Records of 93 consecutive glaucoma patients (185 eyes) who underwent sequential office intraocular pressure (IOP) measurements (every hour from 7 a.m. to 5 p.m. on a single day) were evaluated to determine the usefulness of day-long sequential office measurements of IOP to make therapeutic decisions in patients with progressive glaucomatous damage despite apparently "controlled" IOP. This included 53 patients with normal-tension glaucoma, 12 glaucoma suspects and 28 patients with primary open-angle glaucoma whose visual field deteriorated despite apparently "controlled" IOP. Only one eye per patient was included in the study.
The pattern of the day-long IOP curve was similar in the three groups. IOPs were highest in the early morning hours in all groups. The mean +/- standard deviation of the IOP range was 5 +/- 2 mmHg. An IOP greater than 21 mmHg was found in three eyes (3 percent), whereas a range of IOPs greater than 5 mmHg was detected in 33 eyes (35 percent). In the normal-tension glaucoma group, there was a significant correlation between visual field deterioration and the peak and range of IOP.
Day-long sequential office IOP measurements are useful in selected patients who demonstrate progressive glaucomatous damage. Early-morning measurements are most frequently highest. The range of IOP may be as important, or more important than, the peak IOP level.
SOURCE: Collaer N, Zeyen T, Caprioli J. Sequential office pressure measurements in the management of glaucoma. J Glaucoma 2005;14(3):196-200.
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