24-hour/diurnal IOP monitoring for glaucoma
Should 24-hour intraocular pressure (IOP) monitoring be the basis for treatment decisions in some glaucomatous eyes?


Roibeard O’hEineachain
Published: Friday, April 7, 2017

There is now comprehensive evidence that single pressure readings every few months are not sufficient for the management of many glaucoma patientsIn the first study the peak pressure was found to be almost 5 mm Hg higher over 24 hours than that recorded in the clinic with single random pressure measurements. In the second study both fluctuation and peak IOP was significantly greater than previously detected in the clinic. (Hughes et al J Glaucoma 2003; 12: 232-236; Barkana et al, Archives Ophthalmol 2006;124:793-797) “So there is now comprehensive evidence that single pressure readings every few months are not sufficient for the management of many glaucoma patients. IOP fluctuates widely and thus a single pressure measurement will miss a lot of IOP related disease,” Professor Konstas said. He added that the argument in favour of 24-hour, or at least daytime, IOP monitoring is particularly strong in certain types of glaucoma with worse and more unpredictable 24-hour IOP characteristics, such as exfoliative glaucoma and angle closure glaucoma. The same goes for younger glaucoma cases, progressive glaucoma, and patients with advanced glaucoma on maximal medical therapy who often demonstrate peak pressure outside office hours. konstas@med.auth.gr
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