24-Hour Intra::ular Pressure Rhythm in Young Healthy Subjects Evaluated With Continuous Monitoring Using a Contact Lens Suisor
24-Hour Intra::ular Pressure Rhythm in Young Healthy Subjects Evaluated With Continuous Monitoring Using a Contact Lens Suisor
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DOI：
10.1001/jamaophthalmol.2013.5297
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发表时间：
2013-12-01
影响因子：
8.1
通讯作者：
Chiquet, Christophe
中科院分区：
文献类型：
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作者：
Mottet, Benjamin;Aptel, Florent;Chiquet, Christophe
重要性：本研究评估了一种24小时内持续监测眼压（10P）的新装置。目的：评价非接触式血压计（NCT）和隐形眼镜传感器（CLS）在健康受试者连续24小时10P监测过程中24小时10P节律的可重复性。设计、环境和参与对象：在时间生物学转诊中心对12名年轻健康志愿者进行横断面研究。干预措施参与者被安置在睡眠实验室，在6个月的时间里接受了4次24小时的lop测量。在初始随机归因后，使用CLS连续监测第一只眼睛的lOP，使用NCT每小时测量另一只眼睛的lOP。两组患者分别进行了1只眼的NCT测量和另一只眼的CLS测量，1组患者仅进行了1只眼的CLS测量，1组患者进行了双眼的NCT测量。采用非线性最小二乘、双谐波回归分析对24小时10P节律进行建模。比较3种血压计方法的端相、深相、幅度、节律中线估计统计量、10P值、10P变化及一致性。结果36个疗程中有31个疗程（86%）使用NCT，而所有疗程（100%）使用CLS，均发现明显的夜间10P节律。NCTIOP测量期间的每小时觉醒并未显著改变对侧眼使用CLS评估的24小时10P模式的平均相位。在整个疗程中，CLS初相（0.6 [95% CI, 0.0 ~ 0.9], P = 0.03）、CLS深相（0.7 [95% CI, 0.1 ~ 0.9], P = 0.01）、NCT振幅（0.7 [95% CI, 0.1 ~ 0.9], P = 0.01）和NCT中线节律估计统计量（0.9 [95% CI, 0.9 ~ 1.0], P < 0.01）的类内相关系数均具有统计学意义。当进行眼内NCT测量和对侧眼CLS测量时，从第一次测量（上午9点）开始，每个点的lOP变化在个体或群体中不是对称的。结论和相关性CLS是一种准确且可重复的表征健康参与者昼夜节律的方法，但不允许估计与所测电信号相对变化相对应的以毫米汞柱为单位的lOP值。
IMPORTANCE This study evaluates a new device that has been proposed to continuously monitor intraocular pressure (10P) over 24 hours.OBJECT IVE To evaluate 24-hour 10P rhythm reproducibility during repeated continuous 24-hour 10P monitoring with noncontact tonometry (NCT) and a contact lens sensor (CLS) in healthy participants.DESIGN, SETTING, AND PARTICIPA41s Cross-sectional study of 12 young healthy volunteers at a referral center of chronobiology.INTERVENTIONS Participants were housed in a sleep laboratory and underwent four 24-hour sessions oflOP measurements over a 6-month period. After initial randomized attribution, the lOP of the first eye was continuously monitored using a CLS and the lOP of the fellow eye was measured hourly using NCT. Two sessions with NCT measurements in 1 eye and CLS measurements in the fellow eye, 1session with CLS measurements in only 1 eye, and 1 session with NCT measurements in both eyes were performed.MAIN OUTCOMES AND MEASURES A nonlinear least squares, dual-harmonic regression analysis was used to model the 24-hour 10P rhythm. Comparison of acrophase, bathyphase, amplitude, midline estimating statistic of rhythm, 10P values, 10P changes, and agreement were evaluated in the 3 tonometry methods.RESULTS A significant nyctohemeral 10P rhythm was found in 31 of 36 sessions (86%) using NCT and in all sessions (100%) using CLS. Hourly awakening during NCTIOP measurements did not significantly change the mean phases of the 24-hour 10P pattern evaluated using CLS in the contralateral eye. Throughout the sessions, intraclass correlation coefficients of the CLS acrophase (0.6 [95% CI, 0.0 to 0.9]; P = .03), CLS bathyphase (0.7 [95% CI, 0.1 to 0.9]; P = .01), NCT amplitude (0.7 [95% CI, 0.1 to 0.9]; P = .01), and NCT midline estimating statistic of rhythm (0.9 [95% CI, 0.9 to 1.0]; P < .01) were significant. When performing NCT measurements in leye and CLS measurements in the contralateral eye, the lOP change at each point normalized from the first measurement (9 Am) was not symmetric individually or within the population.CONCLUSIONS AND RELEVANCE The CLS is an accurate and reproducible method to characterize the nyctohemeral 10P rhythm in healthy participants but does not allow for estimating the lOP value in millimeters of mercury corresponding to the relative variation of the electrical signal measured.