title: Comparison of intraocular pressure fluctuations measured by goldmann applanation tonometer and pulsatile ocular blood flow analyser.
abstract: BACKGROUND
  Intraocular pressure (IOP) is the major known risk factor in glaucoma and the primer mover of the functional damage in glaucomatous patients but it is not a unique determinant of glaucomatous damage. Clinical assessment of glaucoma patients may not be a true reflection of overall IOP control. Evaluation of the effect of glaucoma medication is restricted by measurement of IOP as a dynamic physiological parameter.
  
  
  OBJECTIVE
  To compare IOP fluctuations over time using Goldmann applanation tonometry (IOPGAT) and pulsatile ocular blood flow analyzer (IOP-POBFA) under the Dorzolamide/timolol or latanoprost treatment regimes.
  
  
  METHODS
  Prospective 1 year follow-up study.
  
  
  METHODS
  30 randomly chosen controlled open angle glaucoma patients (60 eyes): 16 patients (32 eyes) receiving Dorzolamide/timolol fixed combination (D/T) and 14 (28 eyes) latanoprost 0.005% treatment.
  
  
  METHODS
  Changes in IOP and perfusion pressure dynamics.
  
  
  RESULTS
  THERE WAS NO STATISTICALLY SIGNIFICANT DIFFERENCE IN BASELINE IOP PARAMETERS BETWEEN STUDY GROUPS: 15.69 ± 2.02 mmHg with D/T and 16.71 ± 2.84 mmHg with latanoprost (p=0.314). Both treatment regimes were tolerated and patients were adherent to treatment. Determined a strong positive correlation between IOP-GAT and IOP-POBFA; verified over time period under particular treatment regime. After 1 year follow-up D/T and latanoprost results referred to statistically significant tachyphylaxis effect, i.e. IOP-GAT increased in 2.31mmHg with D/T (p=0.007) and 2.72 mmHg (p=0.004) with latanoprost and IOP-POBFA increased in 1.74 mmHg (p=0.026) and 3.13 mmHg (p=0.007) respectively. Multiple regression analysis revealed no important blood flow factors as predictors in the increase of IOP.
  
  
  CONCLUSIONS
  Strong positive correlation was revealed between IOP-POBFA and IOP-GAT over a time period. Observed tachyphylaxis effects after 1 year under both treatment regimes should be assessed with respect to patient compliance and persistence to treatment.
authors.affiliation: Eye Clinic of Kaunas University of Medicine, Kaunas, Lithuania.
authors.forename: Ingrida
authors.initials: I
authors.lastname: Januleviciene
authors.forename: Loreta
authors.initials: L
authors.lastname: Kuzmiene
authors.forename: Ieva
authors.initials: I
authors.lastname: Sliesoraityte
keywords: Goldmann applanation tonometry; glaucoma; intraocular pressure; pulsatile ocular blood flow analyser