Science: 24-h intraocular pressure patterns measured by Icare PRO rebound in habitual position of open-angle glaucoma eyes
1
Entering edit mode
6 weeks ago
david 2.5k
@david_fe

This recent scientific publication concludes that monitoring intraocular pressure ("IOP") in both seated and lying positions over a 24 hour period is superior to seated in-office intraocular pressure monitoring. That part of the conclusion is not new. The study also concludes that the Icare PRO rebound tonometer is well-tolerated. This is also not new information.

In this study, the researcher hospitalized the patients overnight in order to perform the 24-hour IOP monitoring. It can be argued that we have sufficient studies of that design. Current technology, such as the Icare tonometers designed for home use, allow a glaucoma patient to perform 24-hour IOP monitoring at home and to safely obtain reliable results. These home-use tonometers feature the same rebound technology as the Pro model and are equally as accurate. Physicians can now offer patients the option to rent a tonometer for period of one week or more at a cost far less than even a single overnight stay in the hospital. Ophthalmologists are finding that home monitoring for a week can be even more informative than a hospital-based diurnal curve. Real life activities do impact a patient's intraocular pressure. Therefore, it can be beneficial to monitor IOP in real life as opposed to the patient being isolated in a hospital.

24-h intraocular pressure patterns measured by Icare PRO rebound in habitual position of open-angle glaucoma eyes - PubMed

Graefes Arch Clin Exp Ophthalmol
2021 Apr 29
PMID: 33914159
DOI: 10.1007/s00417-021-05192-2

Abstract

Purpose

To measure the 24-h intraocular pressure (IOP) by the Icare PRO rebound tonometer in healthy and primary open-angle glaucoma (POAG) eyes and compare it with non-contact tonometry (NCT).

Methods

Thirty POAG patients, who were under IOP-lowering treatment, and 30 healthy subjects were included. Participants were hospitalized overnight for the 24-h IOP measurement. IOPs were measured by Icare PRO and NCT according to a standard protocol every 2 h during 24 h. The 24-h IOP curve and IOP-related parameters were compared between Icare PRO and NCT groups in POAG and healthy eyes.

Results

The IOPs measured by Icare PRO in habitual position (i.e., sitting during the day and supine at night), increased notably at 22:00 in the normal group and at 20:00 in the POAG group, reached peak at 0:00, stayed high until 4:00, and then decreased in both groups. The POAG patients had higher mean 24-h IOP, peak IOP, IOP fluctuation, and greater IOP change from supine to sitting position in the nocturnal period than those in the normal subjects even after adjusting for eyes, age, gender, CCT, and axial length.

Conclusions

The Icare PRO provides a well-tolerated approach for 24-h IOP monitoring in habitual position. Twenty-four-hour IOP in habitual position is more sensitive for detecting high nocturnal IOP peaks and greater IOP fluctuation for POAG patients.

FitEyes Commentary

There is one potential confounding variable not addressed in any of the hospital-based 24-hour IOP monitoring studies I am aware of. Some patients report a higher awakening IOP (reported as the IOP measurement taken upon awakening and prior to getting out of the bed or engaging in any type of activity while in bed) when they sleep deeply and without awakening during the night. Most hospital-based 24-hour IOP monitoring studies prevent a patient from sleeping deeply without interruption for the entire night, by design.

24-h intraocular pressure patterns measured by Icare PRO rebound in habitual position of open-angle glaucoma eyes | SpringerLink

References

  1. Kass MA, Heuer DK, Higginbotham EJ, Johnson CA, Keltner JL, Miller JP, Parrish RK 2nd, Wilson MR, Gordon MO (2002) The ocular hypertension treatment study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol 120:701–713; discussion 829-730. [https://doi.org/10.1001/archopht.120.6.701]
  1. Collaborative Normal-Tension Glaucoma Study Group (1998) Comparison of glaucomatous progression between untreated patients with normal-tension glaucoma and patients with therapeutically reduced intraocular pressures. Am J Ophthalmol 126:487–497. [https://doi.org/10.1016/s0002-9394(98)00223-2]
  1. Barkana Y, Anis S, Liebmann J, Tello C, Ritch R (2006) Clinical utility of intraocular pressure monitoring outside of normal office hours in patients with glaucoma. Arch Ophthalmol 124:793–797. [https://doi.org/10.1001/archopht.124.6.793]
  1. Liu JH, Zhang X, Kripke DF, Weinreb RN (2003) Twenty-four-hour intraocular pressure pattern associated with early glaucomatous changes. Invest Ophthalmol Vis Sci 44:1586–1590. [https://doi.org/10.1167/iovs.02-0666]
  1. Liu JH, Kripke DF, Hoffman RE, Twa MD, Loving RT, Rex KM, Gupta N, Weinreb RN (1998) Nocturnal elevation of intraocular pressure in young adults. Invest Ophthalmol Vis Sci 39:2707–2712
  1. Deokule SP, Doshi A, Vizzeri G, Medeiros FA, Liu JH, Bowd C, Zangwill L, Weinreb RN (2009) Relationship of the 24-hour pattern of intraocular pressure with optic disc appearance in primary open-angle glaucoma. Ophthalmology 116:833–839. [https://doi.org/10.1016/j.ophtha.2008.10.034]
  1. Seibold LK, DeWitt PE, Kroehl ME, Kahook MY (2017) The 24-hour effects of brinzolamide/brimonidine fixed combination and timolol on intraocular pressure and ocular perfusion pressure. J Ocul Pharmacol Ther 33:161–169. [https://doi.org/10.1089/jop.2016.0141]
  1. Sit AJ, Liu JH, Weinreb RN (2006) Asymmetry of right versus left intraocular pressures over 24 hours in glaucoma patients. Ophthalmology 113:425–430. [https://doi.org/10.1016/j.ophtha.2005.10.003]
  1. Cutolo CA, De Moraes CG, Liebmann JM, Mansouri K, Traverso CE, Ritch R, Triggerfish C (2019) The effect of therapeutic IOP-lowering interventions on the 24-hour ocular dimensional profile recorded with a sensing contact lens. J Glaucoma 28:252–257. [https://doi.org/10.1097/IJG.0000000000001185]
  1. De Moraes CG, Mansouri K, Liebmann JM, Ritch R, Triggerfish C (2018) Association between 24-hour intraocular pressure monitored with contact lens sensor and visual field progression in older adults with glaucoma. JAMA Ophthalmol 136:779–785. [https://doi.org/10.1001/jamaophthalmol.2018.1746]
  1. Sahin A, Basmak H, Niyaz L, Yildirim N (2007) Reproducibility and tolerability of the ICare rebound tonometer in school children. J Glaucoma 16:185–188. [https://doi.org/10.1097/IJG.0b013e31802fc6bc]
  1. Grigorian F, Grigorian AP, Olitsky SE (2012) The use of the iCare tonometer reduced the need for anesthesia to measure intraocular pressure in children. J AAPOS 16:508–510. [https://doi.org/10.1016/j.jaapos.2012.07.004]
  1. Nakakura S, Mori E, Yamamoto M, Tsushima Y, Tabuchi H, Kiuchi Y (2015) Intradevice and interdevice agreement between a rebound tonometer, Icare PRO, and the Tonopen XL and Kowa hand-held applanation tonometer when used in the sitting and supine position. J Glaucoma 24:515–521. [https://doi.org/10.1097/IJG.0000000000000016]
  1. Serafino M, Villani E, Lembo A, Rabbiolo G, Specchia C, Trivedi RH, Nucci P (2020) A comparison of Icare PRO and Perkins tonometers in anesthetized children. Int Ophthalmol 40:19–29. [https://doi.org/10.1007/s10792-019-01143-3]
  1. Bilgec MD, Atalay E, Sozer O, Gursoy H, Bilgin M, Yildirim N (2020) The influence of corneal geometrical and biomechanical properties on tonometry readings in keratoconic eyes. Int Ophthalmol 40:849–857. [https://doi.org/10.1007/s10792-019-01248-9]
  1. Chen M, Zhang L, Xu J, Chen X, Gu Y, Ren Y, Wang K (2019) Comparability of three intraocular pressure measurement: iCare pro rebound, non-contact and Goldmann applanation tonometry in different IOP group. BMC Ophthalmol 19:225. [https://doi.org/10.1186/s12886-019-1236-5]
  1. Kato Y, Nakakura S, Matsuo N, Yoshitomi K, Handa M, Tabuchi H, Kiuchi Y (2018) Agreement among Goldmann applanation tonometer, iCare, and Icare PRO rebound tonometers; non-contact tonometer; and Tonopen XL in healthy elderly subjects. Int Ophthalmol 38:687–696. [https://doi.org/10.1007/s10792-017-0518-2]
  1. Guler M, Bilak S, Bilgin B, Simsek A, Capkin M, Hakim Reyhan A (2015) Comparison of intraocular pressure measurements obtained by Icare PRO rebound tonometer, Tomey FT-1000 noncontact tonometer, and Goldmann applanation tonometer in healthy subjects. J Glaucoma 24:613–618. [https://doi.org/10.1097/IJG.0000000000000132]
  1. Linden C, Qvarlander S, Johannesson G, Johansson E, Ostlund F, Malm J, Eklund A (2018) Normal-tension glaucoma has normal intracranial pressure: a prospective study of intracranial pressure and intraocular pressure in different body positions. Ophthalmology 125:361–368. [https://doi.org/10.1016/j.ophtha.2017.09.022]
  1. Fang SY, Wan Abdul Halim WH, Mat Baki M, Din NM (2018) Effect of prolonged supine position on the intraocular pressure in patients with obstructive sleep apnea syndrome. Graefes Arch Clin Exp Ophthalmol 256:783–790. [https://doi.org/10.1007/s00417-018-3919-7]
  1. Malihi M, Sit AJ (2012) Effect of head and body position on intraocular pressure. Ophthalmology 119:987–991. [https://doi.org/10.1016/j.ophtha.2011.11.024]
  1. Linder BJ, Trick GL, Wolf ML (1988) Altering body position affects intraocular pressure and visual function. Invest Ophthalmol Vis Sci 29:1492–1497
  1. Agnifili L, Mastropasqua R, Frezzotti P, Fasanella V, Motolese I, Pedrotti E, Di Iorio A, Mattei PA, Motolese E, Mastropasqua L (2015) Circadian intraocular pressure patterns in healthy subjects, primary open angle and normal tension glaucoma patients with a contact lens sensor. Acta Ophthalmol 93:e14–e21. [https://doi.org/10.1111/aos.12408]
  1. Nouri-Mahdavi K, Hoffman D, Coleman AL, Liu G, Li G, Gaasterland D, Caprioli J, Advanced Glaucoma Intervention S (2004) Predictive factors for glaucomatous visual field progression in the Advanced Glaucoma Intervention study. Ophthalmology 111:1627–1635. [https://doi.org/10.1016/j.ophtha.2004.02.017]
  1. Sung KR, Lee S, Park SB, Choi J, Kim ST, Yun SC, Kang SY, Cho JW, Kook MS (2009) Twenty-four hour ocular perfusion pressure fluctuation and risk of normal-tension glaucoma progression. Invest Ophthalmol Vis Sci 50:5266–5274. [https://doi.org/10.1167/iovs.09-3716]
  1. Tojo N, Abe S, Ishida M, Yagou T, Hayashi A (2017) The fluctuation of intraocular pressure measured by a contact lens sensor in normal-tension glaucoma patients and nonglaucoma subjects. J Glaucoma 26:195–200. [https://doi.org/10.1097/IJG.0000000000000517]
  1. Mansouri K, Liu JH, Weinreb RN, Tafreshi A, Medeiros FA (2012) Analysis of continuous 24-hour intraocular pressure patterns in glaucoma. Invest Ophthalmol Vis Sci 53:8050–8056. [https://doi.org/10.1167/iovs.12-10569]
  1. Grippo TM, Liu JH, Zebardast N, Arnold TB, Moore GH, Weinreb RN (2013) Twenty-four-hour pattern of intraocular pressure in untreated patients with ocular hypertension. Invest Ophthalmol Vis Sci 54:512–517. [https://doi.org/10.1167/iovs.12-10709]
  1. Hirooka K, Shiraga F (2003) Relationship between postural change of the intraocular pressure and visual field loss in primary open-angle glaucoma. J Glaucoma 12:379–382. [https://doi.org/10.1097/00061198-200308000-00015]
  1. Wasilewicz R, Varidel T, Simon-Zoula S, Schlund M, Cerboni S, Mansouri K (2020) First-in-human continuous 24-hour measurement of intraocular pressure and ocular pulsation using a novel contact lens sensor. Br J Ophthalmol. [https://doi.org/10.1136/bjophthalmol-2019-315276]

Funding

This study was funded by the Shanghai Jing’an District Health Commission (2016MS12, 2017QN03, 2019MS12), the State Program of National Natural Science Foundation of China (81570887, 81870692), the State Key Program of National Natural Science Foundation of China (81430007), the subject of major projects of National Natural Science Foundation of China (81790641), the Shanghai Committee of Science and Technology, China (17410712500), and the top priority of clinical medicine center of Shanghai (2017ZZ01020). The sponsor or funding organization had no role in the design or conduct of this research.

Authors

  1. Zhaobin Fang
  2. Xiaolei Wang
  3. Siyu Qiu
  4. Xinghuai Sun
  5. Yuhong Chen
  6. Ming Xiao

Corresponding authors

Correspondence to [Yuhong Chen] or [Ming Xiao].

Author information

Author notes

  1. Zhaobin Fang and Xiaolei Wang contributed equally to this work and were regarded as first authors.

  2. Yuhong Chen and Ming Xiao contributed equally to this work and were regarded as corresponding authors.

Affiliations

  1. Department of Ophthalmology, Shanghai Jing’an District Bei Zhan Hospital, Shanghai, 200070, China

    Zhaobin Fang, Siyu Qiu & Ming Xiao

  2. Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, 200031, China

    Xiaolei Wang, Xinghuai Sun & Yuhong Chen

  3. NHC Key Laboratory of Myopia, Ministry of Health (Fudan University), Shanghai, 200031, China

    Xiaolei Wang, Xinghuai Sun & Yuhong Chen

  4. Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, 200031, China

    Xinghuai Sun

  5. State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, 200032, China

    Xinghuai Sun

Ethics declarations

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no competing interests.

icare glaucoma intraocular-pressure-iop tonometer • 40 views
ADD COMMENTlink

Login before adding your answer.

Traffic: 3 users visited in the last hour
Content Search
Tags
Badges
Help About
FAQ
RSS

Use of this site constitutes acceptance of our User Agreement and Privacy Policy.