Comparison of self-measured diurnal intraocular pressure profiles using rebound tonometry between primary angle closure glaucoma and primary open angle glaucoma patients

PLoS One. 2017 Mar 23;12(3):e0173905. doi: 10.1371/journal.pone.0173905. eCollection 2017.

Abstract

Purpose: To document the diurnal intraocular pressure (IOP) profile with rebound tonometry performed by primary glaucoma patients in non-clinic environment.

Patients and methods: Fifty-three medically-treated eyes of 31 primary angle closure glaucoma (PACG) and 22 primary open angle glaucoma (POAG) patients with no previous eye surgery were recruited. Diurnal IOP was measured 5 times per day at four-hourly intervals from 08:00 to 24:00 for 1 week in patients' study eye using rebound tonometry in a non-clinic environment. The diurnal IOP profiles were compared between PACG and POAG eyes.

Results: For both PACG and POAG eyes, mean patient-measured IOP was highest in the morning, gradually decreased over the course of a day, and was lowest by midnight (p < 0.001). The diurnal IOP fluctuation ± 1 standard deviation (SD), as documented by SD in daily IOP values, was lower in PACG group (1.6 ± 1.1 mmHg) than in POAG group (2.0 ± 1.2 mmHg; p = 0.049). The mean trough IOP ± 1 SD was higher in PACG group (12.9 ± 2.8 mmHg), compared to POAG group (11.5 ± 3.8 mmHg; p = 0.041). The mean IOP level at midnight ± 1 SD in PACG group (14.0 ± 3.2 mmHg) was higher than that in POAG group (12.1 ± 3.7 mmHg; p = 0.013).

Conclusions: IOP in primary glaucoma patients was highest in the morning, and decreased over the course of a day in non-clinic environment. Treated diurnal IOP fluctuation seemed to be greater in POAG than PACG eyes.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Circadian Rhythm / physiology
  • Female
  • Glaucoma, Angle-Closure / physiopathology*
  • Glaucoma, Open-Angle / physiopathology*
  • Humans
  • Intraocular Pressure* / physiology
  • Male
  • Middle Aged
  • Self Care* / statistics & numerical data
  • Tonometry, Ocular / methods
  • Tonometry, Ocular / statistics & numerical data

Grants and funding

This project is supported by Direct Grant for Research from the Chinese University of Hong Kong 2011-2012. The funding organization had no role in the design or conduct of this research.