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Abstract #70759 Published in IGR 18-2
24-Hour Intraocular Pressure Rhythm in Patients With Untreated Primary Open Angle Glaucoma and Effects of Selective Laser Trabeculoplasty
Aptel F; Musson C; Zhou T; Lesoin A; Chiquet CJournal of Glaucoma 2017; 26: 272-277
PURPOSE OF THE STUDY: The purpose of the study was to evaluate the 24-hour nyctohemeral rhythm of intraocular pressure (IOP) in patients with untreated primary open angle glaucoma using a contact lens sensor. To evaluate the effect of selective laser trabeculoplasty (SLT) on the 24-hour rhythm of IOP. MATERIALS AND METHODS: Prospective study conducted in a chronobiology center. Fourteen patients with primary open angle glaucoma underwent three 24-hour IOP measurement sessions after a complete wash-out of the medical treatment: before SLT and 1 and 6 months after, using the contact lens sensor Triggerfish (SENSIMED, Lausanne, Switzerland). IOP and the main parameters of nyctohemeral rhythm (existence of a rhythm, acrophase, bathyphase, midline estimating statistic of rhythm, amplitude, and range) before SLT were compared with the same parameters measured 1 and 6 months later. RESULTS: IOP increased from 16.3±3.7 to 22.1±8.4 mm Hg (5.8 mm Hg; 95% confidence interval (CI), 2.41-12.71; P=0.009) after the wash-out procedure. After SLT, IOP significantly decreased by 3.4 mm Hg (95% CI, 0.09-7.89; P=0.041) (14.9%) at 1 month and 1.9 mm Hg (95% CI 0.10-3.84; P=0.044) (8.1%) at 6 months. After medication wash-out, 100% of the subjects had a nyctohemeral IOP rhythm with nocturnal acrophase (01:57±3:32 AM, 01:22±3:01 AM, and 03:17±2:12 AM at inclusion, 1 and 6 mo, respectively). SLT did not significantly change the characteristics of the 24-hour IOP pattern, notably the amplitude and the type of rhythm (persistence of nocturnal acrophase). CONCLUSIONS: After medical treatment wash-out, patients with open angle glaucoma consistently had a significant 24-hour IOP rhythm with nocturnal acrophase. SLT reduces the absolute IOP value but does not modify the nyctohemeral IOP rhythm.
*Université Grenoble Alpes †Department of Ophthalmology, University Hospital of Grenoble ‡INSERM U1042, Lab Hypoxia and Physiopathology, Joseph Fourier University, Grenoble, France.
Full articleClassification:
6.1.2 Fluctuation, circadian rhythms (Part of: 6 Clinical examination methods > 6.1 Intraocular pressure measurement; factors affecting IOP)
12.4 Laser trabeculoplasty and other laser treatment of the angle (Part of: 12 Surgical treatment)
