Glaucoma Research Center, Montchoisi Clinic, Swiss Visio Network, Lausanne, Switzerland.
Department of Ophthalmology, University of Colorado School of Medicine, Denver, CO.
J Glaucoma. 2020 Aug;29(8):666-670. doi: 10.1097/IJG.0000000000001563.
Scarce data are available on the symmetry of 24-hour intraocular pressure (IOP) variations between fellow eyes of glaucoma patients, and such evidence could have profound consequences on the interpretation of monocular therapeutic trials. The objective is to evaluate the intereye correlation of continuously measured circadian IOP-related patterns in untreated glaucoma patients.
In this single-center prospective study, a total of 29 untreated patients with open-angle glaucoma underwent bilateral ambulatory 24-hour monitoring of IOP-related patterns using a contact lens sensor (CLS; SENSIMED Triggerfish). IOP was measured before and after CLS monitoring using Goldmann applanation tonometry. Intereye agreement of 24-hour patterns was calculated using Spearman correlation (r) of raw data and after cosinor rhythmometry modeling.
Complete bilateral CLS data could be obtained in 20 patients (mean age: 55.5±15.7 y; 51.7% women). On average, intereye correlation was r=0.76±0.19 (range: 0.16 to 0.95) and r=0.77±0.15 (range: 0.49 to 0.91), after excluding 8 patients with lower quality recordings. Cosine rhythmometry modeling showed mean acrophases occurring at 4:21±2:20 AM in left eyes and 3:39±1:50 AM in right eyes (r=0.48; P=0.034). Mean acrophase amplitude was 110.9±51.9 for left eyes and 107.8±46.2 for right eyes (r=0.79; P<0.001). No serious adverse events related to CLS monitoring were recorded. Transient conjunctival hyperemia (13 patients) and blurred vision (11 patients) were the most frequent adverse events.
In this group of untreated glaucoma patients, there was good intereye agreement for circadian IOP-related patterns using the CLS. These results show a higher degree of intereye symmetry, in terms of IOP peak timings and amplitudes, than previously reported with standard tonometry.
关于青光眼患者对侧眼 24 小时眼压（IOP）变化的对称性，相关数据十分匮乏，而此类证据可能会对单眼治疗试验的解读产生深远影响。本研究旨在评估未经治疗的青光眼患者连续测量的昼夜节律性IOP 相关模式的眼间相关性。
在这项单中心前瞻性研究中，共有 29 名未经治疗的开角型青光眼患者使用接触镜传感器（CLS；SENSIMED Triggerfish）进行双侧 24 小时眼压相关模式的动态监测。在 CLS 监测前后使用 Goldmann 压平眼压计测量 IOP。使用 Spearman 相关系数（r）对原始数据和余弦节律测量模型后的 24 小时模式进行眼间一致性计算。
20 名患者（平均年龄：55.5±15.7 岁；51.7%为女性）获得了完整的双侧 CLS 数据。平均而言，眼间相关性 r 值为 0.76±0.19（范围：0.16 至 0.95）和 r 值为 0.77±0.15（范围：0.49 至 0.91），排除 8 名记录质量较低的患者后。余弦节律测量模型显示左眼的平均高峰时间为 4:21±2:20 AM，右眼为 3:39±1:50 AM（r=0.48；P=0.034）。左眼的平均高峰时间振幅为 110.9±51.9，右眼为 107.8±46.2（r=0.79；P<0.001）。未记录到与 CLS 监测相关的严重不良事件。最常见的不良事件为短暂性结膜充血（13 例）和视力模糊（11 例）。
在本研究组未经治疗的青光眼患者中，使用 CLS 测量昼夜节律性 IOP 相关模式的眼间一致性良好。这些结果表明，在 IOP 峰值时间和幅度方面，眼间对称性高于之前使用标准眼压计的报道。
