How 24-hour IOP measurements vary with glaucoma treatment
Clinicians should take into account the way IOP varies over the course of 24 hours depending on the glaucoma treatment used, according to the authors of a new literature review.
“We need to check pressures more often than once, outside the ‘office hours’ and if possible at night when patients are asleep,” wrote Anastasios G.P. Konstas, from 1st University Department of Ophthalmology, Aristotle University of Thessaloniki, Greece, and colleagues. They published their finding in Advances in Therapy.
While randomized controlled trials show that reducing IOP reduces the rate of visual loss in most glaucoma patients, researchers have too often assumed that a single daytime measurement provides an adequate understanding of whether a patient’s IOP is under control. Most clinicians only measure IOP during patient visits about every three months.
A single IOP measurement only indicates what is happening for 1 out of 1439 minutes per day, they noted. Other trials have shown that the efficacy of a given therapy can vary over the course of this time. As a consequence, clinicians may not be making the best choice about whether to use surgery, laser, or medication.
Twenty-four-hour monitoring would reveal the true peak IOP and the level at which damage occurs, allowing an optimal level to be set for each patient, the researchers wrote. However, such constant monitoring is not yet possible for most patients.
The researchers analysed randomised controlled trials to see how IOP measurements varied over 24 hours with each therapy in hope of providing information clinicians can use to guide their treatment plans.