Role of 24-Hour Intraocular Pressure Monitoring in Glaucoma Management

Abstract

Glaucoma is the leading cause of irreversible blindness worldwide and the prevalence is on the rising trend. Intraocular pressure (IOP) reduction is the mainstay of treatment. The current practice of IOP monitoring is based on spot measurements during clinic visits during office hours. However, there are up to 50% of glaucoma patients who had normal initial IOP, while some treated patients continued to have progressive glaucomatous optic nerve damage even with a low IOP. Recent studies have shown that the IOP of glaucoma patients fluctuated during the day with different patterns, and some of them had peak IOP outside office hours. These findings provided us with new insights on the role of 24-hour IOP monitoring in managing normal tension glaucoma and patients with progressive deterioration despite apparently well-controlled IOP. Nevertheless, results to date are rather inconsistent, and there is no consensus yet. In this review, we briefly highlighted the current modalities of 24-hour IOP monitoring and summarized the characteristic 24-hour IOP pattern and the clinical relevance of IOP parameters in predicting glaucomatous progression in different glaucoma subtypes. We also discussed the therapeutic efficacy of current glaucoma treatment modalities with respect to the mentioned 24-hour IOP profiles, so as to strengthen the role of 24-hour IOP monitoring in identifying and stratifying the risks of progression in glaucoma patients, as well as optimizing treatments according to their IOP profiles.

All-printed stretchable corneal sensor on soft contact lenses for noninvasive and painless ocular electrodiagnosis

“…Moreover, the fabrication of the device involves the use of a wellestablished DIW method that may facilitate the exploration of high-throughput batch production, potentially making the final product disposable and affordable for widespread adoption in the future. This work produces a first-of-its-kind corneal sensor platform that may be also tailored for a broad range of ophthalmic and optometric clinical needs such as the continuous monitoring of IOP and eye movement [45][46][47] .…”

Increased Risk of Ocular Hypertension in Patients with Cushing’s Disease: An Underestimated Comorbidity

“…We were not able to measure corneal thickness, which was associated with IOP 23 . Typically, IOP varies within 24 hours; thus, these patients should be investigated throughout this time cycle 24 . However, we argue that a 24-hour IOP monitoring might only increase the odds ratio observed in the current result.…”

How to Measure Intraocular Pressure: An Updated Review of Various Tonometers

“…This information could be particularly useful in the so-called normal tension glaucoma patients, which show significant damage progression despite an apparently normalized IOP. In these cases, an elevated IOP can sometimes be found during the night, especially early in the morning, outside office hours [ 134 , 135 ]. A number of devices, most of them only experimental, have been proposed for this purpose over the past 20 years [ 136 , 137 , 138 ].…”