Purpose
To investigate rules included in daily biorythms of the eyeball volume changes and cardiovascular system behavior in Normal (N), Ocular Hypertension (OH), Normal Tension (NTG) and Primary Open Angle Glaucoma (POAG).
Methods
Symultanous, 24hrs evaluation (T”0”- 11 am to 1.pm, washed out eyes) of ocular volume changes using Continuous Ocular Volumetry (Triggerfish, Sensimed) and cardiovascular system parameters using BP and ECG Holter recordings. There were [participants number (mean IOP/Age)]: 140 Ns (14,5mmHg/54yo) , 23 OHs (25,1mmHg/54,6yo), 25 NTGs (16,1mmHg/61,3yo) and 78 POAGs (24,9mmHg/ 60yo). Variables: TF- [Triggerfish data (mVeq) ], TFGAT- [Triggerfish data+GAT (mVeq+mmHg)], SAP- [systolic arterial pressure (mmHg)], DAP- [diastolic arterial pressure (mmHg)], mDPP - [modyfied diastolic perfusion pressure ;DAP-TFGAT(mVeq+mmHg)], HR- [heart rate (bpm)] Data set based on areas under the curves of variables from 24hrs recordings represent general analysis. Data set basing on time of falling asleep (F) and awakening (W) representing Time-interval dependent analysis. Variables averages and linear model α and β were compared within ranges A: (F-5hrs, F], B: (F, F+2hrs], C: (F+2hrs, W], D: (W, W+5hrs].
Results
Statistical significance vs. Ns ( p<0,007) in Wilcoxon test for AUC variables analysis were detected only for POAG at: TFGAT SUM= 0.00001, DPP SUM= 0.00094 Statistical significance vs. Ns ( p<0,007) in Wilcoxon test for Time-interval dependent analysis Group:[significant variable; time-interval, value]: OH: [SAP AVG; B.0,0041, C.0,0002], [SAP β;C.0,0012, D.0,0053], [DAP AVG; C.0,0049],[DAP β; C.0,001], [MAP β;C.0,003] NTG: No significance POAG: [TFGAT AVG; A.0,00001, B.0,00031, C.0,00117, D.0,00000], [TFGAT SUM; A.0,00000, B.0,0009, D.0,00000],[TFGAT β; A.0,00002, B.0,00009, C.0,00085,D.0,00001], [SAP AVG; C.0,001], [SAP β;D. 0,0067], [MAP AVG; A.0,0033,C.0,0037], [MAP β;A.0,007], [mDPP SUM; A.0,0064, C.0,0029].
Conclusions
The study has shown presence of specific, group dependent rules, presented in 24-hour circadian biorythms of eyeball volume changes and functional parameters of cardiovascular system. These figures could bring new insights into the pathogenesis of glaucomatous neuropathy and indicate the location of potential handle points for individual time-dependent therapeutic options.