Barkana Yaniv, Anis Sarah, Liebmann Jeffrey, Tello Celso, Ritch Robert
Department of Ophthalmology, The New York Eye and Ear Infirmary, New York 10003, USA.
Arch Ophthalmol. 2006 Jun;124(6):793-7. doi: 10.1001/archopht.124.6.793.
To determine whether intraocular pressure (IOP) monitoring outside of normal office hours adds clinically useful information.
We reviewed the records of all patients with glaucoma who were admitted for 24-hour IOP monitoring during 3 years. Applanation IOP was recorded in the sitting position from 7 am until midnight and in the supine position at 6 am.
Thirty-two patients (22 women and 10 men) were enrolled (mean +/- SD age, 67.3 +/- 12.1 years). Mean +/- SD 24-hour IOP was 13.0 +/- 2.2 mm Hg. Mean +/- SD peak 24-hour IOP (16.8 +/- 3.2 mm Hg) was significantly higher than peak office IOP (14.7 +/- 3.2 mm Hg) (P<.001). Peak IOP was recorded outside of office hours in at least 1 eye in 22 patients (69%). Mean IOP fluctuation during 24-hour monitoring (6.9 +/- 2.9 mm Hg) was significantly greater than that during office hours (3.8 +/- 2.3 mm Hg) (P<.001). Peak 24-hour IOP was higher than the peak IOP noted during previous office visits in 40 eyes (62%). Results of 24-hour IOP monitoring led to immediate treatment change in 23 eyes (36%).
In glaucoma patients with advanced disease or progression that are disproportionate to known IOP measurements, 24-hour monitoring of IOP may reveal a greater role for pressure-related risk for glaucoma progression than previously suspected and may alter treatment strategies.
确定非正常办公时间的眼压（IOP）监测是否能提供临床有用信息。
我们回顾了3年内所有因进行24小时眼压监测而入院的青光眼患者的记录。在坐位从上午7点至午夜记录压平眼压，在仰卧位于上午6点记录压平眼压。
纳入32例患者（22例女性和10例男性）（平均±标准差年龄，67.3±12.1岁）。24小时平均±标准差眼压为13.0±2.2 mmHg。24小时眼压峰值平均±标准差（16.8±3.2 mmHg）显著高于门诊眼压峰值（14.7±3.2 mmHg）（P<0.001）。22例患者（69%）至少有一只眼的眼压峰值记录于非办公时间。24小时监测期间的平均眼压波动（6.9±2.9 mmHg）显著大于办公时间的波动（3.8±2.3 mmHg）（P<0.001）。40只眼（62%）的24小时眼压峰值高于之前门诊就诊时记录的眼压峰值。24小时眼压监测结果导致23只眼（36%）立即改变治疗方案。
对于患有晚期疾病或病情进展与已知眼压测量值不成比例的青光眼患者，24小时眼压监测可能显示眼压相关风险在青光眼进展中所起的作用比之前怀疑的更大，并可能改变治疗策略。
