouri¹,

Liu²,

Weinreb³

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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PURPOSE.To present a method to analyze circadian intraocular pressure (IOP) patterns in glaucoma patients and suspects undergoing repeated continuous 24-hour IOP monitoring.METHODS. Forty patients with established (n ¼ 19) or suspected glaucoma (n ¼ 21) underwent ambulatory 24-hour IOP monitoring on two sessions 1 week apart using a contact lens sensor (CLS). The CLS provides its output in arbitrary units (a.u.). A modified cosinor rhythmometry method was adapted to the CLS output to analyze 24-hour IOP patterns and their reproducibility. Nonparametric tests were used to study differences between sessions 1 and 2 (S1 and S2). Patients pursued their routine daily activities and their sleep was uncontrolled. CLS data were used to assess sleep times. RESULTS.Complete 24-hour data from both sessions were available for 35 patients. Mean (SD) age of the patients was 55.8 6 15.5 years. The correlation of the cosinor fitting and measured CLS values was r ¼ 0.38 (Spearman r; P < 0.001) for S1, r ¼ 0.50 (P < 0.001) for S2, whereas the correlation between S1 and S2 cosinor fittings was r ¼ 0.76 (P < 0.001). Repeated nocturnal acrophase was seen in 62.9% of patients; 17.1% of patients had no repeatable acrophase. The average amplitude of the 24-hour curve was 143.6 6 108.1 a.u. (S1) and 130.8 6 68.2 a.u. (S2) (P ¼ 0.936).CONCLUSIONS. Adapting the cosinor method to CLS data is a useful way for modeling the rhythmic nature of 24-hour IOP patterns and evaluating their reproducibility. Repeatable nocturnal acrophase was seen in 62.9% of patients. (Clinical Trials.gov number, NCT01319617.) (Invest Ophthalmol Vis Sci. 2012;53:8050-8056) DOI:10.1167/iovs.12-10569 E levated intraocular pressure (IOP) is a major risk factor for glaucoma onset 1 and progression. 2 Current treatment for glaucoma is based on lowering of IOP to reduce the rate of progression. 3 Treatment success is frequently expressed as reaching a target range of IOP on subsequent clinic visits when IOP is generally assessed using Goldmann applanation tonometry (GAT). Despite its limitations, 4 the Goldmann technique is widely accessible, easy to perform, and remains the worldwide standard procedure for measuring IOP. Although it generates reliable results, it can provide only a single temporal value that does not reflect the dynamic nature of IOP and its circadian rhythm. 5,6 As a consequence, variations in IOP are commonly noticed, but not well recognized, and often underappreciated in the management of glaucoma patients. These variations are the result of complex interactions between external environmental stimuli and the biologic IOP rhythm. Although previous studies have implicated peak IOP as a major contributor to glaucoma progression, 7,8 data on the time course of IOP rhythms and their reproducibility in glaucoma patients remain scarce. Evidence suggests that reproducibility of several daytime IOP measurements with GAT is only moderate at best in glaucoma patients.9-11 Important shortcomings of these studies, next to the limited number of available IOP measur...

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“…feasible that the worse mean, fluctuation, or peak 24-hour IOP in the XFS group of our study directly resulted in RNFL damage (42). This may be a fruitful line of future investigations.…”

Section: Scanning Laser Polarimetry In Xfsmentioning

confidence: 64%

Scanning Laser Polarimetry in Eyes with Exfoliation Syndrome

Dimopoulos

Katsanos

Mikropoulos³

et al. 2013

European Journal of Ophthalmology

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Purpose: To compare retinal nerve fiber layer thickness (RNFLT) of normotensive eyes with exfoliation syndrome (XFS) and healthy eyes. 52.8 (49.7-55.7) vs 56.0 (53.0-59.3) µm; superior average mean (SD): 62.3 (6.7) vs 68.8 (8.2) µm; inferior average mean (SD): 58.0 (7.2) vs 64.8 (7.7) µm, respectively. TSNIT SD was significantly lower in the XFS group, median p<0.001. There was no systematic relationship between RNFLT and visual acuity, IOP, central

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Peak Intraocular Pressure and Glaucomatous Progression in Primary Open-Angle Glaucoma

Abstract: This study suggests that daytime peak IOP may be clinically important in predicting long-term glaucomatous progression. Further, daytime peak IOP may assist, as much as daytime mean IOP and, in most cases, 24-h peak IOP, in helping to guide long-term treatment in POAG.

Cited by 78 publications

References 17 publications

Long-term 24-hour Intraocular Pressure Control With Travoprost Monotherapy in Patients With Primary Open-angle Glaucoma

Long-term 24-hour Intraocular Pressure Control With Travoprost Monotherapy in Patients With Primary Open-angle Glaucoma

Analysis of Continuous 24-Hour Intraocular Pressure Patterns in Glaucoma

Scanning Laser Polarimetry in Eyes with Exfoliation Syndrome

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