June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
24-hour intraocular pressure (IOP) fluctuation profile before and after laser peripheral iridotomy in newly diagnosed subjects with primary angle closure
Author Affiliations & Notes
  • Baskaran Mani
    Singapore Eye Research Institute, Singapore, Singapore
    Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  • Tin Aung
    Singapore Eye Research Institute, Singapore, Singapore
    Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  • Footnotes
    Commercial Relationships Baskaran Mani, None; Tin Aung, Alcon (R), Alcon (C), Alcon (F), Allergan (R), Allergan (C), Carl Zeiss Meditec (F), Carl Zeiss Meditec (R), Ellex (F), Ellex (R), Santen (R)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 5637. doi:
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      Baskaran Mani, Tin Aung, ; 24-hour intraocular pressure (IOP) fluctuation profile before and after laser peripheral iridotomy in newly diagnosed subjects with primary angle closure. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5637.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To evaluate the 24-hour circadian intraocular pressure (IOP) fluctuation profile before and after laser peripheral iridotomy (LPI) in newly diagnosed subjects with primary angle closure (PAC) using a contact lens based IOP sensor.

 
Methods
 

Seven newly diagnosed primary angle closure subjects from a glaucoma clinic underwent diurnal IOP profiling with Goldmann applanation tonometry (GAT at 8 am, 10 am, 12 noon and 2 pm), gonioscopy and 24-hour IOP profiling using a contact lens based IOP sensor (Sensimed TriggerfishTM, Lausanne, Switzerland) before and after LPI. Mean GAT IOP and GAT IOP fluctuation (Maximum IOP - Minimum IOP) were compared using Wilcoxon rank sum test. Serial measurement analysis of the time-weighted average of 24-hour IOP fluctuation (in arbitrary units) and comparison between specific times of the day were performed using non-parametric methods.

 
Results
 

The mean age of study participants was 65 (±5.6) years and most of the subjects were of Chinese origin (6/7) and female (5/7). Mean baseline GAT IOP was 23.29 (±0.49) mm Hg. The angle remained closed in 3/7 (42.9%) subjects even after LPI. Comparing pre and post LPI, there was no difference in mean diurnal GAT IOP [19.66 (±2.09) vs 16.7 (±3.57) mm Hg, p=0.25], or mean GAT IOP fluctuation [6.86 (±2.67) vs 5.29 (±1.89), p=0.58]. For both pre and post LPI 24-hour IOP profiling with the IOP sensor, we found nocturnal and morning IOP peaks compared to evening measurements (Figure 1, p<0.0001, Kruskal Wallis test). Using serial measurement analysis, there was no significant change in median IOP fluctuations after LPI overall (p=0.25) or during specific times of the day (p=0.48); however, morning IOP profile showed a trend of less IOP fluctuation after LPI (Figure 1).

 
Conclusions
 

Nocturnal and morning peaks in IOP were found in newly diagnosed PAC subjects. Morning IOP peaks were lower after LPI.

 
 
Figure 1: 24-hour IOP fluctuation profile before and after LPI
 
Figure 1: 24-hour IOP fluctuation profile before and after LPI
 
Keywords: 465 clinical (human) or epidemiologic studies: systems/equipment/techniques • 568 intraocular pressure • 578 laser  
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