Short-Term Reproducibility of Twenty-Four-Hour Intraocular Pressure Curves in Untreated Patients with Primary Open-Angle Glaucoma and Ocular Hypertension

Xu, Shuo; Qin, Jiao; Cheng, Yu; Sun, Jie; Lu, Qiongshi; Zhong, Yisheng

doi:10.1371/journal.pone.0140206

Cited by 11 publications

(7 citation statements)

References 36 publications

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“…In the current study, the overall IOP of the OHTN group was increased, the mean IOP was higher, and the uctuation amplitude of the diurnal and nocturnal IOP (8.91 ± 3.07 mmHg) was signi cantly higher than that of the healthy control group (5.89 ± 0.86 mmHg). Xu et al [11] studied the repeatability of 24-h IOP monitoring in OHTN, and found that the two 24-h IOP uctuation values were 8.94 ± 3.03 mmHg and 9.06 ± 3.19 mmHg, which is similar to the results of the current study (8.91 ± 3.07 mmHg). At the same time, Xu et al reported that the peak IOP occurred at 6:00 h, and that the trough IOP was observed at 20:00 h, which is similar to the results of the current study.…”

Section: Discussionsupporting

confidence: 89%

Rhythm of 24-h Intraocular and Perfusion Pressure in Patients With Ocular Hypertension

Cui

et al. 2020

Preprint

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AIMThe aim of the present study was to characterize the rhythm of 24-h intraocular pressure (IOP) and ocular perfusion pressure (OPP) in patients with ocular hypertension (OHTN), in order to provide a reference for the clinical diagnosis and treatment of OHTN. METHODSAccording to the diagnostic criteria, 107 patients with OHTN were included, and an age- and sex-matched healthy control group (71 patients) was selected. The IOP and blood pressure (BP) of the OHTN and the healthy control groups were recorded every 2 h over a 24-h period. BP was measured using a digital automatic BP monitor, and IOP was measured using a non-contact tonometer. RESULTSThe maximum, minimum and mean IOP were significantly higher in subjects with OHTN than in the healthy control group (P<0.05), and the maximum, minimum and mean MOPP were significantly lower in the OHTN group than in the healthy control group (P<0.05). The minimum and mean SOPP and DOPP values of the OHTN group were lower than those of the healthy control group (P<0.05), and the IOP, MOPP, SOPP and DOPP diurnal and nocturnal fluctuation values were significantly greater in the OHTN group than in the healthy control group (P<0.05). The peak and trough IOP times of the two groups coincided, which tended to be low during the day and higher at night. The peak and trough MOPP and SOPP times of the two groups also coincided, and were primarily higher during the day and lower at night. The 24-h DOPP in the healthy control group was generally higher during the daytime and lower at night, with peak values between 19:00-23:00 h, and trough values between 3:00-7:00 h. No obvious day-to-night fluctuations were observed in the OHTN group. CONCLUSIONThe OPP of patients with OHTN is lower, and the 24-h OPP fluctuates more than that of healthy control subjects. This may be an important blood flow factor for the progression to primary open angle glaucoma in patients with OHTN.

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Section: Discussionsupporting

confidence: 89%

Rhythm of 24-h Intraocular and Perfusion Pressure in Patients With Ocular Hypertension

Cui

et al. 2020

Preprint

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“…The IOP curves over 3 days may not be representative of the IOP pattern in the preceding years during which visual field and/or structural changes may have occurred. Some studies reported that both healthy subjects and glaucoma patients failed to show repeatable diurnal and circadian IOP pattern over a short period of time,17,34,35 whereas others found no significant differences in diurnal IOP fluctuation on 2 consecutive days 36,37. Second, blood pressure, which is associated with IOP, was not monitored 38,39.…”

Section: Discussionmentioning

confidence: 99%

<p>Self-monitoring of intraocular pressure using Icare HOME tonometry in clinical practice</p>

Cvenkel

Velkovska

2019

OPTH

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Purpose: To determine the value of self-monitoring of diurnal intraocular pressure (IOP) by Icare Home rebound tonometer in patients with glaucoma and ocular hypertension. Methods: Patients with open-angle glaucoma or ocular hypertension, controlled IOP at office visits, and at least 3 years of follow-up in the glaucoma clinic were included. Progression of glaucoma was based on medical records and defined by documented structural and/or visual field change. Patients were trained to correctly perform self-tonometry and instructed to measure diurnal IOP in a home setting for 3 days. IOP characteristics (mean, peak IOP, fluctuation of IOP as range, and SD of IOP) were documented and compared between the progressive and stable eyes. Results: Ninety-four patients (50 females) with a mean (SD) age of 57.1 (14.7) years were included. Among the 94 eyes from 94 subjects, 72 (76.6%) eyes had primary open-angle glaucoma, ten (10.6%) had pigmentary glaucoma, four (4.3%) had exfoliative glaucoma, and eight (8.5%) eyes had ocular hypertension. Thirty-six eyes showed progression and 58 eyes were stable. Patients with progression were older than those with stable disease (mean (SD) 65.8 (8.4) years vs 51.7 (15.3) years, P<0.001). The progression group had higher average IOP (mean (SD) 15.8 (4.0) mmHg vs 13.3 (3.7) mmHg, P =0.002), peak IOP (mean (SD) 21.8 (5.8) mmHg vs 18.6 (4.8) mmHg, P =0.01), and greater IOP fluctuation range (mean (SD) 11.6 (4.8) vs 9.1 (3.5) mmHg, P =0.011) compared to non-progression group. Conclusion: Self-monitoring of IOP using Icare Home tonometry provides more complete data on variability of IOP to assist in the management of glaucoma.

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“…As the “target pressure” is one main goal of glaucoma management, at least ideally, the best approach should consider reaching a circadian IOP profile, always within an IOP range that is deemed “safe” for each individual patient. In clinical practice this is rather hard to do, first because with the currently available tools for 24-h IOP assessment, this requires admission to the hospital and a considerable amount of effort and resources, and second because it has been observed that circadian profiles also tend to vary within the same patient [ 168 ]. Therefore, at least theoretically, in order to adopt the best possible management, more than one 24-h curve would be needed for each individual patient.…”

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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Short-Term Reproducibility of Twenty-Four-Hour Intraocular Pressure Curves in Untreated Patients with Primary Open-Angle Glaucoma and Ocular Hypertension

Cited by 11 publications

References 36 publications

Rhythm of 24-h Intraocular and Perfusion Pressure in Patients With Ocular Hypertension

Rhythm of 24-h Intraocular and Perfusion Pressure in Patients With Ocular Hypertension

<p>Self-monitoring of intraocular pressure using Icare HOME tonometry in clinical practice</p>

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

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