Abstract
Abstract: :
Purpose : To evaluate the frequency of nocturnal intraocular pressure spikes in progressive POAG-patients and to investigate whether these spikes are correlated to IOP-level variations during day time. Methods : In a clinical study the diurnal IOP measurements of 31 patients suffering from progressive primary open-angle glaucoma (19 female, 12 male; mean age : 61.5 years) were evaluated. In each of the patients intraocular pressure was measured every 4 hours during daytime by means of Goldmann-applanation tonometry starting at 8 a.m. At midnight a measurement was taken by Perkins-tonometry in a supine position. For statistical analysis IOP levels during day and night time were compared using student's t-test. In addition correlations between variation of intraocular pressure during day time and night spikes were calculated. An intraocular pressure spike was defined as an IOP of at least 1mmHg higher than the maximum reading of intraocular pressure during day time. Results : The mean IOP value during day time measurements was 13.9 mmHg in the right eye (OD) and 13.7 mmHg in the left eye (OS) with an amplitude of 3 mmHg ± 1.5 mmHg (OD) and 3.3 mmHg ± 1.5 mmHg (OS). 25 of 31 patients (81%) showed an intraocular pressure spike at night time. The mean value of nocturnal IOP was 18.1 mmHg (OD) and 17.7 mmHg (OS), which was significantly higher than in daytime measurements (OD : p=0.002 ; OS : p=0.001). One of the patients showed an intraocular pressure spike just in one eye, the others all had an elevation of IOP in both eyes at night time. Comparing day time IOP variations to night time IOP spikes there was found no significant correlation (OD : r=0.01; p=0.95; OS : r=0.32; p=0.95). Conclusion : IOP spikes were frequently found in patients suffering from progressive primary open-angle glaucoma. There was no significant correlation between variation of intraocular pressure during day time and the magnitude of IOP at night time. Therefore it seems to be important to evaluate night time intraocular pressure in glaucoma patients to detect intraocular pressure spikes which might contribute to progression of glaucoma.
Keywords: intraocular pressure • circadian rhythms