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A. G. Junemann, N. Bellios, R. Lämmer, C. Y. Mardin, F. Horn, F. E. Kruse; Longterm Variability of Intraocular Pressure and Progression of Open-Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1052.
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To evaluate whether the longterm variability of office intraocular pressure (IOP) measurements influences the rate of progression of chronic open-angle glaucoma.Patients and
668 patients of the Erlangen Glaucoma Registry with a follow-up of 6.1 ±4 years were included in this study: 95 normal controls (N, 50.3±9.4 years, 108 female, 85 male), 233 patients with ocular hypertension (OHT, 49.6±8.7 years, 107 female, 109 male), 159 patients with preperimetric open-angle glaucoma (preOAG, 49.0±11.6 years, 85 female, 112 male), and 181 patients with perimetric primary OAG (pOAG, 53.7±11.6 years, 131 female, 105 male). Morphological progression was found in 15/233 OHT, 59/159 preOAG, and 76/181 pOAG. The IOP obtained by Goldmann applanation was taken yearly during the office examination at 09 o'clock. In addition, 24hour IOP curve (6 determinations: 0800, noon, 1700, 2100, midnight, 0800) was measured in all patients. Non-parametric testing was performed.
The longterm varability of IOP was significant higher in all patient groups in comparison to normals (N: 3.8±2.2mmHg, OHT: 6.7±4.1, preOAG: 7.2±4.3, OAG: 7.1±4.5, p< 0.001). In all patient groups, patients with progression revealed significant higher longterm variability of IOP (OHT: 6.4±3.7 vs 10.3±6.6, p<006, preOAG: 6.6±4.0 vs 8.2±4.7, p=0.029 OAG: 6.4±4.6 vs 8.2±4.1, p< 0.001). Patients with progression showed significant lower minimal IOP (p<0.01). Mean IOP and maximal IOP showed no significant difference between patients with progression and stable patients in all study groups. In 24hour curve the patients of the progressive pOAG group showed an significant increase of the relative IOP value at mitnight.
Clinical Trial: :
www.clinicaltrials.gov NCT 00494923
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