Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok.
Department of Surgery and Clinical Epidemiology, Clinical Statistic Center, Faculty of Medicine.
J Glaucoma. 2023 Oct 1;32(10):854-859. doi: 10.1097/IJG.0000000000002280. Epub 2023 Aug 1.
Primary angle closure and primary angle closure glaucoma may exhibit normal intraocular pressure. Twenty-four-hour intraocular pressure fluctuation is highest in primary angle closure glaucoma. The degree of peripheral anterior synechiae was associated with a 24-hour intraocular pressure pattern in primary angle-closure disease without laser iridotomy.
The purpose of this study was to study 24-hour intraocular pressure (IOP) patterns in eyes with chronic primary angle-closure disease and evaluate associations between peripheral anterior synechiae (PAS) and 24-hour IOP pattern.
In this prospective cohort study, 59 eyes of 35 Asian patients with chronic primary angle-closure disease underwent complete ocular examinations at Ramathibodi Hospital, Mahidol University. Twenty-four-hour IOP records were obtained using Goldmann applanation tonometry at 2-hour intervals. Peak, mean, and trough 24-hour IOP values and 24-hour IOP fluctuation (difference between peak and trough values) were compared among groups. None of the participants received any treatment before complete data collection.
Even univariable analysis demonstrated a significant difference in peak, mean, and trough IOP and 24-hour IOP fluctuation between the 3 groups; the magnitude of trough IOP was not higher than 21 mmHg in all groups. In multivariable analysis, PAC and PACG eyes showed significantly higher peak IOP ( P =0.020 and 0.006, respectively) and 24-hour IOP fluctuation ( P =0.048 and 0.001, respectively) compared with PACS eyes. In comparison between combined PACS and PAC eyes versus PACG eyes, PACG eyes revealed significantly higher 24-hour IOP fluctuation. The degree of PAS was associated with peak and mean IOP values and with 24-hour IOP fluctuation in PAC and PACG eyes.
Twenty-four-hour IOP fluctuation was highest in PACG eyes. Although PAC and PACG eyes showed higher peak IOP and 24-hour IOP fluctuation values, compared with PACS eyes, trough IOP in PAC and PACG eyes were mostly below 21 mmHg. In addition, the degree of PAS was associated with a 24-hour IOP pattern in either PAC or PACG eyes.
原发性闭角型青光眼和原发性闭角型青光眼可能表现为正常眼压。原发性闭角型青光眼的 24 小时眼压波动最高。在未经激光虹膜切开术治疗的原发性闭角型疾病中，周边前粘连的程度与 24 小时眼压模式相关。
本研究旨在研究慢性原发性闭角型青光眼患者的 24 小时眼压（IOP）模式，并评估周边前粘连（PAS）与 24 小时 IOP 模式之间的关系。
在这项前瞻性队列研究中，对 35 名亚洲慢性原发性闭角型青光眼患者的 59 只眼在玛希隆大学 Ramathibodi 医院进行了全面的眼部检查。使用 Goldmann 压平眼压计每两小时记录 24 小时眼压。比较三组之间的 24 小时眼压高峰值、平均值和谷值以及 24 小时眼压波动（峰值和谷值之间的差异）。在完整数据收集之前，所有参与者均未接受任何治疗。
即使进行单变量分析，三组之间的眼压高峰值、平均值和谷值以及 24 小时眼压波动也存在显著差异；所有组的眼压谷值均未高于 21mmHg。多变量分析显示，PAC 和 PACG 眼的眼压高峰值（P=0.020 和 0.006）和 24 小时眼压波动（P=0.048 和 0.001）显著高于 PACS 眼。与 PAC 眼相比，PACS 和 PAC 眼的组合眼与 PACG 眼相比，PACG 眼的 24 小时眼压波动显著更高。PAC 和 PACG 眼中的 PAS 程度与眼压高峰值和平均值以及 24 小时眼压波动相关。
PACG 眼中的 24 小时眼压波动最高。尽管 PAC 和 PACG 眼的眼压高峰值和 24 小时眼压波动值高于 PACS 眼，但 PAC 和 PACG 眼的眼压谷值大多低于 21mmHg。此外，PAS 的程度与 PAC 或 PACG 眼中的 24 小时眼压模式相关。
