title: Effects of several anti-glaucoma medications on the circadian intraocular pressure fluctuations in patients with primary open-angle glaucoma.
abstract: OBJECTIVE
  The purpose of the present study was to elucidate the effects of several anti-glaucoma medications on the circadian intraocular pressure (IOP) fluctuations in patients with primary open-angle glaucoma (POAG).
  
  
  METHODS
  POAG patients (n=61; 61 eyes) with or without glaucoma medications were included. IOP measurement at 14 time points (12, 15, 18, 21, 0, 6, 9, 12, 15, 18, 21, 0, 6, and 9 o'clock) was performed over a period of 48 h. IOP changes occurring in the first 24 h and the subsequent 24 h were evaluated by several therapeutic factors.
  
  
  RESULTS
  A nocturnal acrophase pattern was observed in all the eyes with POAG. The shape of the first 24 h IOP curve was similar to that of the following 24 h IOP curves. However, there were fewer overall IOP levels in the second 24 h time period. Circadian IOP fluctuation patterns exhibited in each eye on the 1st and 2nd days were single acrophase patterns: diurnal acrophase (1st day, 54.0%; 2nd day, 60.7%) and nocturnal acrophase (1st day, 36.1%; 2nd day, 31.1%), and no single acrophase patterns: flat (1st day, 6.6%; 2nd day, 4.9%) and double acrophase (1st day, 3.3%; 2nd day, 3.3%). Among the different medication groups, a nocturnal acrophase circadian pattern was observed in the patient groups being treated by combinations of prostaglandin analog (PG) and β blocker or PG, β blocker and carbonic anhydrase inhibitor (CAI). However, this was not apparent in patient groups with or without single anti-glaucoma medications or a combination of PG and CAI.
  
  
  CONCLUSIONS
  The present study of IOP monitoring patients with POAG over a period of 48 h indicated that their changes in circadian patterns of IOP were affected by types of anti-glaucoma medications.
authors.affiliation: Department of Ophthalmology, Sapporo Medical University School of Medicine , Sapporo, Japan .
authors.forename: Sachie
authors.initials: S
authors.lastname: Tanaka
authors.forename: Megumi
authors.initials: M
authors.lastname: Watanabe
authors.forename: Shu-ichiro
authors.initials: S
authors.lastname: Inatomi
authors.forename: Kazushi
authors.initials: K
authors.lastname: Umeda
authors.forename: Kaori
authors.initials: K
authors.lastname: Yoshida
authors.forename: Ikuyo
authors.initials: I
authors.lastname: Ohguro
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohguro
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D000368:Aged; D002257:Carbonic Anhydrase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D002940:Circadian Rhythm; D004359:Drug Therapy, Combination; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011465:Prostaglandins, Synthetic / Q000008:administration & dosage / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D000319:Adrenergic beta-Antagonists; D002257:Carbonic Anhydrase Inhibitors; D011465:Prostaglandins, Synthetic