Evaluation of influence of non-office hours diurnal variation of intraocular pressure in management of glaucoma

Authors : Supriya Pendke, Prasanna Patil, R Krishnaprasad

DOI : 10.18231/j.ijceo.2019.039

Volume : 5

Issue : 2

Year : 2019

Page No : 159-163

Aim and Objectives: This article attempts to elucidate the role of round the clock IOP control and its relevance to current glaucoma practice.
Materials and Methods: A prospective observational study was carried out on 50 patients of POAG or CACG on medical management whose intraocular pressures were found to be controlled by daytime office hours IOP estimation. The diurnal IOP readings obtained with Clarkes Hand held Perkins applanation tonometer and Reicherts Tonopen at 7am, 10am, 1pm, 4pm, 7pm, 10pm, 1am and 4am. Comparison of office hours IOP, extended office hours DVT and 24 hours IOP was done.
Results: Fifty patients were enrolled (mean age: 53.88 ± 8.42 years) in the study. The mean office hours IOP for both eyes was significantly less (16.31±2.46) than extended office hours (17.18±2.50) and 24 hours DVT (17.49 ±2.45). There was significant difference in IOP fluctuation in office (3.72±2.14) versus extended office hours (9.26±3.11) and 24 hours DVT (10.28±2.76). The mean office hours peak IOP was significantly lower than that of extended office hours and 24 hours DVT.
Conclusion: 24-hour IOP monitoring can reveal higher peaks and wider fluctuation of IOP than those found during typical office hours, it suggests a greater role for IOP-related risk for glaucoma progression. Thus may justify a more aggressive IOP-lowering treatment strategy.

Keywords: Chronic angle closure glaucoma (CACG), Clarkes hand held perkins applanation tonometer, Intraocular pressure (IOP), glaucoma, Primary open angle glaucoma (POAG), Reicherts tonopen.


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