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24-Hour Intraocular Pressure Rhythm in Patients With Untreated Primary Open Angle Glaucoma and Effects of Selective Laser Trabeculoplasty

Aptel, Florent MD, PhD; Musson, Cécile MD; Zhou, Thierry MD; Lesoin, Antoine MD; Chiquet, Christophe MD, PhD

doi: 10.1097/IJG.0000000000000604
Original Studies
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Purpose of the Study: The purpose of the study was to evaluate the 24-hour nyctohemeral rhythm of intraocular pressure (IOP) in patients with untreated primary open angle glaucoma using a contact lens sensor. To evaluate the effect of selective laser trabeculoplasty (SLT) on the 24-hour rhythm of IOP.

Materials and Methods: Prospective study conducted in a chronobiology center. Fourteen patients with primary open angle glaucoma underwent three 24-hour IOP measurement sessions after a complete wash-out of the medical treatment: before SLT and 1 and 6 months after, using the contact lens sensor Triggerfish (SENSIMED, Lausanne, Switzerland). IOP and the main parameters of nyctohemeral rhythm (existence of a rhythm, acrophase, bathyphase, midline estimating statistic of rhythm, amplitude, and range) before SLT were compared with the same parameters measured 1 and 6 months later.

Results: IOP increased from 16.3±3.7 to 22.1±8.4 mm Hg (5.8 mm Hg; 95% confidence interval (CI), 2.41-12.71; P=0.009) after the wash-out procedure. After SLT, IOP significantly decreased by 3.4 mm Hg (95% CI, 0.09-7.89; P=0.041) (14.9%) at 1 month and 1.9 mm Hg (95% CI 0.10-3.84; P=0.044) (8.1%) at 6 months. After medication wash-out, 100% of the subjects had a nyctohemeral IOP rhythm with nocturnal acrophase (01:57±3:32 AM, 01:22±3:01 AM, and 03:17±2:12 AM at inclusion, 1 and 6 mo, respectively). SLT did not significantly change the characteristics of the 24-hour IOP pattern, notably the amplitude and the type of rhythm (persistence of nocturnal acrophase).

Conclusions: After medical treatment wash-out, patients with open angle glaucoma consistently had a significant 24-hour IOP rhythm with nocturnal acrophase. SLT reduces the absolute IOP value but does not modify the nyctohemeral IOP rhythm.

*Université Grenoble Alpes

Department of Ophthalmology, University Hospital of Grenoble

INSERM U1042, Lab Hypoxia and Physiopathology, Joseph Fourier University, Grenoble, France

This research received grants from the Association for Research and Formation in Ophthalmology (ARFO, Grenoble) and the foundation for medical research “Fondation de l’Avenir” (ETO-578).

Disclosure: The authors declare no conflict of interest.

Reprints: Florent Aptel, MD, PhD, Department of Ophthalmology, University Hospital of Grenoble, 38043 Grenoble cedex 09, France (e-mail: aptel_florent@hotmail.com).

Received May 14, 2016

Accepted November 9, 2016

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