Department of Ophthalmology, Queens Medical Centre, Nottingham NG7 2UH, UK.
Br J Ophthalmol. 2010 Aug;94(8):999-1002. doi: 10.1136/bjo.2009.160267. Epub 2009 Dec 3.
To determine the value of daytime and 24-h phasing in patients treated for progressive glaucoma despite apparently adequate intraocular pressure (IOP) control.
A retrospective analysis of a cohort of patients that had undergone either daytime phasing (08:00-18:00) or 24-h phasing was conducted. IOP measurements were compared between those taken in clinic, daytime phasing and 24-h phasing. The frequency with which phasing results changed clinical management was also compared between daytime and 24-h phasing.
76 patients fulfilling the study criteria were identified. Clinic and daytime phasing IOP were known for all 76 patients, nighttime IOP measurements were known for 41. There was no significant difference between mean IOP values measured in clinic and daytime phasing (p=0.062) or between clinic values and nighttime phasing (p=0.65). The mean daytime phasing IOP was significantly higher than the mean nighttime phasing IOP (p=0.038) (analysis of variance (ANOVA) for three groups, p=0.058). There was no significant difference between the mean peak IOP in clinic or daytime phasing (p=0.13) or between clinic and nighttime phasing (p=0.44). The mean daytime phasing IOP peak was significantly higher than the mean nighttime phasing IOP peak (p=0.015) (ANOVA for three groups, p=0.074). There was no significant difference in the frequency of a change in management that occurred as a result of phasing between the daytime and 24-h groups (p=0.65).
24-H phasing offers little advantage over daytime phasing in the identification of IOP fluctuations or peaks in patients progressing despite acceptable clinic IOP readings. Daytime phasing is likely to be more cost-effective than 24-h phasing.
确定在尽管眼内压（IOP）控制明显，但仍进展性青光眼患者中进行日间和 24 小时时相分析的价值。
对接受日间时相（08：00-18：00）或 24 小时时相分析的患者队列进行回顾性分析。比较日间和 24 小时时相分析之间在诊室、日间时相和 24 小时时相分析时测量的 IOP。还比较了日间和 24 小时时相分析之间改变临床管理的时相分析结果的频率。
确定了 76 名符合研究标准的患者。所有 76 名患者均已知诊所和日间时相分析的 IOP，41 名患者已知夜间 IOP 测量值。诊室和日间时相分析测量的平均 IOP 值之间无显著差异（p=0.062），或者诊所值与夜间时相分析之间无显著差异（p=0.65）。日间时相分析的平均日间 IOP 明显高于夜间时相分析的平均 IOP（p=0.038）（三组的方差分析（ANOVA），p=0.058）。在诊室或日间时相分析的平均峰值 IOP 之间或在诊室和夜间时相分析之间无显著差异（p=0.13）或（p=0.44）。日间时相分析的平均日间 IOP 峰值明显高于夜间时相分析的平均峰值（p=0.015）（三组的 ANOVA，p=0.074）。日间和 24 小时组之间由于时相分析而导致管理变化的频率无显著差异（p=0.65）。
在识别尽管可接受的诊所 IOP 读数仍进展的患者的 IOP 波动或峰值方面，24 小时时相分析比日间时相分析几乎没有优势。日间时相分析可能比 24 小时时相分析更具成本效益。
