Diurnal Intraocular Pressure Fluctuation in Eyes with Angle-closure. 2015

Shibal Bhartiya, and Parul Ichhpujani
Senior Consultant, Department of Ophthalmology, Glaucoma Facility, Fortis Memorial Research Institute, Gurgaon, Haryana, India.

OBJECTIVE To investigate diurnal intraocular pressure (IOP) fluctuation in eyes with angle-closure. METHODS Seventy-seven eyes of 77 newly diagnosed patients with angle closure [33 subjects with primary angle-closure suspects (PACS), 23 subjects with primary angle-closure (PAC), and 21 subjects with primary angle-closure glau-coma (PACG)] were enrolled after laser peripheral iridotomy for this prospective, cross-sectional study. Goldmann applanation tonometry (GAT) was performed at 08:00, 12:00, 16:00, 20:00, and 04:00 hours. Mean diurnal IOP, peak IOP, trough IOP, and IOP fluctuation (peak-trough) were compared between groups. RESULTS The mean age of the enrolled subjects was 56.8 ± 5.4 years, with 30 males and 47 females. Intraocular pressure fluctuation was significantly higher in the PACG (7.4 ± 2.8 mm Hg) and PAC (5.5 ± 2.3 mm Hg) groups compared with PACS subjects (4.4 ± 1.5 mm Hg). The highest IOP was recorded at 04:00 hours in all but two patients. Two PACS, 10 PAC and 8 PACG patients, with normal office hour IOP had IOP peaks > 21 mm Hg at night. Twenty-five percent patients (20/77) had abnormal IOP despite good office hour readings. CONCLUSIONS Primary angle-closure glaucoma and PAC eyes showed diurnal IOP fluctuations greater than 5 mm Hg in most subjects, with peak IOP recorded at 04:00 hours. Peak IOP was higher than office hour IOP recordings in subjects with angle-closure. A diurnal variation curve is recommended in these subjects, especially in cases with controlled IOP during office hours. How to cite this article: Bhartiya S, Ichhpujani P. Diurnal Intraocular Pressure Fluctuation in Eyes with Angle-closure. J Curr Glaucoma Pract 2015;9(1):20-23.

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