title: 24-h Efficacy of Glaucoma Treatment Options.
abstract: Current management of glaucoma entails the medical, laser, or surgical reduction of intraocular pressure (IOP) to a predetermined level of target IOP, which is commensurate with either stability or delayed progression of visual loss. In the published literature, the hypothesis is often made that IOP control implies a single IOP measurement over time. Although the follow-up of glaucoma patients with single IOP measurements is quick and convenient, such measurements often do not adequately reflect the untreated IOP characteristics, or indeed the quality of treated IOP control during the 24-h cycle. Since glaucoma is a 24-h disease and the damaging effect of elevated IOP is continuous, it is logical that we should aim to understand the efficacy of all treatment options throughout the 24-h period. This article first reviews the concept and value of diurnal and 24-h IOP monitoring. It then critically evaluates selected available evidence on the 24-h efficacy of medical, laser and surgical therapy options. During the past decade several controlled trials have significantly enhanced our understanding on the 24-h efficacy of all glaucoma therapy options. Nevertheless, more long-term evidence is needed to better evaluate the 24-h efficacy of glaucoma therapy and the precise impact of IOP characteristics on glaucomatous progression and visual prognosis.
authors.affiliation: 1st University Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece. konstas@med.auth.gr.|3rd University Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece. konstas@med.auth.gr.
authors.forename: Anastasios G P
authors.initials: AG
authors.lastname: Konstas
authors.affiliation: Glaucoma Unit, University of Brescia, Brescia, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Quaranta
authors.affiliation: Department of Ophthalmology, Selcuk University, Konya, Turkey.
authors.forename: Banu
authors.initials: B
authors.lastname: Bozkurt
authors.affiliation: Department of Ophthalmology, University of Ioannina, Ioannina, Greece.
authors.forename: Andreas
authors.initials: A
authors.lastname: Katsanos
authors.affiliation: University of Madrid, Madrid, Spain.
authors.forename: Julian
authors.initials: J
authors.lastname: Garcia-Feijoo
authors.affiliation: Eye Clinic, San Paolo Hospital, University of Milan, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Rossetti
authors.affiliation: Glaucoma Sector, University of Geneva, Geneva, Switzerland.
authors.forename: Tarek
authors.initials: T
authors.lastname: Shaarawy
authors.affiliation: University of Mainz, Mainz, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Pfeiffer
authors.affiliation: Department of Ophthalmology, University Bicocca of Milan, Milan, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Miglior
mesh_terms: D019468:Disease Management; D018450:Disease Progression; D005901:Glaucoma / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007429:Intraocular Pressure; D013997:Time Factors; D014065:Tonometry, Ocular / Q000379:methods; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology / Q000517:prevention & control*
keywords: 24-h efficacy; 24-h intraocular pressure control; Circadian intraocular pressure characteristics; Diurnal intraocular pressure; Glaucoma therapy options; Intraocular pressure monitoring; Ophthalmology