title: Effect of glaucoma medications on 24-hour intraocular pressure-related patterns using a contact lens sensor.
abstract: BACKGROUND
  The aim of this article was to study the circadian intraocular pressure (IOP)-related effects of ocular hypotensive medications using a contact lens sensor (CLS).
  
  
  METHODS
  This is a university-based prospective, randomized, crossover trial.
  
  
  METHODS
  A total of 23 patients with primary open-angle glaucoma participated.
  
  
  METHODS
  Patients underwent ambulatory recording of IOP-related patterns for 24 h in one eye during 3 monthly sessions using a CLS. Patients were untreated in session 1 (S1), were randomized to one of four classes of glaucoma drops for S2 and had a prostaglandin analogue add-on for S3.
  
  
  METHODS
  Changes in IOP-related patterns were defined using (i) slopes from wake/sitting to sleep/supine; (ii) cosinor rhythmometry modelling; and (iii) area under receiver operating curve (AUC) of sleep period.
  
  
  RESULTS
  Mean patient age was 63.8 ± 11.8 years. Positive linear slopes were seen from wake/sitting to sleep/supine at S1 (17.1 ± 14.2 mVeq/h) and S2 (5.5 ± 23.9 mVeq/h) and negative slopes at S3 (-1.9 ± 29.4 mVeq/h) (S1-S2, P = 0.01; S1-S3, P = 0.02). In the prostaglandin group, slopes changed significantly with introduction of drops (S1-S2, P < 0.024), whereas they did not in a mixed group combining the three other classes (S1-S2, P = 0.060). Overall, cosinor amplitudes were 98.4 ± 46.5 mVeq (S1), 113.0 ± 35.6 mVeq (S2) and 109.6 ± 58.3 mVeq (S3) (S1-S2, P = 0.23; S1-S3, P = 0.66; S2-S3, P = 0.93). AUC were 91.8 ± 63.0 mVeq (S1), 76.3 ± 102.7 mVeq (S2) and 19.9 ± 135.8 mVeq (S3). Differences between sessions were not statistically significant (S1-S2, P = 0.541; S1-S3, P = 0.083; S2-S3, P = 0.092).
  
  
  CONCLUSIONS
  Prostaglandin analogues, but not other medications, seem to flatten the IOP-related increase at transition of the wake/sitting to the sleep/supine period, but do not seem to have an effect on acrophase and amplitude.
authors.affiliation: Hamilton Glaucoma Center and Shiley Eye Center, Department of Ophthalmology, University of California, San Diego, California, USA.|Glaucoma Center, Montchoisi Clinic, Genolier Swiss Vision Network, Lausanne, Switzerland.
authors.forename: Kaweh
authors.initials: K
authors.lastname: Mansouri
authors.affiliation: Hamilton Glaucoma Center and Shiley Eye Center, Department of Ophthalmology, University of California, San Diego, California, USA.
authors.forename: Felipe A
authors.initials: FA
authors.lastname: Medeiros
authors.affiliation: Hamilton Glaucoma Center and Shiley Eye Center, Department of Ophthalmology, University of California, San Diego, California, USA.
authors.forename: Robert N
authors.initials: RN
authors.lastname: Weinreb
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D000069580:Bimatoprost / Q000627:therapeutic use; D000068438:Brimonidine Tartrate / Q000627:therapeutic use; D002940:Circadian Rhythm / Q000502:physiology*; D003261:Contact Lenses; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects* / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation; D009883:Ophthalmic Solutions; D011446:Prospective Studies; D013449:Sulfonamides / Q000627:therapeutic use; D013843:Thiazines / Q000627:therapeutic use; D013999:Timolol / Q000627:therapeutic use; D014065:Tonometry, Ocular / Q000295:instrumentation*; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D009883:Ophthalmic Solutions; D013449:Sulfonamides; D013843:Thiazines; D000068438:Brimonidine Tartrate; D013999:Timolol; C111827:brinzolamide; D000069580:Bimatoprost
keywords: circadian; contact lens sensor; eye drop; glaucoma; intraocular pressure