The effect of 24-hour intraocular pressure fluctuation on glaucoma progression in primary angle closure glaucoma

Introduction Primary Angle Closure Glaucoma (PACG) is a common glaucoma type in Asian population. Malays are among affected races in South East Asian with PACG prevalence of 0.12% to 2.5%. To date, intraocular pressure (IOP) is the only modifiable glaucoma risk factor. Two IOP subcomponents; the...

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Main Author:	A.Rahim @ Samsuddin, Haslinda
Format:	Thesis
Language:	English
Published:	2015
Subjects:	RE Ophthalmology
Online Access:	http://eprints.usm.my/40246/1/Dr._Haslinda_Binti_A.Rahim_%40_Samsuddin_%28Ophthalmology%29-OCR.pdf
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spelling	my-usm-ep.402462018-07-16T01:32:00Z The effect of 24-hour intraocular pressure fluctuation on glaucoma progression in primary angle closure glaucoma 2015 A.Rahim @ Samsuddin, Haslinda RE Ophthalmology Introduction Primary Angle Closure Glaucoma (PACG) is a common glaucoma type in Asian population. Malays are among affected races in South East Asian with PACG prevalence of 0.12% to 2.5%. To date, intraocular pressure (IOP) is the only modifiable glaucoma risk factor. Two IOP subcomponents; the higher mean IOP and the wider IOP fluctuations are currently being looked upon as important predictors of glaucoma progression. Objectives To determine and compare the 24-hour overall mean IOP, mean IOP peak, mean IOP trough, and IOP fluctuation in progressed and non-progressed PACG. Methodology A cross-sectional study was conducted in Hospital Universiti Sains Malaysia, Kelantan involving 25 patients with 50 eyes diagnosed with PACG. They were grouped into progressed PACG (11 eyes) and non-progressed PACG (39 eyes). AGIS scoring system was used to determine the progression group. All patients were admitted for 24 hours period. Six IOP measurements were performed at 4-hour time points; at 0800, 1200, 1600, 2000, 2400, and 0400. Goldmann Applanation Tonometer (GAT) was used for all IOP measurements. Statistical analysis used were independent t test, Mann-Whitney U test, and Fisher’s exact test. Results Majority of progressed eye group of PACG exhibited patterns of night peak with afternoon trough, while non-progressed eye group showed patterns of morning peak with night trough. At 4-hour time points, the progressed eye group had lower mean IOP, mean peak IOP, and mean trough IOP but wider mean IOP fluctuation. Over 24 hour period, there was no significant difference for all IOP variables in both groups. The 24-hour mean overall IOP mean range was 13.7 to 15.3 mmHg (p = 0.202), overall mean IOP peak range was 17.0 to 18.0 mmHg (p = 0.285), overall mean trough range was 11.0 to 13.0 mmHg (p = 0.151), and overall mean IOP fluctuation was 6.0 mmHg (p = 0.803). Conclusion Progressed and non-progressed eye group of PACG demonstrated no significant difference in terms of all IOP variables over 24-hour period. Despite similar overall mean IOP fluctuation during 24-hour period, the progressed eye group had wider mean IOP fluctuation than the non-progressed eye group at 4-hour time points. 2015 Thesis http://eprints.usm.my/40246/ http://eprints.usm.my/40246/1/Dr._Haslinda_Binti_A.Rahim_%40_Samsuddin_%28Ophthalmology%29-OCR.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	RE Ophthalmology
spellingShingle	RE Ophthalmology A.Rahim @ Samsuddin, Haslinda The effect of 24-hour intraocular pressure fluctuation on glaucoma progression in primary angle closure glaucoma
description	Introduction Primary Angle Closure Glaucoma (PACG) is a common glaucoma type in Asian population. Malays are among affected races in South East Asian with PACG prevalence of 0.12% to 2.5%. To date, intraocular pressure (IOP) is the only modifiable glaucoma risk factor. Two IOP subcomponents; the higher mean IOP and the wider IOP fluctuations are currently being looked upon as important predictors of glaucoma progression. Objectives To determine and compare the 24-hour overall mean IOP, mean IOP peak, mean IOP trough, and IOP fluctuation in progressed and non-progressed PACG. Methodology A cross-sectional study was conducted in Hospital Universiti Sains Malaysia, Kelantan involving 25 patients with 50 eyes diagnosed with PACG. They were grouped into progressed PACG (11 eyes) and non-progressed PACG (39 eyes). AGIS scoring system was used to determine the progression group. All patients were admitted for 24 hours period. Six IOP measurements were performed at 4-hour time points; at 0800, 1200, 1600, 2000, 2400, and 0400. Goldmann Applanation Tonometer (GAT) was used for all IOP measurements. Statistical analysis used were independent t test, Mann-Whitney U test, and Fisher’s exact test. Results Majority of progressed eye group of PACG exhibited patterns of night peak with afternoon trough, while non-progressed eye group showed patterns of morning peak with night trough. At 4-hour time points, the progressed eye group had lower mean IOP, mean peak IOP, and mean trough IOP but wider mean IOP fluctuation. Over 24 hour period, there was no significant difference for all IOP variables in both groups. The 24-hour mean overall IOP mean range was 13.7 to 15.3 mmHg (p = 0.202), overall mean IOP peak range was 17.0 to 18.0 mmHg (p = 0.285), overall mean trough range was 11.0 to 13.0 mmHg (p = 0.151), and overall mean IOP fluctuation was 6.0 mmHg (p = 0.803). Conclusion Progressed and non-progressed eye group of PACG demonstrated no significant difference in terms of all IOP variables over 24-hour period. Despite similar overall mean IOP fluctuation during 24-hour period, the progressed eye group had wider mean IOP fluctuation than the non-progressed eye group at 4-hour time points.
format	Thesis
qualification_level	Master's degree
author	A.Rahim @ Samsuddin, Haslinda
author_facet	A.Rahim @ Samsuddin, Haslinda
author_sort	A.Rahim @ Samsuddin, Haslinda
title	The effect of 24-hour intraocular pressure fluctuation on glaucoma progression in primary angle closure glaucoma
title_short	The effect of 24-hour intraocular pressure fluctuation on glaucoma progression in primary angle closure glaucoma
title_full	The effect of 24-hour intraocular pressure fluctuation on glaucoma progression in primary angle closure glaucoma
title_fullStr	The effect of 24-hour intraocular pressure fluctuation on glaucoma progression in primary angle closure glaucoma
title_full_unstemmed	The effect of 24-hour intraocular pressure fluctuation on glaucoma progression in primary angle closure glaucoma
title_sort	effect of 24-hour intraocular pressure fluctuation on glaucoma progression in primary angle closure glaucoma
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2015
url	http://eprints.usm.my/40246/1/Dr._Haslinda_Binti_A.Rahim_%40_Samsuddin_%28Ophthalmology%29-OCR.pdf
_version_	1747820788569866240

The effect of 24-hour intraocular pressure fluctuation on glaucoma progression in primary angle closure glaucoma

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