Huchzermeyer Cord, Reulbach Udo, Horn Folkert, Lämmer Robert, Mardin Christian Y, Jünemann Anselm G M
Department of Ophthalmology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, 91054 Erlangen, Germany.
BMC Ophthalmol. 2014 Oct 15;14:122. doi: 10.1186/1471-2415-14-122.
The diurnal fluctuation of intraocular pressure may be relevant in glaucoma. The aim of this study was to find out whether the timing of diurnal fluctuation is stable over the years.
Long-term IOP data from the Erlangen Glaucoma Registry, consisting of several annual extended diurnal IOP profiles for each patient, was retrospectively analyzed. Normal subjects, patients with ocular hypertension and with pigment dispersion syndrome were included because these subjects had not been treated with antiglaucomatous medications at the time of data acquisition. A cosine curve was fitted to the IOP data and the stability of individual rhythms over the years was tested using the Rayleigh test. To compare the peak times among groups, means were calculated only from subjects with a significant Rayleigh test.
Of the fifty-two eligible subjects, a total of 364 extended diurnal IOP profiles measured in a sitting position had been collected over a period of 114 ± 39 months. The Rayleigh test indicated intraindividual stability of phase timing only in 19 subjects (36%). In subjects with pigment dispersions syndrome, peak IOP occurred on average two hours and seven minutes later during the day compared with subjects without this condition (p = 0.05).
Fitting of cosine curves to the clinical IOP profiles was generally feasible, although careful interpretation is warranted due to lack of measurements in supine position and between midnight and 7 am. The interesting observation of a phase lag in eyes with pigment dispersion syndrome warrants confirmation and exploration in future prospective studies. The analysis of the IOP data showed no stable individual rhythm in the long term in a majority of patients.
眼压的昼夜波动可能与青光眼相关。本研究的目的是查明昼夜波动的时间在多年间是否稳定。
对来自埃尔朗根青光眼登记处的长期眼压数据进行回顾性分析，这些数据包括每位患者每年多次的扩展昼夜眼压曲线。纳入了正常受试者、高眼压症患者和色素性青光眼综合征患者，因为这些受试者在数据采集时未接受抗青光眼药物治疗。将余弦曲线拟合到眼压数据上，并使用瑞利检验来测试个体节律在多年间的稳定性。为比较各组之间的峰值时间，仅从瑞利检验结果显著的受试者中计算平均值。
在52名符合条件的受试者中，在114±39个月的时间里共收集了364条坐位测量的扩展昼夜眼压曲线。瑞利检验表明，只有19名受试者（36%）的相位时间具有个体内稳定性。在患有色素性青光眼综合征的受试者中，与没有这种情况的受试者相比，眼压峰值平均出现在白天晚2小时7分钟（p = 0.05）。
将余弦曲线拟合到临床眼压曲线上总体可行，不过由于缺乏仰卧位以及午夜至上午7点之间的测量值，所以需要谨慎解读。色素性青光眼综合征患者眼中出现相位滞后这一有趣的观察结果有待在未来的前瞻性研究中得到证实和探究。眼压数据分析显示，大多数患者长期内不存在稳定的个体节律。
