Twenty-four-Hour Intraocular Pressure-Related Patterns from Contact Lens Sensors in Normal-Tension Glaucoma and Healthy Eyes: The Exploring Nyctohemeral Intraocular pressure related pattern for Glaucoma Management (ENIGMA) Study.
Kim Yong Woo, Kim Jin-Soo, Lee Sang Yoon, Ha Ahnul, Lee Jinho, Park Young Joo, Kim Young Kook, Jeoung Jin Wook, Park Ki Ho
AI Summary
This study found normal-tension glaucoma patients have greater 24-hour IOP-related fluctuations and higher nocturnal peaks than healthy eyes. This suggests continuous monitoring and posture assessment could improve NTG risk evaluation.
Abstract
Purpose
To investigate 24-hour nyctohemeral intraocular pressure (IOP)-related patterns with contact lens sensors (CLSs) in eyes with primary open-angle glaucoma (POAG) with normal baseline IOP (i.e., normal-tension glaucoma [NTG]) and healthy controls.
Design
Prospective, case-control study.
Participants
Thirty eyes of 30 patients with NTG, who had had a wash-out period for their IOP-lowering treatment, and 20 eyes of 20 healthy volunteer subjects.
Methods
Patients and subjects were hospitalized for the purposes of 24-hour CLS (SENSIMED Triggerfish; Sensimed AG, Lausanne, Switzerland) measurement. The IOP-related patterns during wake and sleep times over the course of the 24 hours were compared between the 2 groups. The 24-hour ambulatory blood pressure and posture were monitored simultaneously. A generalized linear model was used to find the factors associated with NTG.
Main outcome measures
The IOP-related patterns, including mean and standard deviation (SD) of measurements, amplitude of cosine-fit curve, acrophase (signal peak), and bathyphase (signal trough) values (millivolt equivalents [mVEq]).
Results
The SDs of the 24-hour CLS measurements were significantly greater in NTG eyes than in healthy controls (112.51±26.90 vs. 85.18±29.61 mVEq, P = 0.002). The amplitudes of cosine-fit curve (141.88±39.96 vs. 106.08±41.49 mVEq, P = 0.004) and acrophase values (277.74±129.80 vs. 190.58±127.88 mVEq, P = 0.024), mostly measured during nocturnal period, were significantly greater in NTG eyes than in healthy controls. The NTG subjects slept longer in the lateral decubitus posture than the healthy controls (199.1±137.8 vs. 113.2±86.2 minutes, P = 0.009). In the multivariable generalized linear model, the greater amplitude of cosine-fit curve (β = 0.218, P = 0.012) and greater time of decubitus posture during sleep (β = 0.180, P = 0.004) were found to be significantly associated with NTG.
Conclusions
Continuous monitoring of 24-hour IOP-related values with CLS can be useful for assessment of glaucoma risk, especially for patients with NTG whose IOP appears to be in the normal range. Fluctuation of 24-hour IOP-related values and posture during sleep time might be associated with NTG.
MeSH Terms
Shields Classification
Key Concepts5
The standard deviations of 24-hour contact lens sensor (CLS) measurements were significantly greater in normal-tension glaucoma (NTG) eyes (112.51±26.90 mVEq) than in healthy controls (85.18±29.61 mVEq) (P = 0.002).
The amplitudes of the cosine-fit curve (141.88±39.96 mVEq vs. 106.08±41.49 mVEq, P = 0.004) and acrophase values (277.74±129.80 mVEq vs. 190.58±127.88 mVEq, P = 0.024), mostly measured during the nocturnal period, were significantly greater in normal-tension glaucoma (NTG) eyes than in healthy controls when measured with contact lens sensors.
Normal-tension glaucoma (NTG) subjects slept longer in the lateral decubitus posture (199.1±137.8 minutes) than healthy controls (113.2±86.2 minutes) (P = 0.009).
In a multivariable generalized linear model, a greater amplitude of the cosine-fit curve (β = 0.218, P = 0.012) and a greater time in the decubitus posture during sleep (β = 0.180, P = 0.004) were significantly associated with normal-tension glaucoma (NTG).
Continuous monitoring of 24-hour intraocular pressure-related values with contact lens sensors (SENSIMED Triggerfish) can be useful for the assessment of glaucoma risk, especially for patients with normal-tension glaucoma (NTG) whose intraocular pressure appears to be in the normal range.
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