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J. H. K. Liu, L. M. Alencar, F. A. Medeiros, R. N. Weinreb; Twenty-Four-Hour Intraocular Pressure and Progression of Glaucoma. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5830.
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To evaluate the correlation between parameter of 24-hour intraocular pressure (IOP) and progression of glaucoma.
Patients with defined or suspicious primary open-angle glaucoma who had undergone a 24-hour IOP recording in the sleep laboratory were included. Measurements of IOP and blood pressure were taken when no ocular hypotensive medication was used or after a four-week washout. Mean, peak, and fluctuation (peak minus trough) of 24-hour IOP and mean, peak, trough, and fluctuation of 24-hour ocular perfusion pressure (OPP) in the habitual body positions were calculated. Time up to the date of glaucoma progression was determined after a comprehensive review of visual fields. For patients with normal visual field at baseline, the development of two consecutive abnormal visual fields was regarded as progression. For patients having visual field defects already, progression was assessed using the criteria in the Early Manifest Glaucoma Trial.
From 108 untreated glaucoma patients and glaucoma suspects having a 24-hour IOP recording, we obtained complete visual field information from 62 patients (ages 44-83 years, mean 63.7 years). One-hundred and five eyes were included in data analyses with the average follow-up period of 74 months. Eighteen eyes presented progression and 87 eyes showed no progression. The mean, peak, and fluctuation of 24-hour habitual IOP for the progression group versus the no progression group were 21.4 ± 2.7 (mean ± SD) vs. 21.7 ± 3.0 mmHg, 26.1 ± 3.9 vs. 26.3 ± 3.8 mmHg, and 8.3 ± 2.8 vs. 8.8 ± 2.8 mmHg, respectively. The logistic regression indicated that no 24-hour IOP parameter was associated with glaucoma progression. None of the odds ratio was statistically significant. Similarly, 24-hour OPP parameters were not statistically different between the two patient groups and none of the odds ratio was statistically significant.
There was no significant correlation between any of the 24-hour IOP parameters that were assessed and glaucoma visual field progression. There was also no significant correlation between the 24-hour OPP and glaucoma progression.
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