Circadian intraocular pressure patterns in healthy subjects, primary open angle and normal tension glaucoma patients with a contact lens sensor.
OBJECTIVE
To examine the circadian intraocular pressure (IOP) patterns in healthy subjects, in primary open angle and normal tension glaucoma (POAG; NTG) using a contact lens sensor (CLS; Sensimed Triggerfish, Lausanne, Switzerland).


METHODS
This was an observational, nonrandomized study. Ten healthy subjects (Group 1, 10 eyes) and 20 glaucomatous patients [20 eyes, 10 with POAG (Group 2) and 10 with NTG (Group 3)] were enrolled. All patients were controlled with prostaglandin analogues. The 24-hr IOP pattern was the main outcome. The morning (6AM-11AM), afternoon/evening (noon-11PM) and night (midnight-5AM) subperiod patterns, peaks and prolonged peaks (>1 hr) were secondary outcomes.


RESULTS
Mean 24-hr IOP pattern showed a nocturnal acrophase in all groups. Patterns were significantly different among groups (p = 0.02), with highest nocturnal IOP values in POAG. Prolonged peaks were more common in patients with glaucoma (70%) than in healthy subjects (33.3%) (p < 0.001). Significant differences were found for Groups 2 and 3 in the morning versus afternoon/evening (p = 0.019 and p = 0.035, Bonferroni correction), morning versus night (p = 0.005 and p < 0.0001) and afternoon/evening versus night periods comparisons (p < 0.0001 for both groups). In Group 1, patterns significantly differed in the morning versus night and afternoon/evening versus night period comparisons (p < 0.0001).


CONCLUSIONS
Continuous 24-hr IOP monitoring with the CLS revealed a nocturnal acrophase in healthy subjects and, more markedly, in glaucoma. Because the diurnal IOP profile seems not to predict the nocturnal rhythm, the circadian IOP pattern should be evaluated in clinical practice. These findings may be worthwhile for the management of glaucoma.
Department of Medicine and Aging Science, Ophthalmology Clinic, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy.
Luca
L
Agnifili
Rodolfo
R
Mastropasqua
Paolo
P
Frezzotti
Vincenzo
V
Fasanella
Ilaria
I
Motolese
Emilio
E
Pedrotti
Angelo
A
Di Iorio
Peter A
PA
Mattei
Eduardo
E
Motolese
Leonardo
L
Mastropasqua
D000368:Aged; D002940:Circadian Rhythm / Q000502:physiology*; D003261:Contact Lenses; D005260:Female; D005902:Glaucoma, Open-Angle / Q000503:physiopathology*; D064368:Healthy Volunteers; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D057066:Low Tension Glaucoma / Q000503:physiopathology; D008297:Male; D008991:Monitoring, Physiologic; D011446:Prospective Studies; D014065:Tonometry, Ocular / Q000295:instrumentation*
24-hr intraocular pressure monitoring; contact lens sensor; normal tension glaucoma; primary open angle glaucoma