Association of Ultra-Short-Term Intraocular Pressure Fluctuation With Disease Progression in Primary Angle Closure Glaucoma: The CUPAL Study.
Tan Shaoying, Yu Marco, Baig Nafees, Chan Poemen P, Tang Fang Yao, Cheung Carol Y, Tham Clement C Y
AI Summary
This study found progressive primary angle closure glaucoma eyes had higher ultra-short-term IOP fluctuations during the first hour of sleep, suggesting this period is key for detecting progression risk.
Abstract
Prcis: This study demonstrated significant differences in ultra-short-term IOP fluctuations, measured by a contact lens sensor between progressive and stable PACG eyes, during the first one hour after falling asleep.
Purpose
To identify the most sensitive period for detecting significant ultra-short-term intraocular pressure (IOP) fluctuation associated with disease progression in primary angle closure glaucoma (PACG).
Materials and methods
PACG eyes, which had been followed up for over 2 years under the CUHK PACG Longitudinal (CUPAL) Study, were recruited. Eyes with or without functional or structural glaucomatous progression were classified into 'progressive' or 'stable' groups on the basis of serial visual field and retinal nerve fiber layer (RNFL) thickness documentations, respectively. Ultra-short-term IOP fluctuations were recorded by Sensimed Triggerfish sensors (Sensimed AG, Lausanne, Switzerland) with 288 readings over 30 seconds, at 5-minute intervals, over a 24-hour period. In each of 7 activity-related 1-hour periods during the examining day, the mean value of the amplitude-frequency profiles of the signal fluctuations in twelve 30-second intervals was calculated by semivariogram/semi-variance. The 'progressive' and 'stable' groups were compared by permutation tests on functional t-statistics.
Results
Among the 25 recruited PACG eyes, 16 eyes were classified as RNFL 'progressive' group (the mean rate of change in global RNFL thickness: -0.199 ±0.128 μm/mo). Higher signal fluctuations, in terms of amplitude-frequency, were found during the first 1-hour period of sleeping in the RNFL 'progressive' group compared with the RNFL 'stable' group ( P =0.028).
Conclusions
Between RNFL 'progressive' and 'stable' PACG eyes, significant differences in ultra-short-term IOP fluctuation at the 1-hour period after falling asleep were identified. The first hour of sleeping may be the most sensitive period for detecting significant ultra-short-term IOP fluctuation in PACG eyes.
MeSH Terms
Shields Classification
Key Concepts4
Significant differences in ultra-short-term intraocular pressure (IOP) fluctuations, measured by a contact lens sensor, were found between progressive and stable primary angle closure glaucoma (PACG) eyes during the first one hour after falling asleep.
Higher signal fluctuations in terms of amplitude-frequency were found during the first 1-hour period of sleeping in the RNFL 'progressive' group of primary angle closure glaucoma (PACG) eyes compared with the RNFL 'stable' group (P = 0.028).
The first hour of sleeping may be the most sensitive period for detecting significant ultra-short-term intraocular pressure (IOP) fluctuation in primary angle closure glaucoma (PACG) eyes.
Ultra-short-term intraocular pressure (IOP) fluctuations were recorded by Sensimed Triggerfish sensors with 288 readings over 30 seconds, at 5-minute intervals, over a 24-hour period in primary angle closure glaucoma (PACG) eyes.
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