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Abstract #9156 Published in IGR 5-2
24-Hour monitoring of intraocular pressure in glaucoma management: a retrospective review
Hughes E; Spry P; Diamond JJournal of Glaucoma 2003; 12: 232-236
PURPOSE: Diurnal variation in intraocular pressure (IOP) is well recognized, yet important decisions in glaucoma management are frequently made after one or two IOP measurements. Twenty-four-hour monitoring of IOP may identify IOP variation and spikes. This study determined the value of 24-hour IOP monitoring in routine clinical practice. METHODS: Data were acquired retrospectively from case notes of 29 glaucoma patients sequentially admitted for 24-hour IOP monitoring while taking their established antiglaucoma therapy. RESULTS: While there was no difference between the mean clinic (office) and mean 24-hour IOP measurements, the peak IOP during 24-hour monitoring was on average 4.9 mmHg higher than the peak clinic IOP (p < 0.0001). In four (13.8%) patients, the peak IOP over 24 hours was at least 12 mmHg higher than the clinic peak. Peak IOP values occurred outside normal office hours in 51.7% of patients. Twenty-four-hour IOP monitoring resulted in a change of clinical management in 23 (79.3%) patients, including 13 (44.8%) who were offered trabeculectomy. CONCLUSIONS: Twenty-four-hour monitoring of IOP frequently led to a change of glaucoma management by identifying IOP fluctuations and spikes. High IOP and wide diurnal IOP variation are considered major risk factors for glaucoma progression, and standard clinic follow-up evaluations failed to identify these phenomena.
Dr. E.H. Hughes, Bristol Eye Hospital, Lower Maudlin Street, Bristol, BS1 2LX, UK. e.h.hughes@bristol.ac.uk
Classification:
6.1 Intraocular pressure measurement; factors affecting IOP (Part of: 6 Clinical examination methods)
