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R. Lin, P. Yoon, J. Lumba, K. Huang, K. Singh; Inter–Visit IOP Fluctuation in "Stable" Glaucoma Patients . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4831.
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Purpose: To determine the magnitude of inter–visit IOP fluctuation in a cohort of stable glaucoma patients based upon optic nerve and visual field criteria and to determine if there are differences in such fluctuation based upon whether these patients are receiving prostaglandin medications alone or in combination with aqueous suppressants Methods: This was a retrospective review of a cohort of 30 patients with open angle glaucoma and those suspected of having glaucoma who were treated with IOP lowering agents for up to 10 years. Inclusion criteria included both ‘stable’ optic nerve exams based upon stereoscopic examination and stereo disc photography; as well as ‘stable’ visual field status based primarily on automated perimetry. In addition, the study only evaluated eyes receiving at least one IOP lowering medication, with no therapeutic adjustments during the study period. All eyes that underwent laser trabeculoplasty, glaucoma filtration surgery or any other intraocular surgical procedure were excluded. IOP fluctuation was measured as IOP range and standard deviation over the follow up period. Results: IOP fluctuation data was collected from the 57 eligible eyes in these 30 patients. The mean inter–visit fluctuation (IOP range) in these eyes was 5.5 mm Hg +/– 2.4. The IOP range in the 26 eyes which were on a prostaglandin agent alone was 5.3 mm Hg +/– 2.6. In the remaining 31 eyes which received one or more aqueous suppressants with or without a prostaglandin during the study period, the IOP range was 5.7 mm Hg +/– 2.3. There was no statistical difference found between groups (P = 0.47). Similarly, when the IOP fluctuation in the 26 eyes receiving a prostaglandin alone were compared with the 25 eyes receiving a prostaglandin with at least on aqueous suppressant, there was no significant difference found between the two groups. There was also no significant difference between the average standard deviation in the prostaglandin only group (1.78) compared to the aqueous suppressant group (1.79) (P = 0.95). Conclusions: This study shows the magnitude of IOP fluctuation in a cohort of eyes, stable with regard to glaucomatous disease based upon optic nerve and visual field criteria, receiving medications to lower IOP, without adjustment of such therapy during the study period. It also shows that there is no significant difference in IOP fluctuation when comparing patients receiving prostaglandin agents alone with those receiving prostaglandins along with aqueous suppressants.
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