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A.U. Koeller, K. Wozniak, E. Spoerl, A.G. Boehm, L.E. Pillunat; IOP Measurements During Day and Night Time in Glaucoma Patients and Healthy Controls by Goldmann and Perkins Applanation Tonometry . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4832.
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Purpose: To evaluate IOP levels in glaucoma patients and healthy controls during day and night time while measuring in an upright as well as in a supine position. Methods: In a prospective clinical trial 30 glaucoma patients on topical treatment and 50 healthy controls received IOP measurements every 4 hours for a 24 hour period starting at 8 am. Additionally blood pressure and heart rate were taken and perfusion pressures were calculated. At 12 am IOP was firstly measured in a sitting position and then after 20 min staying in a supine position and at midnight the other way round. At 4am IOP was measured in a supine position all other measurements were performed in a sitting position. Measurements in the sitting position were performed by Goldmann and Perkins tonometry and in a supine position by Perkins tonometry. For statistical analysis ANOVA was used. Results: IOP was 0.96 mmHg (12 pm), 0.94 mmHg (12 am) to 0.7 mmHg (8 pm) lower in Perkins tonometry measurements compared to Goldmann tonometry (P=0.001). There was no difference between the two patient groups. In a supine position IOP measured by Perkins tonometry was higher than in an upright position. At 12 am the difference was 1.9 mmHg ± 2.7 mmHg (P=0.001) in healthy subjects and 1.3 ± 2.7mmHg (P=0.013) in POAG patients. At 12 pm the increase of IOP in the supine position was even more pronounced with 3.2 ± 3.2 mmHg in healthy subjects and 5.5 ± 3.2 mmHg in POAG patients (P=0.001). The blood pressure and the perfusion pressure were lowest at 4 am. There were no differences between the groups (P=0.586). Conclusions: During diurnal IOP measurements in an upright position there were no statistically significant differences in IOP change between both groups. However, in a supine position IOP was significantly higher than in the sitting position and increased more in the glaucoma patients than in healthy controls. This observation might be due to a faulty regulation of the fluid shift in glaucoma patients and might cause progression of glaucomatous damage.
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