Sit Arthur J
Department of Ophthalmology, Mayo Clinic, Rochester, Minn..
Can J Ophthalmol. 2014 Dec;49(6):484-8. doi: 10.1016/j.jcjo.2014.07.008.
Reduction of intraocular pressure (IOP) is the only known effective treatment for glaucoma. However, IOP is a highly variable and dynamic parameter, undergoing virtually constant changes from numerous factors, including body position and circadian rhythms. Despite this variability, evidence for the efficacy of IOP reduction in glaucoma is based on studies designed to assess mean IOP and not IOP variations. Post hoc analysis of data from major clinical trials has suggested that IOP variations may be an independent risk factor for the development of glaucoma or glaucomatous progression, at least in some patients, but the evidence is incomplete and further studies are required. In the interim, judicious selection of existing therapies can help to minimize IOP variations. In general, therapies that improve outflow instead of suppressing aqueous humor production result in more stable IOP. However, new technology to allow better monitoring of IOP, ideally in a continuous 24-hour manner, is required to fully understand the role of IOP variations in glaucoma.
降低眼压（IOP）是目前已知的治疗青光眼的唯一有效方法。然而，眼压是一个高度可变且动态的参数，实际上会因众多因素（包括体位和昼夜节律）而不断变化。尽管存在这种变异性，但降低眼压治疗青光眼疗效的证据是基于旨在评估平均眼压而非眼压波动的研究。对主要临床试验数据的事后分析表明，眼压波动可能是青光眼发生或青光眼病情进展的独立危险因素，至少在部分患者中如此，但证据并不完整，还需要进一步研究。在此期间，明智地选择现有治疗方法有助于尽量减少眼压波动。一般来说，改善房水流出而非抑制房水生成的治疗方法会使眼压更稳定。然而，需要新技术以更好地监测眼压，理想情况下是以连续24小时的方式进行监测，以便充分了解眼压波动在青光眼中的作用。
