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    Continuous IOP monitoring: Tools for addressing an unmet need

    Take-home: Devices for continuous IOP monitoring will address the need to better understand IOP levels and patterns in patients with glaucoma.

    Kaweh Mansouri, MDDenver, CO—The opportunity for practical and reliable 24-hour IOP measurements is one of the major unmet needs in glaucoma management. According to Kaweh Mansouri, MD, considerable progress has been made in recent years, and he is optimistic that the future will bring even better technology.

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    Describing his “wish list” for a 24 hour IOP monitoring device, Dr. Mansouri said,” It should be inexpensive, safe, accurate, and obtain measurements with a high frequency (>40 Hz) so that ultrashort events can be detected. The jackpot, however, would be a device that could store and release IOP-lowering drugs on demand.”
    “My prediction is that the next generation of ophthalmologists will see such a device, and they will take its use for granted similar to how we now do with OCT and intravitreal injections.”

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    The benefit of having a 24-hour IOP monitoring device lies in the fact that in-office measurements provide a mere snapshot of IOP.

    “In a patient seen 3 to 4 times a year, we obtain about 12 seconds worth of IOP data. Realizing there are more than 31 million seconds in a year, we are not even looking at the tip of the iceberg when it comes to measuring IOP,” said Dr. Mansouri, consultant ophthalmologist, Glaucoma Center, Montchoisi Clinic, Lausanne, Switzerland, and adjoint associate professor of ophthalmology, University of Colorado, Denver.

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    The paucity of in-office measurements means that clinicians miss fluctuations in IOP and also nocturnal values, which may be significant considering that peak IOP peak values in most people occur during the night.

    “Thus, it is not surprising that axonal injury often occurs in patients whose IOPs are considered physiologically normal based on current approaches to measuring IOP,” Dr. Mansouri said.

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