PURPOSE: To evaluate the effect of 24-h peak intraocular pressure (IOP) on the progression of primary open-angle glaucoma (POAG) and the 24 h time points that best predict peak pressure. METHODS: A retrospective analysis of clinical data evaluating long-term glaucomatous progression in patients with POAG who were previously in a 24-h study of the authors (IOP readings at 2/6/10 A.M. and 2/6/10 PM); had ≥3 treated 10 A.M. (±1 h) IOP measurements over 5-years after an untreated 24-h baseline; and had a treated 24-h curve with a 10 A.M. IOP±2 mmHg within the 10 A.M. mean IOP over 5-years. RESULTS: We included 98 nonprogressed and 53 progressed patients with POAG (n=151). The mean 24-h peak IOP (mmHg) was 19.9±2.7 for progressed and 18.3±2.0 for nonprogressed patients (P<0.001). Progressed patients also showed a higher mean 24-h IOP. Generally, patients with a mean or peak daytime (readings at 10 A.M., 2 and 6 P.M.) or 24-h peak IOP of ≤18 remained nonprogressed in 75%-78% of cases. Further, measuring IOP at night found a higher peak in only 20% of cases, which was ≤2 of the daytime peak in 98% of cases. A multivariate regression analysis showed only 24-h peak IOP as an independent risk factor for progression (P=0.002). CONCLUSIONS: This study suggests that daytime peak IOP may be clinically important in predicting long-term glaucomatous progression. Further, daytime peak IOP may assist, as much as daytime mean IOP and, in most cases, 24-h peak IOP, in helping to guide long-term treatment in POAG.
PURPOSE: To evaluate the effect of 24-h peak intraocular pressure (IOP) on the progression of primary open-angle glaucoma (POAG) and the 24 h time points that best predict peak pressure. METHODS: A retrospective analysis of clinical data evaluating long-term glaucomatous progression in patients with POAG who were previously in a 24-h study of the authors (IOP readings at 2/6/10 A.M. and 2/6/10 PM); had ≥3 treated 10 A.M. (±1 h) IOP measurements over 5-years after an untreated 24-h baseline; and had a treated 24-h curve with a 10 A.M. IOP±2 mmHg within the 10 A.M. mean IOP over 5-years. RESULTS: We included 98 nonprogressed and 53 progressed patients with POAG (n=151). The mean 24-h peak IOP (mmHg) was 19.9±2.7 for progressed and 18.3±2.0 for nonprogressed patients (P<0.001). Progressed patients also showed a higher mean 24-h IOP. Generally, patients with a mean or peak daytime (readings at 10 A.M., 2 and 6 P.M.) or 24-h peak IOP of ≤18 remained nonprogressed in 75%-78% of cases. Further, measuring IOP at night found a higher peak in only 20% of cases, which was ≤2 of the daytime peak in 98% of cases. A multivariate regression analysis showed only 24-h peak IOP as an independent risk factor for progression (P=0.002). CONCLUSIONS: This study suggests that daytime peak IOP may be clinically important in predicting long-term glaucomatous progression. Further, daytime peak IOP may assist, as much as daytime mean IOP and, in most cases, 24-h peak IOP, in helping to guide long-term treatment in POAG.
Authors: Kaweh Mansouri; John H K Liu; Robert N Weinreb; Ali Tafreshi; Felipe A Medeiros Journal: Invest Ophthalmol Vis Sci Date: 2012-12-13 Impact factor: 4.799
Authors: Emmanuel S Buys; Yu-Chieh Ko; Clemens Alt; Sarah R Hayton; Alexander Jones; Laurel T Tainsh; Ruiyi Ren; Andrea Giani; Maeva Clerté; Emma Abernathy; Robert E T Tainsh; Dong-Jin Oh; Rajeev Malhotra; Pankaj Arora; Nadine de Waard; Binglan Yu; Raphael Turcotte; Daniel Nathan; Marielle Scherrer-Crosbie; Stephanie J Loomis; Jae H Kang; Charles P Lin; Haiyan Gong; Douglas J Rhee; Peter Brouckaert; Janey L Wiggs; Meredith S Gregory; Louis R Pasquale; Kenneth D Bloch; Bruce R Ksander Journal: PLoS One Date: 2013-03-20 Impact factor: 3.240