[Nyctohemeral variations in intraocular pressure]

Abstract

Intraocular pressure (IOP) varies and depends on many factors. These variations throughout the nycthemeron (the full 24-h period of a night and a day) are the most interesting to study. With the current techniques, it is impossible to measure continuously without waking the subject. Therefore, IOP must be measured hourly over 24 h with a portable tonometer, which provides short measurements in any posture, without requiring the subjects to rise during the night. Intraocular pressure depends on a nyctohemeral rhythm and in healthy subjects is higher at night than during the day, with a nocturnal peak value (acrophase). In the same normal individual, several 24-h measurements are identical. Each individual has his own 24-h IOP pattern. In glaucoma patients, however, the 24-h IOP rhythm was shown to be reversed, with values higher during the day (a midday peak in IOP) than during the night. The time course of the nyctohemeral curve of intraocular pressure is considered to play a role in the prognosis of glaucoma and can serve to classify the type of glaucoma (POAG, NTG). Lowering IOP is still the only option that is available for treating patients with glaucoma. Variations encountered in the individual's nyctohemeral IOP pattern must be taken into consideration to provide the most effective treatment.