Back to Search
Start Over
Diurnal Intraocular Pressure Fluctuations with Self-tonometry in Glaucoma Patients and Suspects: A Clinical Trial
- Source :
- Optometry and Vision Science
- Publication Year :
- 2018
- Publisher :
- Lippincott Williams & Wilkins, 2018.
-
Abstract
- SIGNIFICANCE This article shows that self-tonometry can provide robust measures of diurnal intraocular pressure (IOP) and also detect changes to IOP in response to treatment within a short period of monitoring. These advances in IOP monitoring may contribute to improved management of glaucoma patients and suspects. PURPOSE The aim of this study was to prospectively investigate the utility of rebound self-tonometry performed over several weeks for detecting diurnal IOP fluctuations in glaucoma patients and suspects and also initial response to topical treatment in glaucoma patients. METHODS Forty patients were recruited following glaucoma-specific examination. Subsequent to successful training with the iCare HOME tonometer, patients were instructed to measure IOP, in a sitting position, four times a day over 4 to 6 weeks. Date, time, laterality, and IOP downloaded from the tonometer and clinical examination data, including applanation IOP and corneal thickness, were analyzed. A user satisfaction survey was also administered at study completion. t Test and analysis of variance were used to compare groups and IOP across days. Pearson correlation was used to compare measurements to Goldmann applanation tonometry and IOP measurements from the first day/s to the overall mean IOP. RESULTS Twenty-seven patients (18 suspects and 9 glaucoma patients) completed data collection. Patients self-measured IOP on 118 (±29) occasions for 40 (±7.4) days. Two dominant patterns of fluctuation were revealed: peak IOP upon awakening (n = 11) and at midday (n = 13). Diurnal IOP measured in the first 7 days showed strong correlation to diurnal IOP across the entire study period (r2 = 0.82, P < .0001). Within 24 hours of treatment commencement (latanoprost 0.005% ophthalmic solution), IOP reduced from 23.9 (±5.2) to 16.1 (±2.6) mmHg. Overall, patients rated the instrument as easy to use, although difficulties with correct alignment were expressed. CONCLUSIONS Rebound self-tonometry demonstrated utility for measuring diurnal IOP fluctuations in most patients, hence enhancing management of patient with or at risk of developing glaucoma.
- Subjects :
- Adult
Male
Intraocular pressure
medicine.medical_specialty
genetic structures
Corneal Pachymetry
Posture
Gonioscopy
Glaucoma
Physical examination
Slit Lamp Microscopy
law.invention
03 medical and health sciences
chemistry.chemical_compound
Tonometry, Ocular
0302 clinical medicine
Randomized controlled trial
law
Ophthalmology
Feature Article–Public Access
medicine
Humans
Prospective Studies
Latanoprost
Corneal pachymetry
Prospective cohort study
Physical Examination
Antihypertensive Agents
Intraocular Pressure
Aged
medicine.diagnostic_test
business.industry
Reproducibility of Results
Middle Aged
medicine.disease
eye diseases
Circadian Rhythm
Self Care
chemistry
030221 ophthalmology & optometry
Female
Ocular Hypertension
sense organs
business
030217 neurology & neurosurgery
Glaucoma, Open-Angle
Optometry
Subjects
Details
- Language :
- English
- ISSN :
- 15389235 and 10405488
- Volume :
- 95
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Optometry and Vision Science
- Accession number :
- edsair.doi.dedup.....07b684656a99f3cc04c1762588698f8a