[Diurnal variation curve of intraocular pressure and ocular pulse amplitude with dynamic contour tonometer in primary open-angle glaucoma and normal tension glaucoma patients]

Abstract

Objective: To observe the diurnal variations of intraocular pressure (IOP) measured with dynamic contour tonometer (DCT) in primary open angle glaucoma (POAG) patients, normal tension glaucoma (NTG) patients, and healthy controls, and to compare the differences of diurnal variation curves between the two eyes of each subject and define the distribution of the peak of IOP; to analyze the diurnal variation range of ocular pulse amplitude (OPA) and compare the differences among the POAG and NTG patients and healthy controls.

Methods: DCT was used to measure the diurnal variations of IOP and OPA in the two eyes of 18 POAG patients, 17 NTG patients and 30 normal controls at 5:00, 7:00, 10:00, 14:00, 18:00, and 22:00 and the distribution of the peak IOP was observed. The range of the diurnal variation of OPA was identified.

Results: The diurnal variation curves of IOP were different among the POAG patients, NTG patients, and normal people, and also between the two eyes of each subject. Four right eyes (13.3%) and 6 left eyes (20.0%) of the healthy controls, 4 right eyes (23.5%) and 5 left eyes (29.4%) of the NTG patients, and 5 right eyes (27.8%) and 4 left eyes (22.2%) of the POAG patients reached the peak IOP values in out-office period. Diurnal variation of OPA was detected in both the patients and controls, and the variation curves were different within different groups sampled and between the two eyes of each subject. The diurnal OPA range of the right and left eyes of the POAG group were (2.1 +/- 1.3) mm Hg, and (2.4 +/- 1.9) mm Hg respectively, significantly larger than those of the normal controls [(1.1 +/- 0.5) mm Hg and 1.2 +/- 0.5) mm Hg respectively], and those of the NTG group [(1.1 +/- 0.8) mm Hg and (1.0 +/- 0.5) mm Hg) respectively] (all P < 0.01).

Conclusion: OPA has diurnal variation. The diurnal variation of the POAG patients is the largest. NTG patients and normal controls have asymmetric IOP and OPA diurnal variations. The two eyes of the same individual cannot always be treated as the same. The value of IOP measured in the office-time cannot completely represents the 1 d IOP.