Abstract
Abstract: :
Purpose: Aim of our study was to evaluate the frequency of intraocular pressure spikes at night time in patients suffering from primary open–angle glaucoma and to examine whether these nocturnal spikes show any correlation to IOP–level variations in day time measurements. Methods: In a clinical study intraocular pressure values of 99 POAG–patients (61 female, 38 male, mean age 59.5 years) were evaluated during day– and night time. In each of the patients IOP measurements took place every 4 hours during daytime and were taken by means of Goldmann–applanation tonometry starting at 7 a.m. At midnight the patients were measured in a supine position, which they had to be in for at least 20 minutes, by Perkins–tonometry. Student's t–test was used for statistical analysis to compare IOP levels during day and night time. Moreover correlations between IOP variation during day time and the occurrence of nocturnal intraocular pressure spikes were calculated. Defined as an intraocular pressure spike was an IOP of at least 1.5 mmHg higher than the maximum reading of intraocular pressure values during day time. Results: During day time measurements the mean IOP value was 15.5 mmHg in the right eye (OD) and 14.9 mmHg in the left eye (OS) with an amplitude of 2.3 mmHg ± 1.2 mmHg (OD) and 2.1 mmHg ± 1.4 mmHg (OS). The total amount of patients showing an intraocular pressure spike at night was 49 of 99 patients. The mean value of nocturnal IOP was 16.8 mmHg (OD) and 16 mmHg (OS), which was significantly higher than in daytime measurements (OD: p=0.0005; OS: p=0.003). Most of the patients showed pressure spikes at night time in both eyes. Comparing day time IOP variations to night time IOP spikes there was found no significant correlation (r=0.172; p=0.088)). Conclusion: There was a high frequency of IOP spikes at night time in patients suffering from primary open–angle glaucoma. No significant correlation between variation of intraocular pressure values during day time and the magnitude of IOP at night time was found. Therefore it seems to be especially important to evaluate night time intraocular pressure in glaucoma patients to find out whether they show intraocular pressure spikes which might lead to progression of glaucomatous damage.
Keywords: intraocular pressure • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials