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A. Dastiridou, A. Katsanos, B. Dimasi, M. Fanariotis, P. Cholevas, P. Makris, M. Kotoula, E. Tsironi; Posture-Related IOP Change in Open Angle Glaucoma Patients and Healthy Controls. Invest. Ophthalmol. Vis. Sci. 2010;51(13):986.
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© ARVO (1962-2015); The Authors (2016-present)
To measure intraocular pressure (IOP) in the sitting, supine and 30 degrees inverted (Trendelenburg) position in open angle glaucoma (OAG) patients and normal controls.
Twenty six primary open angle and peudoexfoliation glaucoma patients under medical treatment and fourteen healthy controls were included. None of the subjects had a history of other ocular pathology, diabetes, major cardiovascular disease apart from mild hypertension, or previous antiglaucoma surgery. IOP was measured in one eye with a Perkins tonometer and blood pressure was measured with a sphygmomanometer in the sitting, supine and Trendelenburg position consecutively. A period of five minutes was allowed before measurements were performed on assumption of each position.
There was no difference in age between the two groups. Mean IOP in the OAG group was 13.8±2.9mmHg in the sitting position increasing to 16.7±3.4 mmHg in the supine and 18.8±4.0 mmHg in the Trendelenburg position (repeated measures ANOVA, p<0.05 for all comparisons). IOP was 13.1±1.8 mmHg in the control group, increasing to 14.4±2.6 mmHg and 15.5±2.6 mmHg (ANOVA, p<0.05 for all comparisons) for the same positions. No significant difference between the two groups was found in IOP in the sitting position (Mann-Whitney test, p=0.8). There was a bigger IOP increase from baseline in the OAG patients compared to the control group on assuming both the supine (2.9±1.7 mmHg versus 1.3±1.4 mmHg, Mann-Whitney, p=0.04) and the Trendelenburg position (5.0±2.5 mmHg versus 2.4±1.7 mmHg, p<0.01). ANOVA for the intraindividual and between groups comparisons revealed no difference in mean arterial pressure with changing position.
IOP increases when assuming the supine and the Trendelendurg position in both groups. However, medically treated OAG patients exhibit a bigger posture-related IOP change compared to healthy subjects, especially in the Trendelenburg position.
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