Koutsonas A, Walter P, Plange N
Klinik für Augenheilkunde, Uniklinik RWTH Aachen.
Klin Monbl Augenheilkd. 2016 Jun;233(6):743-8. doi: 10.1055/s-0041-106191. Epub 2015 Nov 26.
Accurate acquisition of intraocular pressure (IOP) data, particularly short-term and long-term fluctuations, plays an important role in the medical care of glaucoma patients. Non-invasive self-tonometry with a telemetric IOP sensor can provide important data on the individual IOP profile.
Within the framework of a prospective, single-centre pilot clinical trial, a ring-shaped telemetric IOP sensor was inserted into the ciliary sulcus after implantation of the intracapsular lens during planned cataract surgery. In accordance with the protocol, at the 5-month visit, all patients received a reading unit for one-month self-tonometry assessment. All patients were asked to measure the IOP at least once daily, and, if possible, at many different times. The first IOP measurement of each day was evaluated (covering one measurement daily per patient on 20 different days within the assessment interval). Furthermore, IOP data were analysed according to the time of day, divided into early phase (5 am to 11 am), midday (11 am to 4 pm) and late phase (4 am to 11 pm) (patients with at least 10 measurements and max. 20 measurements were included). Descriptive statistics of the original ARGOS system values were calculated, with evaluation of the percentiles and presentation in box plots.
All patients successfully performed self-tonometry at home after receiving brief instructions. The first IOP measurement of each day covered a very wide interindividual range (between 3.1 mmHg in patient 5 and 21.7 mmHg in patient 4). Analysis of IOP values by time of day showed that patient 1 had significantly higher IOP values in the late day phase. For patient 5, the highest values were at midday. Patients 3 and 4 showed no significant fluctuations during the day.
Self-tonometry encourages patients to be actively involved in the management of their own illness and allows non-invasive assessment of IOP at different times and during diverse activities. However, the analysis and interpretation of these new data require further study, especially in relation to Goldmann applanation tonometry.
准确获取眼压(IOP)数据,尤其是短期和长期波动数据,在青光眼患者的医疗护理中起着重要作用。使用遥测眼压传感器进行非侵入性自我眼压测量可为个体眼压情况提供重要数据。
在一项前瞻性、单中心试点临床试验框架内,在计划的白内障手术中植入囊内晶状体后,将环形遥测眼压传感器插入睫状沟。按照方案,在5个月随访时,所有患者均获得一个用于为期1个月自我眼压测量评估的读数装置。要求所有患者每天至少测量一次眼压,如有可能,在多个不同时间测量。对每天的首次眼压测量值进行评估(在评估期内,每位患者在20个不同日期每天进行一次测量)。此外,根据一天中的时间对眼压数据进行分析,分为早期(上午5点至11点)、中午(上午11点至下午4点)和晚期(下午4点至晚上11点)(纳入至少10次测量且最多20次测量的患者)。计算原始ARGOS系统值的描述性统计数据,评估百分位数并以箱线图形式呈现。
所有患者在接受简短指导后均成功在家中进行了自我眼压测量。每天的首次眼压测量值个体间范围非常广泛(患者5为3.1 mmHg,患者4为21.7 mmHg)。按一天中的时间分析眼压值显示,患者1在晚期眼压值显著更高。对于患者5,最高值出现在中午。患者3和4在白天未显示出明显波动。
自我眼压测量鼓励患者积极参与自身疾病管理,并允许在不同时间和各种活动期间进行非侵入性眼压评估。然而,对这些新数据的分析和解释需要进一步研究,尤其是与Goldmann压平眼压测量法相关的研究。