Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, New York.
Department of Ophthalmology, Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, New York.
Ophthalmology. 2016 Apr;123(4):744-53. doi: 10.1016/j.ophtha.2015.11.020. Epub 2016 Jan 21.
PURPOSE: To test the hypothesis that a 24-hour recording of intraocular pressure (IOP)-related measurements derived from a contact lens sensor (CLS) correlates to the rate of visual field progression in treated glaucomatous eyes. DESIGN: Prospective, cross-sectional study. PARTICIPANTS: Forty treated glaucomatous patients with 8 or more 24-2 visual field tests. METHODS: Twenty-four-hour recording with a CLS that provides IOP-related measurements. MAIN OUTCOME MEASURES: Rates of visual field mean deviation (MD) change before and at the time of CLS recording and CLS parameters, namely number of large peaks, mean peak ratio, wake-to-sleep slope, amplitude and area under the cosine curve, and variability from the mean. RESULTS: When comparing the rate of MD change before and at the time of CLS recording of all patients, the average slope was -0.05 dB/year faster in the beginning compared with the end (P = 0.087), suggesting a deceleration of progression by the time of CLS recording. The number of long peaks and the mean peak ratio when patients were awake were the best predictors of faster progression. The combination of CLS parameters provided better measures of goodness of fit than Goldmann IOP parameters (mean, peak, and fluctuation) in the same period. CONCLUSIONS: Intraocular pressure-related parameters obtained with 24-hour recording with a CLS were associated with the rate of visual field progression in treated glaucomatous eyes. This technology may be useful in detecting eyes at higher risk of glaucoma progression while receiving treatment.
目的:验证假设,即从接触镜传感器(CLS)获得的 24 小时眼压(IOP)相关测量值的记录与治疗青光眼眼中视野进展的速度相关。
设计:前瞻性、横断面研究。
参与者:40 名患有 8 次或更多 24-2 视野测试的治疗性青光眼患者。
方法:使用 CLS 进行 24 小时记录,该传感器可提供与 IOP 相关的测量值。
主要观察指标:在 CLS 记录之前和记录时的视野平均偏差(MD)变化率,以及 CLS 参数,即大峰值数、平均峰值比、清醒到睡眠斜率、幅度和余弦曲线下面积,以及平均值的变异性。
结果:当比较所有患者在 CLS 记录前后 MD 变化率时,与结束时相比,开始时的平均斜率快 0.05 dB/年(P = 0.087),表明进展速度在 CLS 记录时有所减慢。当患者清醒时,长峰值数和平均峰值比是预测进展更快的最佳指标。与同一时期的 Goldmann IOP 参数(平均值、峰值和波动)相比,CLS 参数的组合提供了更好的拟合优度测量。
结论:使用 CLS 进行 24 小时记录获得的与 IOP 相关的参数与治疗性青光眼眼中的视野进展速度相关。这种技术可能有助于在接受治疗时检测到青光眼进展风险较高的眼睛。
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