The role of 24-hour intraocular pressure fluctuation on glaucoma progression in primary open angle claucoma

Introduction: The accurate assessment of patient’s intraocular pressure profile is critical in the management of primary open angle glaucoma. Although it is a multifactorial disease, IOP remain the only treatable risk factor for the condition. Currently, wide diurnal IOP fluctuation has been identif...

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Main Author:	Abdullah, Norhayati
Format:	Thesis
Language:	English
Published:	2015
Subjects:	RE Ophthalmology
Online Access:	http://eprints.usm.my/40656/1/Dr._Norhayati_Abdullah-24_pages.pdf
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spelling	my-usm-ep.406562018-08-01T03:40:31Z The role of 24-hour intraocular pressure fluctuation on glaucoma progression in primary open angle claucoma 2015 Abdullah, Norhayati RE Ophthalmology Introduction: The accurate assessment of patient’s intraocular pressure profile is critical in the management of primary open angle glaucoma. Although it is a multifactorial disease, IOP remain the only treatable risk factor for the condition. Currently, wide diurnal IOP fluctuation has been identified as an independent risk factor of glaucoma progression. Therefore a single IOP reading taken in our clinic will failed to detect diurnal IOP fluctuation in glaucoma patients. The recognition of diurnal IOP may also explain the progression of visual field in patients who appear to be controlled. Objectives: To study the pattern of 24-hour intraocular pressure fluctuation in primary open angle glaucoma patients and compare the 24 hours mean intraocular pressure, peak trough and IOP fluctuation between POAG patients with and without visual field progression. Patients and Methods: A comparative cross sectional study was conducted involving POAG patients. They divided into non-progressed and progressed group based on AGIS score. Patients were admitted in the ward and IOP measured by GAT at 4-hourly interval for 24-hour. Mean intraocular pressure, peak trough and IOP fluctuation IOP were compared between non-progressed and progressed groups. Analysis was conducted using repeated measure ANOVA and independent t-test A total of 68 patients (36 non-progressed and 32 progressed) were recruited. Mean age for all recruited patients were 68.3±8.6 years old. There was significant more Male among patient with progressed group than in non-progressed group (P=0.022). Mean follow-up was 6.7±3.8 years in progressed group and 5.0±2.6 years in non-progressed group. Patient in progressed group has significantly more moderate to severe glaucoma (P=0.001) and 71.9% of them were on more than two topical pressure lowering agents (P=0.001). There was significantly higher 24-hour mean peak IOP (P=0.001) and wider 24-hour mean IOP fluctuation (P=0.003) in progressed group compared to non-progressed group. There was significant higher mean IOP at 1200 hour in progressed group (P=0.003). Both group showed afternoon peak pattern. Conclusion: 24-hour IOP profile showed that there was significant higher 24-hour mean peak IOP and wider 24-hour mean IOP fluctuation found in progressed group. Both group showed pattern of afternoon peak. 2015 Thesis http://eprints.usm.my/40656/ http://eprints.usm.my/40656/1/Dr._Norhayati_Abdullah-24_pages.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 Abdullah, Norhayati The role of 24-hour intraocular pressure fluctuation on glaucoma progression in primary open angle claucoma
description	Introduction: The accurate assessment of patient’s intraocular pressure profile is critical in the management of primary open angle glaucoma. Although it is a multifactorial disease, IOP remain the only treatable risk factor for the condition. Currently, wide diurnal IOP fluctuation has been identified as an independent risk factor of glaucoma progression. Therefore a single IOP reading taken in our clinic will failed to detect diurnal IOP fluctuation in glaucoma patients. The recognition of diurnal IOP may also explain the progression of visual field in patients who appear to be controlled. Objectives: To study the pattern of 24-hour intraocular pressure fluctuation in primary open angle glaucoma patients and compare the 24 hours mean intraocular pressure, peak trough and IOP fluctuation between POAG patients with and without visual field progression. Patients and Methods: A comparative cross sectional study was conducted involving POAG patients. They divided into non-progressed and progressed group based on AGIS score. Patients were admitted in the ward and IOP measured by GAT at 4-hourly interval for 24-hour. Mean intraocular pressure, peak trough and IOP fluctuation IOP were compared between non-progressed and progressed groups. Analysis was conducted using repeated measure ANOVA and independent t-test A total of 68 patients (36 non-progressed and 32 progressed) were recruited. Mean age for all recruited patients were 68.3±8.6 years old. There was significant more Male among patient with progressed group than in non-progressed group (P=0.022). Mean follow-up was 6.7±3.8 years in progressed group and 5.0±2.6 years in non-progressed group. Patient in progressed group has significantly more moderate to severe glaucoma (P=0.001) and 71.9% of them were on more than two topical pressure lowering agents (P=0.001). There was significantly higher 24-hour mean peak IOP (P=0.001) and wider 24-hour mean IOP fluctuation (P=0.003) in progressed group compared to non-progressed group. There was significant higher mean IOP at 1200 hour in progressed group (P=0.003). Both group showed afternoon peak pattern. Conclusion: 24-hour IOP profile showed that there was significant higher 24-hour mean peak IOP and wider 24-hour mean IOP fluctuation found in progressed group. Both group showed pattern of afternoon peak.
format	Thesis
qualification_level	Master's degree
author	Abdullah, Norhayati
author_facet	Abdullah, Norhayati
author_sort	Abdullah, Norhayati
title	The role of 24-hour intraocular pressure fluctuation on glaucoma progression in primary open angle claucoma
title_short	The role of 24-hour intraocular pressure fluctuation on glaucoma progression in primary open angle claucoma
title_full	The role of 24-hour intraocular pressure fluctuation on glaucoma progression in primary open angle claucoma
title_fullStr	The role of 24-hour intraocular pressure fluctuation on glaucoma progression in primary open angle claucoma
title_full_unstemmed	The role of 24-hour intraocular pressure fluctuation on glaucoma progression in primary open angle claucoma
title_sort	role of 24-hour intraocular pressure fluctuation on glaucoma progression in primary open angle claucoma
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2015
url	http://eprints.usm.my/40656/1/Dr._Norhayati_Abdullah-24_pages.pdf
_version_	1747820799561039872

The role of 24-hour intraocular pressure fluctuation on glaucoma progression in primary open angle claucoma

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