Detecting IOP Fluctuations in Glaucoma Patients



Brenda Nuyen1, Kaweh Mansouri*, 2, 3
1 Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA
2 Glaucoma Center, Montchoisi Clinic, Genolier Swiss Vision Network, Lausanne, Switzerland
3 Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, USA


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© Nuyen and Mansouri; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Glaucoma Center, Montchoisi Clinic, Genolier Swiss Vision Network, Chemin des Allinges 16, Chemin des Allinges 16, CH-1006 Lausanne, Switzerland; Tel: +41 21 619 37 42; Fax: +41 21 619 36 28, +41 21 619 37 42, 41 21 619 36 28; E-mail: kawehm@yahoo.com


Abstract

Lowering intraocular pressure (IOP) remains the guiding principle of glaucoma management. Although IOP is the only treatable risk factor, its 24-hour behavior is poorly understood. Current glaucoma management usually relies on single IOP measurements during clinic hours, even though IOP is a dynamic parameter with rhythms dependent on individual patients. It has further been shown that most glaucoma patients have their highest IOP measurements outside clinic hours. The fact that these IOP peaks go largely undetected may explain why certain patients progress in their disease despite treatment. Nevertheless, single IOP measurements have determined all major clinical guidelines regarding glaucoma treatment. Other potentially informative parameters, such as fluctuations in IOP and peak IOP, have been neglected, and effects of IOP-lowering interventions on such measures are largely unknown. Continuous 24-hour IOP monitoring has been an interest for more than 50 years, but only recent technological advances have provided clinicians with a device for such an endeavor. This review discusses current uses and shortcomings of current measurement techniques, and provides an overview on current and future methods for 24-hour IOP assessment. It may be possible to incorporate continuous IOP monitoring into clinical practice, potentially to reduce glaucoma-related vision loss.

Keywords: 24-h IOP monitoring, fluctuations, intraocular pressure, laucoma.