Asymmetry of right versus left intraocular pressures over 24 hours in glaucoma patients
Asymmetry of right versus left intraocular pressures over 24 hours in glaucoma patients
复制标题
DOI：
10.1016/j.ophtha.2005.10.003
复制
发表时间：
2006-03-01
期刊：
影响因子：
13.7
通讯作者：
Weinreb, RN
中科院分区：
文献类型：
--
作者：
Sit, AJ;Liu, JHK;Weinreb, RN
目的：评估未治疗的开角型青光眼（OAG）患者左右眼24小时眼内压（IOPs）的不对称性及其对单眼治疗试验（monocular therapeutic trial.Design）的影响。从上午7点到下午11点，患者每2小时用气压计测量一次双眼的眼内压，患者处于坐位和仰卧位，仅从下午11点到上午7点，患者处于仰卧位。比较右眼与左眼的平均、峰值和谷值IOP。使用决定系数（R-2）评估右侧和左侧IOP之间的关联强度。单眼治疗试验的有效性进行了评估，通过检查从2个线性回归模型的右与左IOP.Main结果的测量：右，左眼的IOP之间的关联强度，和从线性模型的IOP.Results的残余值：平均值，峰值，或谷值之间的差异无统计学意义的差异，发现在24小时内的右眼和左眼的IOP。平均IOP的相关强度仅为中度（R-2=0.421-0.623）。在14.0%+/- 12.0%中发现3 mmHg的残留值在24小时内，对称线性回归模型的IOP测量值为8.5% ± 10.6%（平均值+/-标准差），最佳拟合线性回归模型的IOP测量值为8.5% ± 10.6%。在这组未经治疗的青光眼患者中，右眼和左眼平均IOP之间的关联强度仅为中度。与最佳拟合模型相比，使用对称模型时3 mmHg的残差值更常见。目前在青光眼患者中进行单眼治疗试验的方法是不可靠的，但是通过使用在一天中不同时间获得的几个IOP测量值而不是单一的办公室测量值，可以提高可靠性。
Purpose: To assess the asymmetry of 24-hour intraocular pressures (IOPs) between right and left eyes of untreated open-angle glaucoma (OAG) patients, and its influence on the monocular therapeutic trial.Design: Experimental study with human patients.Participants: Forty-one subjects (40-78 years old) with untreated OAG.Methods: Subjects were housed in a sleep laboratory for 24 hours. Intraocular pressures of both eyes were measured with a pneumatonometer every 2 hours with the patient in the sitting and supine positions from 7 AM to 11 Pm and in the supine position only from 11 Pm to 7 AM. Mean, peak, and trough IOPs were compared in right versus left eyes. The strength of association between right and left IOPs was assessed using coefficients of determination (R-2). Validity of the monocular therapeutic trial was assessed by examining residual values from 2 linear regression models of right versus left IOP.Main Outcome Measures: Strength of association between IOPs of right and left eyes, and residual values from linear models of IOP.Results: No statistically significant difference was found between mean, peak, or trough IOPs of right and left eyes over a 24-hour period. The strength of association for mean IOP was only moderate (R-2=0.421-0.623). Residual values of 3 mmHg were found in 14.0%+/- 12.0% (mean +/- standard deviation) of IOP measurements for a symmetric linear regression model, and 8.5%+/- 10.6% of IOP measurements for a best-fit linear regression model over 24 hours.Conclusions: In this group of untreated glaucoma patients, the strength of association between the right and left eye mean IOPs is only moderate. Residual values of 3 mmHg were more common using a symmetric model than with a best-fit model. The current method of performing monocular therapeutic trials in glaucoma patients is unreliable, but it may be possible to improve reliability by using several IOP measurements obtained at different times of the day instead of a single office measurement.