Increase of Peak Intraocular Pressure During Sleep in Reproduced Diurnal Changes by Posture

Hara, Takeshi; Hara, Tsutomu; Tsuru, Tadahiko

doi:10.1001/archopht.124.2.165

Cited by 72 publications

(46 citation statements)

References 19 publications

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“…The present study showed that the diurnal curve between 8 a.m. and 4 p.m., performed in the supine position, presented higher absolute values for IOP (on average 4 mmHg higher) compared to those in the sitting position (p<0.0001) ( Table 3 and Figure) which corroborated with previous studies (12,24) . After evaluating 198 patients with POAG, Hara et al evaluat observed a difference of 2.9 mmHg between the pressure peaks of the SDTC in the sitting and supine positions (24) .…”

Section: Discussionsupporting

confidence: 92%

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Intraocular pressure fluctuation in healthy and glaucomatous eyes: a comparative analysis between diurnal curves in supine and sitting positions and the water drinking test

Caiado¹,

Badaró²,

Kasahara³

2014

Arquivos Brasileiros De Oftalmologia

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Approved by the Research Ethics Committee on human beings with the process number 106/06. RESUMO Objetivo: Comparar a flutuação da pressão intraocular (PIO) nas posições sentada e supina, através da curva tensional diária simplificada (CTDS), durante o horário de consultório em pacientes saudáveis e com glaucoma primário de ângulo aberto (GPAA Descritores: Glaucoma de ângulo aberto/fisiopatologia; Pressão intraocular/fi sio logia; Ritmo circadiano ABSTRACTPurpose: To compare intraocular pressure (IOP) using the simplified daily tensional curve (SDTC) between supine and sitting positions in terms of peak levels and amount of fluctuation in both, glaucomatous and healthy subjects. The secondary endpoint was the comparison of these measures with those derived from the water drinking test (WDT). Methods: Thirty patients with primary open-angle glaucoma (POAG) that were undergoing medical therapy and 30 healthy subjects were enrolled in this study. Each patient underwent a diurnal curve between 8 am and 4 pm. After lying down for 5 minutes, the IOP was measured with the Perkins tonometer. Patients were instructed to sit in the upright position for 5 minutes and the tonometry was repeated. At 4:15 pm, the WDT test was performed. Fluctuation was defined as the difference between the highest and the lowest IOP readings (range). The Student's t test was used to assess differences and a P value <0.05 was considered to be statistically significant. Results: The diurnal curve in the supine position demonstrated higher IOP average values (on average 3-4 mmHg higher) compared to the sitting position (p<0.0001) for both groups. IOP peaks were higher in the supine position; however, the IOP range was essentially the same between the three methods. Treated glaucomatous patients had higher IOP levels in all measurements, but the fluctuation for all tests performed appeared to be similar to that of healthy patients. Conclusion:The data suggested that WDT can be used to estimate the diurnal IOP peak and fluctuation observed in the SDTC of the supine position for treated glaucomatous patients. Further studies can compare the possible correlation between the WDT results and those obtained from nocturnal supine measurements.

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Section: Discussionsupporting

confidence: 92%

“…After evaluating 198 patients with POAG, Hara et al evaluat observed a difference of 2.9 mmHg between the pressure peaks of the SDTC in the sitting and supine positions (24) . Liu et al studied 16 youths with healthy eyes and noticed an a verage difference of 4.5 mmHg in the SDTC measurements in both positions.…”

Section: Discussionmentioning

confidence: 99%

Intraocular pressure fluctuation in healthy and glaucomatous eyes: a comparative analysis between diurnal curves in supine and sitting positions and the water drinking test

Caiado¹,

Badaró²,

Kasahara³

2014

Arquivos Brasileiros De Oftalmologia

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“…[24][25][26][27] At present there is lack of consensus on the 24-h IOP characteristics of NTG patients. [28][29][30][31][32][33] Some investigators report that peak IOP in NTG occurs at nighttime. 31,33 Others, however, disagree suggesting that most NTG patients exhibit their peak 24-h IOP at daytime.…”

Section: Introductionmentioning

confidence: 99%

“…[28][29][30][31][32][33] Some investigators report that peak IOP in NTG occurs at nighttime. 31,33 Others, however, disagree suggesting that most NTG patients exhibit their peak 24-h IOP at daytime. 30,34 Besides differences in study design and populations, a further reason for such discrepancies in the literature may stem from the fact that systemic medications (prescribed for cardiovascular conditions) can meaningfully influence circadian IOP and OPP rhythm.…”

Section: Introductionmentioning

confidence: 99%

Twenty-four-hour intraocular pressure and ocular perfusion pressure characteristics in newly diagnosed patients with normal tension glaucoma

Quaranta

Katsanos

Riva

et al. 2016

Eye

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Purpose To determine the mean 24-h intraocular pressure (IOP) and mean ocular perfusion pressure (MOPP) characteristics of newly diagnosed, previously untreated, Caucasian, normal tension glaucoma (NTG) patients and to identify relationships between these features and visual field (VF) loss at diagnosis. Methods Consecutive newly diagnosed NTG patients underwent 24-h habitual IOP and blood pressure (BP) monitoring. Parameters from pooled measurements obtained in the sitting (0800-2200 hours) and supine (1200-0600 hours) positions were compared and associations were sought with VF mean deviation (MD) and pattern standard deviation (PSD). Results Sixty-two Caucasian NTG patients (24 men and 38 women) successfully completed circadian IOP and BP monitoring. In habitual position, 8 subjects (12.9%) exhibited a diurnal acrophase, 42 subjects (67.7%) demonstrated a nocturnal acrophase, one subject (1.6%) showed a flat rhythm and 11 patients (17.7%) revealed a biphasic/ polyphasic rhythm. Nighttime MOPP values (supine position) were significantly greater than diurnal values (sitting position); (Po0.001). No association could be demonstrated between glaucomatous damage, as indicated by VF parameters, and either mean habitual 24-h IOP (P = 0.20 and P = 0.12 for MD and PSD, respectively), or habitual 24-h MOPP (P = 0.96 and 0.29, for MD and PSD, respectively).

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“…(2)(3)(4)(5)(6) Some authors have suggested that nocturnal IOP is higher than in the waking periods.…”

Section: Introductionmentioning

confidence: 99%

Sleeping posture and intraocular pressure

Wong¹,

Lai²,

Singh³

et al. 2013

smedj

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INTRODUCTIONIntraocular pressure (IOP) is a measure of the fluid inside the eye. Controlling IOP has been the primary focus of glaucoma treatment.(1) IOP is affected by various factors such as diurnal variation and posture. (2)(3)(4)(5)(6) Some authors have suggested that nocturnal IOP is higher than in the waking periods.(2) Several studies have compared IOPs in the supine and sitting positions, and found that IOP in the supine position is consistently higher than that in the sitting position. (2,4,7) As such, it is believed that optimal control of IOP in glaucoma patients during sleep may be more crucial than that during the daytime. In this study, the authors aimed to determine whether lying in a lateral decubitus position, which is a common position adopted during sleep, would contribute to an elevation in the IOP of the dependent eye as compared to lying in a supine position. METHODSIn this prospective observational case series, informed consent was obtained from all patients. Approval for the study, which was carried out in accordance with the tenets of the Declaration of Helsinki, was obtained from the institutional ethics committee.For ease of recruitment, adult patients who were above the age of legal consent (21 years) were recruited from a general ophthalmology outpatient clinic. These patients were reviewed for conditions such as floaters and cataracts. The following patients were excluded: (a) patients who did not consent to the study or were unable to lie supine or decubitus for the study;and (b) patients with significant anterior segment pathologies (significant cataracts with visual acuity worse than 6/18 or nuclear sclerosis 3+ or more) or posterior segment pathologies that could act as secondary causes of raised IOP.IOP measurements were taken in a separate room at the clinic using the Tono-Pen ® XL applanation tonometer (Reichert Inc, Depew, NY, USA). The Tono-Pen XL was chosen, as it was more convenient to obtain IOP from patients in the lying down position using this instrument. In addition, the two observers involved in the study were familiar with its usage. to ensure that the patient's naso-occipital plane was at 45° to the horizontal plane and that the pillow was at least in partial contact with the eyelids over the temporal globe. IOP was measured

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Increase of Peak Intraocular Pressure During Sleep in Reproduced Diurnal Changes by Posture

Cited by 72 publications

References 19 publications

Intraocular pressure fluctuation in healthy and glaucomatous eyes: a comparative analysis between diurnal curves in supine and sitting positions and the water drinking test

Intraocular pressure fluctuation in healthy and glaucomatous eyes: a comparative analysis between diurnal curves in supine and sitting positions and the water drinking test

Twenty-four-hour intraocular pressure and ocular perfusion pressure characteristics in newly diagnosed patients with normal tension glaucoma

Sleeping posture and intraocular pressure

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