原发性开角型青光眼与正常眼24小时眼压波动规律

目的 分析其眼压昼夜变化规律,以期为青光眼的个性化治疗提供参考依据.方法 收集2006年4月至2009年4月上海市北站医院和复旦大学附属眼耳鼻喉科医院门诊的原发性开角型青光眼患者102例及正常志愿者83名,进行24 h眼压测量,用非接触性眼压计从8 am起每隔2 h测1次眼压,零点至6 am为唤醒后即刻坐位眼压.结果 二组之间峰值眼压[正常组右眼(16.0±2.7)mm Hg,左眼(16.2±2.7)mm Hg;POAG组右眼(25.3±5.6)mm Hg,左眼(24.8±5.1)mm Hg]、谷值眼压[正常组右眼(11.1±2.5)mm Hg,左眼(11.0±2.3)mm Hg;POAG组右眼(16.3±3.7)mm Hg,左眼(16.2±3.3)mm Hg]、平均眼压[正常组右眼(13.4±2.5)mm Hg,左眼(13.4±2.5)mm Hg;POAG组右眼(19.9±4.3)mm Hg,左眼(19.8±3.8)mm Hg]及眼压波动值[正常组右眼(5.0±1.6)mm Hg,左眼(5.2±1.7)mm Hg;POAG组右眼(9.1±3.6)mm Hg,左眼(8.6±3.8)mm Hg]的差异均具有统计学意义(均P＜0.01),正常组59.6%,POAG组73.5%的峰值眼压位于门诊工作时间以外;尤其是在零点至早上6点这一时间段,正常组50%,POAG组64.7%的峰值位于凌晨0:00至06:00.结论 通过对比分析,24 h眼压可以为我们提供治疗前的基础状态,从而为个性化治疗提供详实的资料.建议有条件的话,应该将24 h昼夜眼压监测作为开角型青光眼的检查常规.

Abstract：

Objective To analyze the discipline of intraocular pressure (IOP) variation, through circadian intraocular pressure monitoring in primary open-angle glaucoma (POAG) patients and normal controls, with a view to provide basis for individualized treatment of glaucoma. Methods Subjects were enrolled from the outpatients of Shanghai Beizhan Hospital and Eye and ENT Hospital of Fudan University,which were diagnosed as primary open angle glaucoma, from April 2006 to April 2009. Totally there were 102 cases of patients and 83 cases of normal volunteers. All the subjects accepted 24-hour IOP measurements using non-contact tonometer every two hours starting from 8:00 am. And the IOP between O0:00 to 06:00 am was measured in sitting position immediately after wake up. Results The differences of peak IOP[ (16.0±2.7)mm Hg of right eye and ( 16.2±2.7)mm Hg of left eye in normal group; (25.3±5.6) mm Hg of right eye and (24.8±5.1) mm Hg of left eye in POAG group], valley IOP ( 11.1±2.5) mm Hg of right eye and (11.0±2.3) mm Hg of left eye in normal group; ( 16. 3 ±3.7) mm Hg of right eye and ( 16.2 ±3. 3 ) mm Hg of left eye in POAG group, average IOP (13.4±2.5) mm Hg of right eye and ( 13.4 ± 2.5)mm Hg of left eye in normal group; ( 19.9 ±4.3) mm Hg of right eye and ( 19. 8 ±3. 8) mm Hg of left eye in POAG group), and IOP fluctuations (5.0 ± 1.6) mm Hg of right eye and (5. 2 ± 1.7) mm Hg of left eye in normal group; (9.1 ±3.6) mm Hg of right eye and (8.6±3.8 ) mm Hg of left eye in POAG group between two groups were all of statistically significance (P ＜ 0. 01 ). Notably, the peak IOP of 59. 6% in normal control group and 73.5% in POAG group were outside working hours, especially in the time period from 00:00 to 06:00 am. The peak value of 50% in normal group and 64.7% in POAG group located between 00:00 to 06:00 in the morning. Conclusions By comparison and analysis, 24-hour intraocular pressure measurement could provide us pre-treatment basic state, so as to provide detailed information for individualized treatment. If possible, it is suggested that 24-hour IOP monitoring should be added as a routine examination of primary open angle glaucoma.

Study on changes of intraocular pressure within 24 hours in primary open angle glaucoma and normal eyes

Objective To analyze the discipline of intraocular pressure (IOP) variation, through circadian intraocular pressure monitoring in primary open-angle glaucoma (POAG) patients and normal controls, with a view to provide basis for individualized treatment of glaucoma. Methods Subjects were enrolled from the outpatients of Shanghai Beizhan Hospital and Eye and ENT Hospital of Fudan University,which were diagnosed as primary open angle glaucoma, from April 2006 to April 2009. Totally there were 102 cases of patients and 83 cases of normal volunteers. All the subjects accepted 24-hour IOP measurements using non-contact tonometer every two hours starting from 8:00 am. And the IOP between O0:00 to 06:00 am was measured in sitting position immediately after wake up. Results The differences of peak IOP[ (16.0±2.7)mm Hg of right eye and ( 16.2±2.7)mm Hg of left eye in normal group; (25.3±5.6) mm Hg of right eye and (24.8±5.1) mm Hg of left eye in POAG group], valley IOP ( 11.1±2.5) mm Hg of right eye and (11.0±2.3) mm Hg of left eye in normal group; ( 16. 3 ±3.7) mm Hg of right eye and ( 16.2 ±3. 3 ) mm Hg of left eye in POAG group, average IOP (13.4±2.5) mm Hg of right eye and ( 13.4 ± 2.5)mm Hg of left eye in normal group; ( 19.9 ±4.3) mm Hg of right eye and ( 19. 8 ±3. 8) mm Hg of left eye in POAG group), and IOP fluctuations (5.0 ± 1.6) mm Hg of right eye and (5. 2 ± 1.7) mm Hg of left eye in normal group; (9.1 ±3.6) mm Hg of right eye and (8.6±3.8 ) mm Hg of left eye in POAG group between two groups were all of statistically significance (P ＜ 0. 01 ). Notably, the peak IOP of 59. 6% in normal control group and 73.5% in POAG group were outside working hours, especially in the time period from 00:00 to 06:00 am. The peak value of 50% in normal group and 64.7% in POAG group located between 00:00 to 06:00 in the morning. Conclusions By comparison and analysis, 24-hour intraocular pressure measurement could provide us pre-treatment basic state, so as to provide detailed information for individualized treatment. If possible, it is suggested that 24-hour IOP monitoring should be added as a routine examination of primary open angle glaucoma.