Circadian intraocular pressure patterns in healthy subjects, primary open angle and normal tension glaucoma patients with a contact lens sensor
Circadian intraocular pressure patterns in healthy subjects, primary open angle and normal tension glaucoma patients with a contact lens sensor
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健康受试者、原发性开角型青光眼和正常张力型青光眼患者的昼夜眼压模式与隐形眼镜传感器
DOI：
10.1111/aos.12408
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发表时间：
2015-02-01
影响因子：
3.4
通讯作者：
Mastropasqua, Leonardo
中科院分区：
文献类型：
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作者：
Agnifili, Luca;Mastropasqua, Rodolfo;Mastropasqua, Leonardo
目的：使用隐形眼镜传感器（CLS; Sensimed Triggerfish，瑞士洛桑）检测原发性开角型和正常张力型青光眼（POAG； NTG）健康受试者的昼夜眼内压（IOP）模式。方法：这是一项观察性、非随机研究。纳入健康受试者10例（1组，10只眼）和青光眼患者20例[20只眼，POAG 10例（2组），NTG 10例（3组）]。所有患者均用前列腺素类似物进行控制。24小时IOP模式是主要结果。早晨（6AM-11AM）、下午/晚上（中午- 11pm）和夜间（午夜- 5am）亚周期模式、高峰和延长的高峰（bb0 -1小时）是次要结果。结果：各组平均24小时IOP模式均为夜间顶相。各组间差异有统计学意义（p = 0.02）， POAG组夜间IOP值最高。青光眼患者（70%）比健康人（33.3%）更常出现延长的峰值（p < 0.001）。第2组和第3组在上午与下午/晚上比较（p = 0.019和p = 0.035， Bonferroni校正）、上午与夜间比较（p = 0.005和p < 0.0001）和下午/傍晚与夜间比较（两组均p < 0.0001）均有显著差异。在第1组中，早晨与夜间、下午/傍晚与夜间的模式差异显著（p < 0.0001）。结论：用CLS连续24小时IOP监测显示健康受试者存在夜间顶相，青光眼患者更明显。由于昼夜IOP特征似乎不能预测夜间节律，因此应在临床实践中评估昼夜IOP模式。这些发现可能对青光眼的治疗有价值。
Purpose: To examine the circadian intraocular pressure (IOP) patterns in healthy subjects, in primary open angle and normal tension glaucoma (POAG; NTG) using a contact lens sensor (CLS; Sensimed Triggerfish, Lausanne, Switzerland).Methods: This was an observational, nonrandomized study. Ten healthy subjects (Group 1, 10 eyes) and 20 glaucomatous patients [20 eyes, 10 with POAG (Group 2) and 10 with NTG (Group 3)] were enrolled. All patients were controlled with prostaglandin analogues. The 24-hr IOP pattern was the main outcome. The morning (6AM-11AM), afternoon/evening (noon-11PM) and night (midnight-5AM) subperiod patterns, peaks and prolonged peaks (>1 hr) were secondary outcomes.Results: Mean 24-hr IOP pattern showed a nocturnal acrophase in all groups. Patterns were significantly different among groups (p = 0.02), with highest nocturnal IOP values in POAG. Prolonged peaks were more common in patients with glaucoma (70%) than in healthy subjects (33.3%) (p < 0.001). Significant differences were found for Groups 2 and 3 in the morning versus afternoon/evening (p = 0.019 and p = 0.035, Bonferroni correction), morning versus night (p = 0.005 and p < 0.0001) and afternoon/evening versus night periods comparisons (p < 0.0001 for both groups). In Group 1, patterns significantly differed in the morning versus night and afternoon/evening versus night period comparisons (p < 0.0001).Conclusions: Continuous 24-hr IOP monitoring with the CLS revealed a nocturnal acrophase in healthy subjects and, more markedly, in glaucoma. Because the diurnal IOP profile seems not to predict the nocturnal rhythm, the circadian IOP pattern should be evaluated in clinical practice. These findings may be worthwhile for the management of glaucoma.