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Abstract #25796 Published in IGR 12-2
Comparison of ability to find abnormal IOP between diurnal and circadian IOP curve
Zhen Y; Wang N; Guo Y; Zhang XChinese Ophthalmic Research 2010; 28: 360-364
Background: To seek the regulation of diurnal intraocular pressure ( IOP ) fluctuate is very important for preventing the damage of optical nerve in the patient with glaucoma. The diurnal IOP curve is a key index in clinic. Objective: This study is to compare the diurnal mean and peak IOP value in the patients with glaucoma and evaluate the ability of daytime IOP and diurnal IOP to reflect the abnormality of IOP. Methods: The 24-hour IOP values were recorded in the right eyes from 21 patients with primary open angle glaucoma (POAG), 11 patients with suspect normal tension glaucoma (SNTG) and 24 patients with suspect glaucoma (SG). The IOP values from applanation tonometer in supine were measured in two-hour interval through the 24 hours with applanation tonometer, and the sitting IOP and non-contact tonometer were recorded in 9:30, 11:30, 13:30 and 15:30 respectively. The abnormal peak IOP value and fluctuation IOP value was determined as > 21 mmHg and > 5 mmHg respectively. Results: The mean circadian IOPs were significantly different in different examination methods in POAG patients (F = 6. 434, P = 0.001) and SG patients (F = 15. 719, P = 0.000). The daytime non-contact IOP value was significantly lower than the diurnal supine IOP value in POAG and SG patients ( P < 0.05 ). The mean circadian peak IOP values in daytime non-contact and daytime sitting IOP value were considerably declined in comparison with diurnal supine IOP value in POAG and SG patients (P < 0.01 ). The mean circadian IOP fluctuation values were markedly lower in daytime supine IOP value, daytime non-contact and daytime sitting IOP value in comparison with diurnal supine IOP value in all of the three types of glaucoma groups ( P < 0.01 ). The peak IOP occurred during the sleep duration in the majority of the patients with the probability ratio 57.14% ,72.73% and 66.67% in POAG, SNTG and SG patients separately. The sensitivity of diurnal IOP curve to abnormal IOP circadian fluctuation was from 10.00% to 36.84% in different groups. Conclusion: This study indicates that it is unreliable for us to accurately determine the change of IOP just rely on the daytime IOP curve. Diumal variation of IOP must be considered in the treatment of glaucoma. LA: Chinese
Y. Zhen. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Classification:
6.1.2 Fluctuation, circadian rhythms (Part of: 6 Clinical examination methods > 6.1 Intraocular pressure measurement; factors affecting IOP)