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Abstract #22950 Published in IGR 11-1
Daily and nightly fluctuation of intraocular pressure and blood pressure in glaucoma and non-glaucoma patients
Chiselita D; Motoc I; Danielescu COftalmologia 2008; 52: 119-125
PURPOSE: To determine and compare 24-hour fluctuations of intraocular pressure (IOP) and systemic blood pressure (BP) in patients with ocular hypertension (OHT) and primary open angle glaucoma (POAG) versus non-glaucoma patients. METHODS: Applanation IOP and BP were measured every 2 hours by one observer for 24 hours in 102 patients. The patients were classified: group 1 - 21 patients with OHT and POAG without treatment, group 2 - 40 patients with OHT and POAG with a satisfactory diurnal therapeutic control of IOP (daytime IOP ? 21 mmHg), group 3 - 13 patients with POAG with unsatisfactory control of IOP under maximal tolerated medication (daytime IOP > 21 mmHg), and group 0-28 non-glaucoma patients (control group). RESULTS: In all glaucoma patients groups 24-hour IOP fluctuations were greater than in the control group (group 0 - 3.62 ± 0.82 mmHg, ANOVA p < 0.001). Untreated OHT/POAG had 24-hour IOP fluctuations significantly greater than those with good therapeutic control (group 1 - 5.66 ± 1.66 mmHg versus group 2 - 4.27 ± 1.86 mmHg, p = 0.0001). POAG with uncontrolled IOP under maximal tolerated medication had the 24-hour IOP fluctuations significantly greater than the other groups (group 3 - 8.38 ± 3.78 mmHg, p?0.0001). In these patients there was an evident nocturnal mean IOP peak between 0-2 am which temporally correlates with nocturnal systemic BP "dip". Nocturnal IOP peaks (between 11 pm-7 am) were found more frequently in treated glaucoma patients (45.28% - groups 2 and 3 versus 10.2% - groups 0 and 1, p < 0.0001). CONCLUSIONS: Circadian lOP fluctuations in glaucoma patients, even with a satisfactory diurnal therapeutic control, are greater than in the age-matched control subjects. Patients with uncontrolled lOP under topical maximal tolerated medication had the greatest 24-hour lOP fluctuations. Nocturnal lOP peaks occur more often in medically treated patients and 24-hour monitoring of lOP may be useful in this patients. LA: Romanian
Dr. D. Chiselita, D. Chiselita. Clinica I Oftalmologie, Sp. Sf. Spiridon, Iasi, Romania
Classification:
6.1.2 Fluctuation, circadian rhythms (Part of: 6 Clinical examination methods > 6.1 Intraocular pressure measurement; factors affecting IOP)
