Clinical utility of intraocular pressure monitoring outside of normal office hours in patients with glaucoma.
OBJECTIVE
To determine whether intraocular pressure (IOP) monitoring outside of normal office hours adds clinically useful information.


METHODS
We reviewed the records of all patients with glaucoma who were admitted for 24-hour IOP monitoring during 3 years. Applanation IOP was recorded in the sitting position from 7 am until midnight and in the supine position at 6 am.


RESULTS
Thirty-two patients (22 women and 10 men) were enrolled (mean +/- SD age, 67.3 +/- 12.1 years). Mean +/- SD 24-hour IOP was 13.0 +/- 2.2 mm Hg. Mean +/- SD peak 24-hour IOP (16.8 +/- 3.2 mm Hg) was significantly higher than peak office IOP (14.7 +/- 3.2 mm Hg) (P<.001). Peak IOP was recorded outside of office hours in at least 1 eye in 22 patients (69%). Mean IOP fluctuation during 24-hour monitoring (6.9 +/- 2.9 mm Hg) was significantly greater than that during office hours (3.8 +/- 2.3 mm Hg) (P<.001). Peak 24-hour IOP was higher than the peak IOP noted during previous office visits in 40 eyes (62%). Results of 24-hour IOP monitoring led to immediate treatment change in 23 eyes (36%).


CONCLUSIONS
In glaucoma patients with advanced disease or progression that are disproportionate to known IOP measurements, 24-hour monitoring of IOP may reveal a greater role for pressure-related risk for glaucoma progression than previously suspected and may alter treatment strategies.
Barkana
Yaniv
Y
Department of Ophthalmology, The New York Eye and Ear Infirmary, New York 10003, USA.
Anis
Sarah
S
Liebmann
Jeffrey
J
Tello
Celso
C
Ritch
Robert
R
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002940:Circadian Rhythm; D018450:Disease Progression; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008991:Monitoring, Physiologic; D011187:Posture
D000959:Antihypertensive Agents