J Glaucoma. 2023 Aug 1. doi: 10.1097/IJG.0000000000002280. Online ahead of print.
ABSTRACT
PRECIS: 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 24-hour intraocular pressure pattern in primary angle-closure disease without laser iridotomy.
PURPOSE: To study 24-hour intraocular pressure (IOP) patterns in eyes with chronic primary angle-closure disease (PACD) and evaluate associations between peripheral anterior synechiae (PAS) and 24-hour IOP pattern.
PATIENTS AND METHODS: Prospective cohort study. Fifty-nine eyes of 35 Asian patients with chronic PACD 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.
RESULTS: Even univariable analysis demonstrated a significant difference in peak, mean, and trough IOP and 24-hour IOP fluctuation between the three 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 P=0.006, respectively) and 24-hour IOP fluctuation (P=0.048 and P=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.
CONCLUSIONS: 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.
PMID:37566875 | DOI:10.1097/IJG.0000000000002280
