advertisement
Editors Selection IGR 7-1
Medical treatment: Target pressure
Comment by Joseph Caprioli on:
12420 Intraocular pressure variability in patients who reached target intraocular pressure, Malerbi FK; Hatanaka M; Vessani RM et al., British Journal of Ophthalmology, 2005; 89: 540-542
Malerbi et al. (600) conducted a retrospective analysis of their clinical data of 65 patients with POAG. Patients had four IOP office measurements between 8.00 am and 5.00 pm; so these measurements are clearly not diurnal, by definition. Patients also underwent a water drinking test, presumably as a stress test of the functionality of the outflow system. Not surprisingly, additional pressure measurements yielded a wider range of IOPs, some of which were above the individual's target pressure. Also not surprisingly, the water drinking test caused a significant elevation of IOP in these treated patients with POAG at target pressure. The main message here is that additional IOP measurements will reveal a wider range of IOP fluctuation. It is not clear, however how to use this finding in practice. There is accumulating evidence that long-term IOP fluctuation is an important risk factor for glaucomatous progression (Nouri-Mahdavi et al. Predictive factors for glaucomatous visual field progression in the Advanced Glaucoma Intervention Study. Ophthalmol 2004; 111: 1627-1635). As for the water drinking test, this was largely abandoned long ago along with tonography, since they added little to the sacred glaucoma triumvirate of carefully evaluated pressure, disc, and field.
Comments
The comment section on the IGR website is restricted to WGA#One members only. Please log-in through your WGA#One account to continue.Log-in through WGA#One