Sit Arthur J, Asrani Sanjay
Department of Ophthalmology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Surv Ophthalmol. 2008 Nov;53 Suppl1:S45-55. doi: 10.1016/j.survophthal.2008.08.009.
Intraocular pressure (IOP) varies dynamically throughout the circadian cycle. IOP elevations during the nocturnal period may be particularly important in the pathogenesis of glaucoma, although sleeping IOP cannot be measured at this time. Additionally, IOP fluctuations may be an independent risk factor for glaucoma. However, not all glaucoma therapies are equally effective at lowering IOP throughout the 24-hour period. The prostaglandin analogs have excellent IOP control throughout the 24-hour period, although less at night than during the day. In contrast, some other classes of medications, such as the beta-blockers, have little or no IOP-lowering effect at night. The prostaglandin analogs also have excellent persistency of IOP lowering, lasting at least as long as the 24-hour dosing period, and likely much longer. Glaucoma filtering surgery appears to have even better 24-hour IOP reduction and smaller fluctuations than maximal medical therapy including prostaglandin analogs.
眼压（IOP）在整个昼夜周期中呈动态变化。夜间眼压升高在青光眼的发病机制中可能尤为重要，尽管此时无法测量睡眠期间的眼压。此外，眼压波动可能是青光眼的一个独立危险因素。然而，并非所有青光眼治疗方法在24小时内降低眼压的效果都相同。前列腺素类似物在24小时内对眼压有很好的控制效果，尽管夜间的效果不如白天。相比之下，其他一些药物类别，如β受体阻滞剂，在夜间几乎没有或根本没有降低眼压的作用。前列腺素类似物降低眼压的持续性也很好，至少能持续24小时的给药周期，而且可能更长。与包括前列腺素类似物在内的最大程度药物治疗相比，青光眼滤过手术似乎能在24小时内更好地降低眼压，且眼压波动更小。
