Twenty-four-Hour Intraocular Pressure-Related Patterns from Contact Lens Sensors in Normal-Tension Glaucoma and Healthy Eyes: The Exploring Nyctohemeral Intraocular pressure related pattern for Glaucoma Management (ENIGMA) Study.

Abstract

PURPOSE:

To investigate 24-hour nyctohemeral intraocular pressure (IOP)-related patterns with contact lens sensors (CLSs) in eyes with primary open-angle glaucoma (POAG) with normal baseline IOP (i.e., normal-tension glaucoma [NTG]) and healthy controls.

DESIGN:

Prospective, case-control study.

PARTICIPANTS:

Thirty eyes of 30 patients with NTG, who had had a wash-out period for their IOP-lowering treatment, and 20 eyes of 20 healthy volunteer subjects.

METHODS:

Patients and subjects were hospitalized for the purposes of 24-hour CLS (SENSIMED Triggerfish; Sensimed AG, Lausanne, Switzerland) measurement. The IOP-related patterns during wake and sleep times over the course of the 24 hours were compared between the 2 groups. The 24-hour ambulatory blood pressure and posture were monitored simultaneously. A generalized linear model was used to find the factors associated with NTG.

MAIN OUTCOME MEASURES:

The IOP-related patterns, including mean and standard deviation (SD) of measurements, amplitude of cosine-fit curve, acrophase (signal peak), and bathyphase (signal trough) values (millivolt equivalents [mVEq]).

RESULTS:

The SDs of the 24-hour CLS measurements were significantly greater in NTG eyes than in healthy controls (112.51±26.90 vs. 85.18±29.61 mVEq, P = 0.002). The amplitudes of cosine-fit curve (141.88±39.96 vs. 106.08±41.49 mVEq, P = 0.004) and acrophase values (277.74±129.80 vs. 190.58±127.88 mVEq, P = 0.024), mostly measured during nocturnal period, were significantly greater in NTG eyes than in healthy controls. The NTG subjects slept longer in the lateral decubitus posture than the healthy controls (199.1±137.8 vs. 113.2±86.2 minutes, P = 0.009). In the multivariable generalized linear model, the greater amplitude of cosine-fit curve (β = 0.218, P = 0.012) and greater time of decubitus posture during sleep (β = 0.180, P = 0.004) were found to be significantly associated with NTG.

CONCLUSIONS:

Continuous monitoring of 24-hour IOP-related values with CLS can be useful for assessment of glaucoma risk, especially for patients with NTG whose IOP appears to be in the normal range. Fluctuation of 24-hour IOP-related values and posture during sleep time might be associated with NTG.

• Authors: Yong Woo Kim, Jin-Soo Kim, Sang Yoon Lee, Ahnul Ha, Jinho Lee, Young Joo Park, Young Kook Kim, Jin Wook Jeoung, Ki Ho Park
• Journal: Ophthalmology (Ophthalmology) Vol. 127 Issue 11 Pg. 1487-1497 (11 2020) ISSN: 1549-4713 [Electronic] United States
• PMID: 32417391 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2020 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Topics

• Aged
• Case-Control Studies
• Circadian Rhythm (physiology)
• Contact Lenses
• Equipment Design
• Female
• Follow-Up Studies
• Glaucoma, Open-Angle (diagnosis, physiopathology)
• Humans
• Intraocular Pressure (physiology)
• Low Tension Glaucoma (diagnosis, physiopathology)
• Male
• Middle Aged
• Prospective Studies
• Tonometry, Ocular (instrumentation)