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T. C. Moreira, F. N. Kanadani, A. C. Nery, F. H. Melo, J. Rousso, J. N. Dias, V. C. Barbosa, W. D. Batista; Diurnal Curve of the Ocular Perfusion Pressure. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4611.
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To describe the diurnal variation of the ocular perfusion pressure(OPP) in normal, suspects and glaucoma patients.
Seventy-one subjects were enrolled in a prospective study. The diurnal curve of intraocular pressure (IOP) was performed and blood pressure measurements were obtained. Each participant was grouped into one of the following based upon the clinical evaluation of the optic disc, IOP and standard achromatic perimetry (SAP): 18 eyes were classified as normal (normal SAP, normal optic disc evaluation and IOP < 21 mmHg in two different measurements), 30 eyes as glaucoma suspect (GS) (normal SAP and mean deviation (MD), C/D ration > 0,5 or asymmetry > 0,2 and/or ocular hypertension), 31 eyes as early glaucoma (MD < -6 dB, glaucomatous optic neuropathy and SAP and MDs on SAP. SAP was performed with the Octopus 3.1.1 Dynamic 24-2 program. IOP and blood pressure measurements were taken at 6 am, 9 am, 12 pm, 3 pm and 6 pm. The patients stayed in the seated position for 5 minutes prior to blood pressure measurements.
The mean IOP values in all groups did not followed any regular pattern. The peak IOP was found to be greater in suspect (18.70 ± 3.31 [mmHg ± SD]) and glaucoma (18.77 ± 4.30 mmHg) patients as compared to normal subjects (16.11 ± 2.27 mmHg). In studying the diurnal variation of the OPP, we found lower values at 3 pm in normals (34.21 ± 2.07 mmHg), at 9 am in suspects (54.35 ± 3.32 mmHg) and at 12 pm in glaucoma patients (34.84 ± 1.44 mmHg.
Each group has a specific ocular perfusion pressure variation during the day with the most homogeneous group being the suspect one. It is important to keep studying the IOP and OPP variation ifor increased comprehension of the pathophysiology of glaucomatous optic neuropathy.
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