Diurnal Intraocular Pressure Variability Assessment

原发性开角型青光眼（POAG）是一种以进行性视神经病变为特征的眼部疾病 损伤、视野丧失，在许多情况下还会导致眼压 (IOP) 升高。治疗上 降低 IOP 可防止 POAG 进展，并且是唯一已知的治疗方法 波格。但仅仅降低眼压并不总是足够的，青光眼进展和失明 在接受青光眼降眼压治疗的患者中，这种情况并不少见。众所周知，IOP 随着时间的推移，眼压会发生波动，并且最近发现接受治疗的青光眼眼的眼压出现大幅波动。 尽管平均眼压水平似乎在治疗上足够，但仍与进展相关。因此， IOP 变异性是评估的重要参数。目前的 IOP 变异模型是单日模型 每日眼压变化。我们对每日 IOP 行为的了解基于许多单日 24 小时的数据 （或更少）正常和青光眼眼睛的每日眼压评估。基于这些一日时间 测量时，假设该 IOP 节律在个体的另一只眼睛之间是对称的 并日复一日地保持恒定的节奏。这项提议挑战了这一教条。基于我们的 自己的初步研究和极少数研究表明，昼夜眼压节律的变化 随着时间的推移，我们假设眼压变异性在正常眼压和眼压正常眼中都是随时间推移的混乱事件。 和青光眼的眼睛，并且知道特定日期特定眼睛的昼夜眼压节律 不允许预测任何其他日期的昼夜节律。反驳正则的存在 持续的昼夜眼压节律将迫使范式转向更长期的指数 IOP 变异性。通过收集基线和 1 天、1 周、1 个月的每日 IOP 测量值， 六个月和一年后，我们可以实现我们的具体目标来描述短期（天）， 眼压的中期（数周至数月）和长期（年）日变化 正常眼睛和青光眼眼睛。我们假设重复的眼内测量 正常眼和青光眼眼的压力将显示出昼间眼压的显着变化 随着时间的推移，患者之间、对侧眼睛之间以及患者和眼睛内部的节律。

Primary open-angle glaucoma (POAG) is an ocular disease characterized by progressive optic nerve damage, visual field loss and in many cases, elevation of intraocular pressure (IOP). Therapeutically lowering IOP confers protection against progression of POAG, and is the only known treatment for POAG. But simply lowering IOP is not always enough, and glaucomatous progression and blindness are not uncommon in patients receiving IOP-lowering treatment for glaucoma. IOP is known to fluctuate over time, and large fluctuations of IOP in treated glaucomatous eyes have recently been associated with progression despite mean IOP levels that appear to be therapeutically adequate. Thus, IOP variability is an important parameter to assess. The current model for IOP variability is single-day diurnal IOP variability. Our knowledge of diurnal IOP behavior is based on many single-day 24-hour (or less) diurnal IOP assessments in normal and glaucomatous eyes. Based on these one-day-in-time measurements, it is assumed that this IOP rhythm is symmetric between fellow eyes of individuals and remains a constant rhythm from day to day. This proposal challenges that dogma. Based upon our own preliminary studies and a very few studies which suggest that diurnal IOP rhythms change in patients over time, we hypothesize that IOP variabilityis a chaotic event over time in both normal and glaucomatous eyes, and that knowing the diurnal IOP rhythm of a given eye on a given day does not permit prediction of the diurnal rhythm on any other day. Disproving the existence of a regular and sustained diurnal IOP rhythm would force a paradigm shift toward more long-term indices of IOP variability. By collecting diurnal IOP measurements at baseline and 1 day, 1week, 1 month, six months, and one year later, we can achieve our specific aims to characterize the short- (days), intermediate- (weeks to months), and long-term (year) diurnal variability of intraocular pressure in normal and glaucomatous eyes. We hypothesize that repeated diumal measurements of intraocular pressure in normal and glaucomatous eyes will demonstrate significant variability in the diurnal IOP rhythms between patients, between fellow eyes, and within patients and eyes over time.