title: Relationship of the 24-hour pattern of intraocular pressure with optic disc appearance in primary open-angle glaucoma.
abstract: OBJECTIVE
  To study the relationship between the 24-hour pattern of intraocular pressure (IOP) with optic disc appearance in primary open-angle glaucoma (POAG) patients.
  
  
  METHODS
  Observational clinical study.
  
  
  METHODS
  Seventy-five eyes of 45 POAG patients.
  
  
  METHODS
  Patients underwent 24-hour IOP assessment in a sleep laboratory. Two observers classified the optic disc appearance for each eye as either concentric or nonconcentric. The IOP measurements were obtained with the subjects in the supine and sitting positions during the diurnal period and in the supine position during the nocturnal period. The mean, peak, and trough IOP and IOP range (peak through trough) were calculated for the office-hour period (9 am to 4 pm), the diurnal period (7 am to 11 pm), the nocturnal period (11 pm to 7 am), and the 24-hour period. Further, the difference in supine and sitting IOP during the diurnal periods was calculated, and generalized estimating equations were used to compare IOP measurements in both groups.
  
  
  METHODS
  Diurnal and nocturnal IOP measurements.
  
  
  RESULTS
  Forty eyes were classified as having concentric optic disc appearance and 35 eyes as having nonconcentric optic disc appearance. The mean nocturnal IOP was significantly greater in the concentric group (mean+/-standard deviation [SD], 24.0+/-3.8 mmHg) compared with the nonconcentric group (mean+/-SD, 21.9+/-1.9 mmHg; P = 0.004). Most IOP peaks of patients with the concentric optic disc appearance occurred during the nocturnal period, as opposed to the diurnal period of patients with the nonconcentric optic disc appearance.
  
  
  CONCLUSIONS
  Concentric optic disc appearance may be associated with higher nocturnal IOP compared with nonconcentric optic disc appearance.
  
  
  BACKGROUND
  The author(s) have no proprietary or commercial interest in any materials discussed in this article.
authors.affiliation: Hamilton Glaucoma Center and Department of Ophthalmology, University of California-San Diego, 9415 Campus Point Drive, La Jolla, CA 92037, USA.
authors.forename: Sunil P
authors.initials: SP
authors.lastname: Deokule
authors.forename: Amish
authors.initials: A
authors.lastname: Doshi
authors.forename: Gianmarco
authors.initials: G
authors.lastname: Vizzeri
authors.forename: Felipe A
authors.initials: FA
authors.lastname: Medeiros
authors.forename: John H K
authors.initials: JH
authors.lastname: Liu
authors.forename: Christopher
authors.initials: C
authors.lastname: Bowd
authors.forename: Linda
authors.initials: L
authors.lastname: Zangwill
authors.forename: Robert N
authors.initials: RN
authors.lastname: Weinreb
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002940:Circadian Rhythm / Q000502:physiology*; D003315:Cornea / Q000473:pathology; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000503:physiopathology*; D012372:ROC Curve; D014065:Tonometry, Ocular; D014786:Vision Disorders / Q000175:diagnosis; D058609:Visual Field Tests; D014794:Visual Fields