title: Twenty-four-hour intraocular pressure patterns in patients with thyroid eye disease.
abstract: BACKGROUND
  To prospectively investigate the safety, tolerability and 24-h intraocular pressure (IOP) patterns in patients with thyroid eye disease (TED) using a contact lens sensor (CLS).
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Ten patients with established TED.
  
  
  METHODS
  Ten eyes of 10 patients were prospectively evaluated in an ambulatory 24-h IOP monitoring session using the CLS (Sensimed AG, Lausanne, Switzerland). Patients pursued daily activities, and sleep behaviour was uncontrolled.
  
  
  METHODS
  Incidence of adverse events (AEs) and tolerability (scale of 0-10, increasing intolerance) were assessed. IOP patterns were evaluated using a cosinor rhythmometry model, and linear regression slopes were constructed for the transition from wake/sitting (W/S) to sleep/supine (S/S) and vice versa.
  
  
  RESULTS
  Mean age was 61.8 ± 21.6 years, and 90% of patients were female. Main AEs were blurred vision (50%), conjunctival hyperaemia (100%) and superficial punctate keratitis (20%). Tolerability of the lens was found to be 1.5 ± 0.7. Positive linear slopes of the CLS signal from wake to sleep were detected (18.0 ± 43.8 arbitrary units [a.u.]; P = 0.254), whereas at the transition from S/S to W/S a significant decrease (-62.9 ± 56.8 a.u.; P = 0.010) was found. Five patients (50%) had a significant nocturnal/sleep acrophase with the peak occurring at 6:30 a.m. The mean amplitude of the 24-h curves was 102.2 ± 52.6 a.u.
  
  
  CONCLUSIONS
  In patients with TED, the CLS provides a safe and well-tolerated approach to 24-h IOP monitoring. After modelling the 24-h IOP curves, TED patients were found to have a morning acrophase.
authors.affiliation: Hamilton Glaucoma Center, Shiley Eye Center, University of California, San Diego, La Jolla, California, USA.
authors.forename: Anjali S
authors.initials: AS
authors.lastname: Parekh
authors.forename: Kaweh
authors.initials: K
authors.lastname: Mansouri
authors.forename: Robert N
authors.initials: RN
authors.lastname: Weinreb
authors.forename: Ali
authors.initials: A
authors.lastname: Tafreshi
authors.forename: Bobby S
authors.initials: BS
authors.lastname: Korn
authors.forename: Don O
authors.initials: DO
authors.lastname: Kikkawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D049970:Graves Ophthalmopathy / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation*; D011446:Prospective Studies; D015203:Reproducibility of Results; D014065:Tonometry, Ocular / Q000295:instrumentation*; D055815:Young Adult
keywords: contact lens sensor; glaucoma; intraocular pressure; thyroid eye disease