Seasonal changes of 24-hour intraocular pressure rhythm in healthy Shanghai population

Cheng, Jingyi; Xiao, Ming; Xu, Huan; Fang, Shaobin; Chen, Xu; Kong, Xiangmei; Sun, Xinghuai

doi:10.1097/md.0000000000004453

Cited by 29 publications

(16 citation statements)

References 46 publications

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“…Our results are compatible with previous studies of a seasonal fluctuation in IOP 21,22 wherein IOP was higher during the winter than the summer by 0.5 mmHg for non-glaucoma patients without DED and by 1.0 mmHg for glaucoma patients without DED. Glaucoma medications might not contribute to this fluctuation since they tend to instead reduce the magnitude of diurnal fluctuations 23,24 .…”

Section: Discussionsupporting

confidence: 93%

Seasonal variation of intra-ocular pressure in glaucoma with and without dry eye

Kuze

Ayaki

Yuki

et al. 2020

Sci Rep

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the management of intra-ocular pressure (iop) is important for glaucoma treatment. iop is recognized for showing seasonal fluctuation. Glaucoma patients can be at high risk of dry eye disease (DeD). We thus evaluated seasonal variation of iop with and without DeD in glaucoma patients. this study enrolled 4,708 patients, with mean age of 55.2 years, who visited our clinics in Japan from Mar 2015 to Feb 2017. We compared the seasonal variation in IOP (mean ± SD) across spring (March-May), summer (June-August), fall (September-November), and winter (December-February). IOP was highest in winter and lowest in summer, at 14.2/13.7 for non-glaucoma without DED group (n = 2,853, P = 0.001), 14.5/13.6 for non-glaucoma with DED group (n = 1,500, P = 0.000), 14.0/13.0 for glaucoma without DED group (n = 240, P = 0.051), and 15.4/12.4 for glaucoma with DED group (n = 115, P = 0.015). Seasonal variation was largest across the seasons in the glaucoma with DeD group. iop was also inversely correlated with corneal staining score (P = 0.000). In conclusion, the seasonal variation was significant in most of study groups and IOP could tend to be low in summer. Glaucoma is the second leading cause of blindness worldwide 1. Elevated intra-ocular pressure (IOP) is the only adaptable risk factor for glaucoma and the progression of visual field loss is strongly related to IOP. The management of glaucoma aims to reduce IOP 2,3 , which could be influenced by various factors including blood pressure, body posture, and diurnal and seasonal variations 4-6. Mean IOPs are reportedly higher in winter and lower in summer in both normal 7-9 and glaucoma 10,11 subjects, and the magnitude of these fluctuations are larger in patients with glaucoma than in normal subjects. Clinically, it is important to control IOP since a large diurnal fluctuation in IOP is a known risk factor for the progression of glaucoma 12. Seasonal and diurnal fluctuations could thus mislead a clinical decision regarding medication and surgery. Although this seasonal pattern was described two decades ago, the phenomenon is not completely characterised 8. Due to the chronic nature of glaucoma, many affected patients experience long-term exposure to commercial pharmaceutical components and preservatives that are known to cause corneal and conjunctival toxicity 13-15. Previous studies have shown that up to 40% of glaucoma patients use more than one topical medication 16 , and benzalkonium chloride (BAK), the most common preservative in anti-glaucoma solutions, has been strongly implicated in inducing and/or exacerbating ocular toxicity such as corneal epithelial cell dysfunction and inflammatory and toxic side effects on the conjunctiva. Consequently, glaucoma-affected patients can be at high risk of also developing the commonly seen dry eye disease (DED) 17-19. DED also exhibits seasonal fluctuations in vulnerability against environmental conditions. DED signs and symptoms tend to vary throughout the year, and particularly with seasonal changes across summer to winter 8. These ...

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Section: Discussionsupporting

confidence: 93%

Seasonal variation of intra-ocular pressure in glaucoma with and without dry eye

Kuze

Ayaki

Yuki

et al. 2020

Sci Rep

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“…Findings from this study provide a new perspective on prior reports of seasonal variations in IOP observed in both healthy (Cheng et al, 2016;Qureshi et al, 1996) and ocular hypertensive humans (Gardiner et al, 2013;Qureshi et al, 1999). These studies show that IOP tends to be higher during winter months, which has been attributed to reduced sunlight exposure.…”

Section: Discussionsupporting

confidence: 62%

Reduced humidity experienced by mice in vivo coincides with reduced outflow facility measured ex vivo

Reina-Torres

Bertrand

O’Callaghan

et al. 2019

Experimental Eye Research

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Mice are routinely used to study aqueous humour dynamics. However, physical factors such as temperature and hydration affect outflow facility in enucleated eyes. This retrospective study examined whether differences in temperature and relative humidity experienced by living mice within their housing environment in vivo coincide with differences in outflow facility measured ex vivo. Facility data and environmental records were collected for one enucleated eye from 116 mice (C57BL/6J males, 9-14 weeks) at two institutions. Outflow facility was reduced when relative humidity was below the lower limit of 45% recommended by the UK Code of Practice, but there was no detectable effect of temperature on outflow facility. Even when accounting for effects of humidity, there were differences in outflow facility measured between institutions and between individual researchers at the same institution. These data indicate that humidity, as well as additional environmental factors experienced by living mice within their housing environment, may significantly affect outflow facility measured ex vivo.

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“…All subjects underwent 24-h IOP monitoring at Beizhan Hospital using published methods [ 4 , 8 ]. In brief, participants were asked to maintain normal biological activities and rhythms, and were housed in special area of the hospital a day in advance of the 24-h recording.…”

Section: Methodsmentioning

confidence: 99%

“…There were previous researches demonstrating that long-term IOP fluctuation is significantly related to the risk of glaucoma progression [2,3]. Twentyfour-hour IOP monitoring [4][5][6][7][8] and its association with glaucomatous optic neuropathy needs further investigation.…”

Section: Introductionmentioning

confidence: 99%

Mean amplitude of intraocular pressure excursions: a new assessment parameter for 24-h pressure fluctuations in glaucoma patients

Zhai

Cheng

et al. 2020

Eye

Self Cite

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Background Intraocular pressure (IOP) is important in the pathogenesis of glaucoma and its circadian fluctuations are important in the disease management; however, there are no adequate parameters to describe the fluctuations. This study investigates a new parameter, mean amplitude of intraocular pressure excursion (MAPE), and compares its ability in assessing 24-h IOP fluctuations with other ocular parameters. Methods Only the right eye was evaluated in each of the 79 healthy people and 164 untreated patients with primary open angle glaucoma (POAG). Each participant underwent 24-h IOP monitoring by measuring IOP every 2 h. IOP fluctuations were expressed as MAPE calculations and currently used parameters included mean IOP, standard deviation of IOP, max difference and area under the circadian IOP curve. Comprehensive ophthalmologic examinations were also performed. Associations between visual field deficits and IOP fluctuation parameters were investigated via partial least squares (PLS) regression. Diagnostic performance was evaluated with area under the receiver operating characteristic curves (ROC). Results Compared with healthy volunteers, the MAPE values in POAG patients were higher (4.16 ± 1.90 versus 2.45 ± 0.89, p < 0.01). In PLS regressions where visual field deficits were as dependent variable, MAPE had the highest score regarding variable importance in projection, and its standard regression coefficient was larger than other parameters. Diagnostic performance analysis showed the area under ROC of MAPE for glaucoma detection was 0.822 (0.768–0.868, p < 0.001). Conclusions MAPE might be an effective parameter in clinic to characterise IOP circadian fluctuations.

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Seasonal changes of 24-hour intraocular pressure rhythm in healthy Shanghai population

Cited by 29 publications

References 46 publications

Seasonal variation of intra-ocular pressure in glaucoma with and without dry eye

Seasonal variation of intra-ocular pressure in glaucoma with and without dry eye

Reduced humidity experienced by mice in vivo coincides with reduced outflow facility measured ex vivo

Mean amplitude of intraocular pressure excursions: a new assessment parameter for 24-h pressure fluctuations in glaucoma patients

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