Diurnal intraocular pressure profiles and progression of chronic open-angle glaucoma

Abstract

Purpose To evaluate whether the amplitude of day-and-night intraocular pressure (IOP) profiles influences the rate of progression of chronic open-angle glaucoma. Methods The hospital-based clinical observational study included day-and-night profiles of IOP measurements performed on 458 patients (855 eyes) with chronic open-angle glaucoma or ocular hypertension. The 24-h pressure profiles obtained by Goldmann applanation tonometry contained measurements at 0700, noon, 1700, 2100, and midnight. Results In the whole study population, IOP amplitude was significantly (Po0.001) and positively associated with the mean (r ¼ 0.26), minimal (r ¼ À0.23) and maximal (r ¼ 0.59) IOP values. Taking the whole study population, glaucoma progression was not associated with the IOP amplitude (P ¼ 0.09). After adjustment for age, neuroretinal rim area and the other IOP measurements, age (Po0.001) and neuroretinal rim area (P ¼ 0.05) remained as significant predictive factors in the selected Cox model. In the normal-pressure glaucoma group (n ¼ 174 eyes), progression was significantly positive associated with the minimal IOP value (Po0.001), the mean of the IOP values (P ¼ 0.024), and, less significantly (P ¼ 0.037) and negatively, with the pressure profile amplitudes. In the high-pressure glaucoma group (n ¼ 681 eyes), rate of glaucoma progression was not associated with the IOP amplitude (P ¼ 0.734) or the other IOP parameters. Conclusions Taking into account the highly significant associations between the IOP amplitude and the mean, minimal and maximal IOP values suggests that it is the IOP itself, and less the pressure amplitude, which has the main influence on the rate of the glaucoma progression.

The effect of travoprost on daytime intraocular pressure in normal tension glaucoma: a randomised controlled trial

“…In one study, Asrani et al concluded that the diurnal IOP range was a significant risk factor for glaucoma progression 16. However, a subsequent report by Jonas et al showed no statistically significant association between progression and IOP amplitude; a subgroup analysis for 174 NTG eyes showing that progression of NTG was associated instead with the minimum and mean IOPs 17. Interestingly, in the present study, as many as 43.0% (34/79) of treated eyes attained at least a 20% reduction in minimum IOP, and 22.8% (18/79) attained at least a 30% reduction.…”

Long-term 24-hour Intraocular Pressure Control With Travoprost Monotherapy in Patients With Primary Open-angle Glaucoma

“…These results are not consistent with other studies investigating the role of peak IOP established with single IOP measurements over a long-term follow-up, in which peak IOP was not found to be an independent risk factor for progression. [41][42][43] To date only one previous study 44 analyzed retrospectively the effect of 24-hour peak IOP on long-term progression in POAG. In that study 24-hour peak IOP was documented to be an independent risk factor for progression, and a 24-hour peak IOP below 18 mm Hg ensured a 78% nonprogression rate in treated POAG patients after 5 years of follow-up.…”

24-hour Intraocular Pressure and Ocular Perfusion Pressure in Glaucoma

“…Others, however, have failed to find similar associations. 43 Consequently, the importance of 24-hour IOP parameters in glaucoma remains an area of controversy even among glaucoma experts. 57 …”

“…Jonas et al 43 performed a retrospective chart review of 855 eyes from 458 treated patients with normal tension glaucoma (NTG), POAG, or ocular hypertension. They investigated the potential association of 24-hour IOP parameters with disease progression after a mean follow-up of almost 56 months.…”