title: Analysis of continuous 24-hour intraocular pressure patterns in glaucoma.
abstract: OBJECTIVE
  To present a method to analyze circadian intraocular pressure (IOP) patterns in glaucoma patients and suspects undergoing repeated continuous 24-hour IOP monitoring.
  
  
  METHODS
  Forty patients with established (n = 19) or suspected glaucoma (n = 21) underwent ambulatory 24-hour IOP monitoring on two sessions 1 week apart using a contact lens sensor (CLS). The CLS provides its output in arbitrary units (a.u.). A modified cosinor rhythmometry method was adapted to the CLS output to analyze 24-hour IOP patterns and their reproducibility. Nonparametric tests were used to study differences between sessions 1 and 2 (S1 and S2). Patients pursued their routine daily activities and their sleep was uncontrolled. CLS data were used to assess sleep times.
  
  
  RESULTS
  Complete 24-hour data from both sessions were available for 35 patients. Mean (SD) age of the patients was 55.8 ± 15.5 years. The correlation of the cosinor fitting and measured CLS values was r = 0.38 (Spearman r; P < 0.001) for S1, r = 0.50 (P < 0.001) for S2, whereas the correlation between S1 and S2 cosinor fittings was r = 0.76 (P < 0.001). Repeated nocturnal acrophase was seen in 62.9% of patients; 17.1% of patients had no repeatable acrophase. The average amplitude of the 24-hour curve was 143.6 ± 108.1 a.u. (S1) and 130.8 ± 68.2 a.u. (S2) (P = 0.936).
  
  
  CONCLUSIONS
  Adapting the cosinor method to CLS data is a useful way for modeling the rhythmic nature of 24-hour IOP patterns and evaluating their reproducibility. Repeatable nocturnal acrophase was seen in 62.9% of patients. (ClinicalTrials.gov number, NCT01319617.).
authors.affiliation: Hamilton Glaucoma Center and Shiley Eye Center, Department of Ophthalmology, University of California, San Diego, La Jolla, California.
authors.forename: Kaweh
authors.initials: K
authors.lastname: Mansouri
authors.forename: John H K
authors.initials: JH
authors.lastname: Liu
authors.forename: Robert N
authors.initials: RN
authors.lastname: Weinreb
authors.forename: Ali
authors.initials: A
authors.lastname: Tafreshi
authors.forename: Felipe A
authors.initials: FA
authors.lastname: Medeiros
mesh_terms: D000203:Activities of Daily Living; D002940:Circadian Rhythm / Q000502:physiology*; D063171:Corneal Pachymetry; D005260:Female; D005902:Glaucoma, Open-Angle / Q000503:physiopathology*; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009798:Ocular Hypertension / Q000503:physiopathology; D014065:Tonometry, Ocular / Q000295:instrumentation