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Yaniv Barkana, MD; Sarah Anis, MD; Jeffrey Liebmann, MD; Celso Tello, MD; Robert Ritch, MD

Arch Ophthalmol. 2006;124:793-797.

Objective  To determine whether intraocular pressure (IOP) monitoring outside of normal office hours adds clinically useful information.

Methods  We reviewed the records of all patients with glaucoma who were admitted for 24-hour IOP monitoring during 3 years. Applanation IOP was recorded in the sitting position from 7 AM until midnight and in the supine position at 6 AM.

Results  Thirty-two patients (22 women and 10 men) were enrolled (mean ± SD age, 67.3 ± 12.1 years). Mean ± SD 24-hour IOP was 13.0 ± 2.2 mm Hg. Mean ± SD peak 24-hour IOP (16.8 ± 3.2 mm Hg) was significantly higher than peak office IOP (14.7 ± 3.2 mm Hg) (P<.001). Peak IOP was recorded outside of office hours in at least 1 eye in 22 patients (69%). Mean IOP fluctuation during 24-hour monitoring (6.9 ± 2.9 mm Hg) was significantly greater than that during office hours (3.8 ± 2.3 mm Hg) (P<.001). Peak 24-hour IOP was higher than the peak IOP noted during previous office visits in 40 eyes (62%). Results of 24-hour IOP monitoring led to immediate treatment change in 23 eyes (36%).

Conclusions  In glaucoma patients with advanced disease or progression that are disproportionate to known IOP measurements, 24-hour monitoring of IOP may reveal a greater role for pressure-related risk for glaucoma progression than previously suspected and may alter treatment strategies.

Author Affiliations: Departments of Ophthalmology, The New York Eye and Ear Infirmary, New York (Drs Barkana, Anis, Tello, and Ritch), New York Medical College, Valhalla (Drs Tello and Ritch), New York University School of Medicine, New York (Dr Liebmann), and Manhattan Eye, Ear & Throat Hospital, New York (Dr Liebmann).

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