正常眼压性青光眼患者眼压的昼夜变化

Diurnal variation in intraocular pressure of normal-tension glaucoma eyes.

作者信息

Yamagami J, Araie M, Aihara M, Yamamoto S

机构信息

Department of Ophthalmology, University of Tokyo School of Medicine, Japan.

出版信息

Ophthalmology. 1993 May;100(5):643-50. doi: 10.1016/s0161-6420(93)31594-0.

DOI:10.1016/s0161-6420(93)31594-0

PMID:8493005

Abstract

BACKGROUND

The nature of intraocular pressure (IOP) in normal-tension glaucoma (NTG) has not been studied in detail, although the information on the IOP is indispensable for diagnosis and treatment of NTG.

METHODS

After at least six IOP measurements at daytime clinic, diurnal IOP was measured at 10:00 AM, 12:00 noon, 2:00, 4:00, 6:00, 8:00, 10:00 PM, 12:00 midnight, and at 3:00, 6:00, 8:00, and 10:00 AM by 1-day hospitalization in 118 NTG suspects. Four subjects with peak IOPs exceeding 21 mmHg were diagnosed as primary open-angle glaucoma (POAG) whose eyes all had mean clinic IOPs above 16 mmHg. The remaining 114 patients were diagnosed as having NTG, and their right eye data were used for analysis.

RESULTS

The rhythmic nature of the diurnal IOP of NTG was analyzed by fitting the data to a cosine curve. In 54.4% of the eyes, the correlation between the measured IOP and the values predicted from the cosine curve was significant (r > 0.60, P < 0.05), and the equation, diurnal IOP = 13.9 + 1.7 cos 2 pi (t/24-0.40) mmHg, which was similar to that reported in normals, was obtained. Multiple regression analysis showed that the mean diurnal IOP was best predicted with the mean of the six clinic IOPs and systolic blood pressure (R2 = 0.67), and the peak diurnal IOP with the mean of six clinic IOPs (R2 = 0.50). The estimate fell within +/- 1 and +/- 2 mmHg of the actual value in 83% and 96% of the left eyes for the former and in 69% and 93% for the latter, respectively. No eyes with peak diurnal IOP exceeding 21 mmHg were overlooked with the cutoff IOP of 16 mmHg.

CONCLUSION

The mean and peak diurnal IOP could be predicted with the mean of clinic IOPs.

摘要

背景

尽管眼压信息对于正常眼压性青光眼（NTG）的诊断和治疗不可或缺，但尚未对其进行详细研究。

方法

在日间门诊至少进行6次眼压测量后，对118例NTG疑似患者进行为期1天的住院治疗，分别于上午10:00、中午12:00、下午2:00、4:00、6:00、8:00、晚上10:00、午夜12:00以及次日上午3:00、6:00、8:00和10:00测量昼夜眼压。4例眼压峰值超过21 mmHg的患者被诊断为原发性开角型青光眼（POAG），其所有患眼的日间门诊平均眼压均高于16 mmHg。其余114例患者被诊断为NTG，以其右眼数据进行分析。

结果

通过将数据拟合到余弦曲线来分析NTG昼夜眼压的节律性。在54.4%的患眼中，测量眼压与根据余弦曲线预测的值之间的相关性显著（r > 0.60，P < 0.05），并得出与正常人报告相似的方程：昼夜眼压 = 13.9 + 1.7 cos 2π（t/24 - 0.40）mmHg。多元回归分析表明，用6次门诊眼压平均值和收缩压能最好地预测平均昼夜眼压（R2 = 0.67），用6次门诊眼压平均值能最好地预测昼夜眼压峰值（R2 = 0.50）。对于前者，在83%的左眼和96%的左眼以及对于后者，在69%和93%的情况下，估计值落在实际值的±1 mmHg和±2 mmHg范围内。没有一只昼夜眼压峰值超过21 mmHg的眼睛被16 mmHg的眼压临界值遗漏。