Factors associated with fluctuations in repeated measurements of intraocular pressure using the Goldmann applanation tonometer in Japanese patients with primary open-angle glaucoma.
Factors associated with fluctuations in repeated measurements of intraocular pressure using the Goldmann applanation tonometer in Japanese patients with primary open-angle glaucoma.
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DOI：
10.2147/opth.s174277
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Fukuchi T
中科院分区：
文献类型：
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作者：
Yaoeda K;Fukushima A;Shirakashi M;Miki A;Fukuchi T
本研究的目的是确定青光眼患者的眼内压（IOP）波动是否因IOP测量顺序或连续IOP测量而发生，如果是，则确定引起这些波动的因素。研究对象为214例日本原发性开角型青光眼（POAG）患者的428只眼。纳入了仅接受β受体阻滞剂或前列腺素类似物治疗的患者。此外，在通过非接触式眼压计进行的IOP测量中，本研究纳入了本研究之前右眼和左眼的相同IOP病例。如下使用Goldmann压平眼压计进行四次连续的IOP测量：在第一只眼睛（右或左）中测量IOP，然后在对侧眼睛中测量IOP，再次在第一只眼睛中测量IOP，然后在对侧眼睛中测量IOP。重复测量方差分析用于检验连续测量之间的IOP差异。广义线性混合模型被用来测试重复压平眼压计和根据测量顺序的右眼和左眼之间的IOP测量的差异。条件二项逻辑回归分析用于确定与反复压平眼压测量值波动相关的因素。P值<0.05被认为具有统计学意义。根据测量次数，IOP值显著降低（分别为13.8-13.0; P<0.001-0.036）。右眼和左眼之间的IOP测量值没有显著差异。第一次IOP测量值显著高于第四次测量值（P=0.038）;然而，其他组合之间无显著差异。前列腺素类似物的使用是IOP测量值波动的唯一显著因素（P=0.002）。在日本POAG患者中，第一只眼（右眼或左眼）测量的IOP高于对侧眼测量的IOP。前列腺素类似物的使用可能与反复压平眼压测量的IOP波动有关。
The aim of this study was to determine whether fluctuations in intraocular pressure (IOP) occur as a result of the order of IOP measurements or successive IOP measurements in patients with glaucoma and, if so, identify the factors causing these fluctuations. Four hundred twenty-eight eyes of 214 Japanese patients with primary open-angle glaucoma (POAG) were enrolled. Patients treated with beta-blockers or prostaglandin analogs alone were included. Additionally, in the IOP measurements by noncontact tonometer, the same cases of IOP of the right and left eyes prior to this study were included in this study. Four successive IOP measurements were carried out using a Goldmann applanation tonometer as follows: IOP was measured in the first eye (right or left) and then in the fellow eye and IOP was again measured in the first eye and then in the fellow eye. Repeated-measures analysis of variance was used to test the differences in IOP between successive measurements. Generalized linear mixed models were used to test differences in IOP measurements between the right and the left eyes on repeated applanation tonometry and according to the order of measurement. Conditional binomial logistic regression analysis was used to identify factors associated with fluctuating repeated applanation tonometry measurements. A P-value of <0.05 was considered statistically significant. IOP values decreased significantly according to the number of measurements (13.8–13.0; P<0.001–0.036, respectively). There was no significant difference in IOP measurements between the right and left eyes. The first IOP measurement was significantly higher than the fourth measurement (P=0.038); however, there was no significant difference between other combinations. The use of a prostaglandin analog was the only significant contributor to fluctuating IOP measurements (P=0.002). IOP measured in the first eye, either right or left, was higher than that measured in the fellow eye in Japanese patients with POAG. The use of a prostaglandin analog may be associated with fluctuating IOP on repeated applanation tonometry.