June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Simultaneous ambulatory 24-hour blood pressure monitoring and intraocular pressure-related patterns estimated with a contact-lens sensor in treated glaucoma patients.
Author Affiliations & Notes
  • Joseph H Lee
    Sergievsky Center, Columbia University, New York, New York, United States
  • Carlos Gustavo De Moraes
    Bernard and Shirlee Brown Glaucoma Research Laboratory Columbia University Medical Center, Columbia University Medical Center, New York, New York, United States
  • Luis J Mena
    Academic Unit of Computing, Universidad Politecnica de Sinaloa, Mazatlan, Mexico
  • Zhezhen Jin
    Biostatistics, Columbia University, New York, New York, United States
  • Gladys Maestre
    Department of Biomedical Sciences, University of Texas at Rio Grande Valley, Brownsville, Texas, United States
  • Jeffrey M Liebmann
    Bernard and Shirlee Brown Glaucoma Research Laboratory Columbia University Medical Center, Columbia University Medical Center, New York, New York, United States
  • Robert Ritch
    Einhorn Clinical Research Center, New York Eye and Ear of Mount Sinai, New York, New York, United States
  • Footnotes
    Commercial Relationships   Joseph Lee, None; Carlos De Moraes, Sensimed (C); Luis Mena, None; Zhezhen Jin, None; Gladys Maestre, None; Jeffrey Liebmann, Alcon Laboratories Inc (C), Allergan Inc (C), Carl Zeiss Meditec Inc (C), Dyopsis Inc (C), Pfizer Inc (C), Topcon Medical Systems Inc (C); Robert Ritch, Diopsys Inc (F), Dyopsis Inc (C), iSonic Medical (C), Ocular Instruments (P), Pfizer Inc (C), Santen (R), Sensimed, AG (C), Topcon Medical Systems Inc (F), Topcon Medical Systems Inc (C)
  • Footnotes
    Support  Unrestricted departmental grant from Research to Prevent Blindness, New York, NY (Department of Ophthalmology, Columbia University Medical Center
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5329. doi:
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      Joseph H Lee, Carlos Gustavo De Moraes, Luis J Mena, Zhezhen Jin, Gladys Maestre, Jeffrey M Liebmann, Robert Ritch; Simultaneous ambulatory 24-hour blood pressure monitoring and intraocular pressure-related patterns estimated with a contact-lens sensor in treated glaucoma patients.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5329.

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

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Abstract

Purpose : Cross-sectional studies using single-day, snapshot measurements have shown that, between-patients, blood pressure (BP) and intraocular pressure (IOP) measurements correlate positively.[1,2] Yet, the investigation of the variability of these clinical parameters within-patients with simultaneous, semi-continuous monitoring during 24 hours has not yet been conducted. Here we test the hypothesis that IOP and BP patterns are correlated within treated glaucoma patients undergoing 24-hour monitoring.

Methods : 36 eyes (36 patients) with treated, established glaucoma underwent 24-hour BP and IOP-related measurements on the same day. IOP-related (IOPr) patterns were recorded with a validated contact-lens sensor (CLS, Sensimed Triggerfish®; Sensimed AG) that captures spontaneous circumferential changes at the corneoscleral area due to volume changes, which are correlated with IOP.[3] The CLS recorded consecutive readings every 5 minutes for up to 30 seconds, at intervals of 100 milliseconds. BP measurements (Spacelabs, Inc.) were taken every 30 minutes from 10:00 pm to 7:00 am and every 15 minutes for the rest of the day. We estimated the IOPr variability with the Average Real Variability (ARV) index: ARV=1/(N-1) ∑ | Pk+1-Pk |. Additionally, generalized estimating equations (GEE) were used to test the relationship between IOP and systolic (SBP) and diastolic (DBP) BP within-patients over 24 hours.

Results : Pearson’s correlation revealed a significant, moderate correlation between IOPr ARVs and DBP (r =0.34, P=0.03). Further, GEE models revealed a significant relation between IOPr vs. DBP and IOPr vs. SBP within-patients (β=-1.87; 95% CI=-2.98 to -0.75; P=0.0010 and β=-1.42; 95% CI=-2.39 to -0.45; P=0.0039, respectively). The Figure below depicts the 24-hour patterns of average SBP, DBP, and IOPr of the 36 patients.

Conclusions : In glaucoma patients undergoing simultaneous 24-hour IOPr and BP measurements, higher DBP was associated with higher IOPr variability. Also, IOPr had a significant inverse relationship with both SBP and DBP. That is, IOPr was highest when BP was lowest. Impaired auto-regulation of these relationships could lead to optic nerve ischemia and progressive vision loss from glaucoma.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

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