Diurnal variation of intraocular pressure and its correlation with retinal nerve fiber analysis in Turkish patients with exfoliation syndrome |
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Authors: | Koray Gumus Banu Bozkurt Bar?s Sonmez Murat Irkec Mehmet Orhan Osman Saracbasi |
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Institution: | (1) Department of Ophthalmology, Hacettepe University, Ankara, Turkey;(2) Department of Ophthalmology, Hacettepe University School of Medicine, Sıhhiye, 06100 Ankara, Turkey |
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Abstract: | Purpose The purpose was to evaluate the diurnal variation (DV) of intraocular pressure (IOP) in patients with exfoliation syndrome
(XS), to measure retinal nerve fiber layer (RNFL) thickness by using scanning laser polarimetry, and to compare these measurements
with those of normal subjects.
Methods Forty-five subjects with XS and 40 healthy, age/sex matched subjects were recruited into the study. A detailed ophthalmologic
examination was performed. IOP measurements were obtained at 08:00 am, 12:00 pm, 03:00 pm, and 06:00 pm. The XS group was
further divided into DV ≥5 mmHg and DV<5 mmHg groups and also according to the existence of IOP fluctuation. The IOP measurements
and RNFL thickness measurements were compared between the groups.
Results The mean IOP value was found to be highest in the morning both in the XS and control groups. IOP showed a gradual decrease
from 8.00 am to 6.00 pm in the control group, whereas a second peak at 03:00 pm was observed in the XS group. There was a
fluctuation in 53.3% of the XS group, while none of the healthy subjects showed fluctuation. Superior and inferior ratios
were statistically lower in XS patients than those in control subjects (p<0.05). Moreover, in patients with XS showing a DV ≥5 mmHg and/or a fluctuation, the superior ratio, inferior ratio, the number,
superior average and superior integral were significantly different (all p values <0.05) from those of control subjects.
Conclusions As the XS patients with high diurnal IOP variation and fluctuating pattern of IOP had lower RNFL thickness measurements, it
is crucial to follow up these patients by performing scanning laser polarimetry in order to discover any possible glaucomatous
damage at an earlier stage than with the use of conventional visual field analysis. |
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Keywords: | Exfoliation syndrome Diurnal IOP variation Retinal nerve fiber analysis |
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