Sit Arthur J, Liu John H K, Weinreb Robert N
Hamilton Glaucoma Center and Department of Ophthalmology, University of California San Diego, La Jolla, California 92093-0946, USA.
Ophthalmology. 2006 Mar;113(3):425-30. doi: 10.1016/j.ophtha.2005.10.003. Epub 2006 Jan 10.
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.
Experimental study with human patients.
Forty-one subjects (40-78 years old) with untreated OAG.
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 (R2). Validity of the monocular therapeutic trial was assessed by examining residual values from 2 linear regression models of right versus left IOP.
Strength of association between IOPs of right and left eyes, and residual values from linear models of IOP.
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 > or =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.
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 > or =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.
评估未经治疗的开角型青光眼（OAG）患者左右眼24小时眼压（IOP）的不对称性及其对单眼治疗试验的影响。
针对人类患者的实验研究。
41名未经治疗的OAG患者（年龄40 - 78岁）。
受试者在睡眠实验室中停留24小时。从上午7点至晚上11点，每2小时用气动眼压计测量患者坐位和仰卧位时双眼的眼压，从晚上11点至上午7点仅测量仰卧位时的眼压。比较右眼和左眼的平均、峰值和谷值眼压。使用决定系数（R2）评估左右眼眼压之间的关联强度。通过检查右眼与左眼眼压的两个线性回归模型的残差值来评估单眼治疗试验的有效性。
左右眼眼压之间的关联强度以及眼压线性模型的残差值。
在24小时内，右眼和左眼的平均、峰值或谷值眼压之间未发现统计学上的显著差异。平均眼压的关联强度仅为中等（R(2) = 0.421 - 0.623）。对于对称线性回归模型，在24小时内眼压测量值中有14.0%±12.0%（平均值±标准差）的残差值≥3 mmHg，对于最佳拟合线性回归模型，该比例为8.5%±10.6%。
在这组未经治疗的青光眼患者中，左右眼平均眼压之间的关联强度仅为中等。使用对称模型时，残差值≥3 mmHg比使用最佳拟合模型更为常见。目前在青光眼患者中进行单眼治疗试验的方法不可靠，但通过使用一天中不同时间获得的多个眼压测量值而非单次门诊测量值，可能提高可靠性。
