Diurnal Intraocular Pressure Variability Assessment

摘要原发性开角型青光眼是一种以进行性视神经为特征的眼科疾病。 损害，视野丧失，在许多情况下，眼压升高。从治疗上讲 降低眼压可以防止POAG的进展，是唯一已知的治疗方法 普阿格。但仅仅降低眼压是不够的，而且青光眼的进展和失明 在接受青光眼降眼压治疗的患者中并不少见。眼压是已知的 随着时间的推移而波动，接受青光眼治疗的眼睛的眼压波动很大 与病情进展有关，尽管平均眼压水平似乎在治疗上是足够的。因此， 眼压变异性是评估眼压变化的重要参数。眼压变化的当前模型是单日变化 眼压昼夜变异性。我们对昼夜眼压行为的了解是基于许多单日24小时 (或更少)正常和青光眼患者的昼夜眼压评估。基于这些时间上的一天 测量时，假设这种眼压节律在个体的双眼之间是对称的 日复一日地保持着恒定的节奏。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，昼夜眼压节律在 患者随着时间的推移，我们假设眼压变异性是随着时间的推移而发生的混沌事件，在这两种情况下 和青光眼，知道一只眼睛在特定一天的昼夜眼压节律 不允许预测其他任何一天的昼夜节律。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 眼压变异性。通过收集基线和1天、1周、1个月、 六个月，一年后，我们可以实现我们的特定目标，来表征短-(天)， 眼压的中年(周至月)和长期(年)日变化 正常和青光眼。我们假设重复测量眼内的直径 正常和青光眼患者的眼压在昼夜眼压上表现出显著的变化。 随着时间的推移，患者之间、双眼之间以及患者和眼睛内部的节奏。

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.