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Editors Selection IGR 11-2

Diurnal IOP-variation and RNFL

Comment by Andreas Boehm on:

13391 Diurnal variation of intraocular pressure and its correlation with retinal nerve fiber analysis in Turkish patients with exfoliation syndrome, Gumus K; Bozkurt B; Sonmez B et al., Graefe's Archive for Clinical and Experimental Ophthalmology, 2006; 244: 170-176

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Gumus et al. (107) examined the effect of diurnal variation of IOP on retinal nerve fiber layer thickness in subjects with exfoliation syndrome (XS) compared to normals. XS patients showed a higher rate of IOP fluctuation (defined as a difference of more than 3 mmHg in two consecutive measurements) and diurnal variation of IOP than normals. Moreover, XS patients with diurnal variation of IOP ≥ 5 mmHg or IOP fluctuation tended to have a thinner retinal nerve fiber layer compared to normals measured by GDx with fixed corneal compensation.

This study suggests that in XS a thinning of the retinal nerve fiber layer is correlated to diurnal variation of IOP and IOP fluctuation. Therefore, diurnal variation of IOP and IOP fluctuation need to be considered as risk factors for developing of glaucomatous damage in XS. However, as the retinal nerve fiber layer measurements were performed with a fixed corneal compensation, a confirmation of these results with an individual corneal compensation, e.g., the GDx VCC seems to be necessary.

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