Twenty‐four‐hour intraocular pressure patterns in patients with thyroid eye disease

Background To prospectively investigate the safety, tolerability and 24‐h intraocular pressure ( IOP ) patterns in patients with thyroid eye disease ( TED ) using a contact lens sensor ( CLS ). Design Prospective study. Participants Ten patients with established TED . Methods Ten eyes of 10 patients were prospectively evaluated in an ambulatory 24‐h IOP monitoring session using the CLS ( S ensimed AG , L ausanne, S witzerland). Patients pursued daily activities, and sleep behaviour was uncontrolled. Main Outcome Measures Incidence of adverse events ( AE s) and tolerability (scale of 0–10, increasing intolerance) were assessed. IOP patterns were evaluated using a cosinor rhythmometry model, and linear regression slopes were constructed for the transition from wake/sitting ( W/S ) to sleep/supine ( S/S ) and vice versa. Results Mean age was 61.8 ± 21.6 years, and 90% of patients were female. Main AEs were blurred vision (50%), conjunctival hyperaemia (100%) and superficial punctate keratitis (20%). Tolerability of the lens was found to be 1.5 ± 0.7. Positive linear slopes of the CLS signal from wake to sleep were detected (18.0 ± 43.8 arbitrary units [a.u.]; P  = 0.254), whereas at the transition from S/S to W/S a significant decrease (−62.9 ± 56.8 a.u.; P  = 0.010) was found. Five patients (50%) had a significant nocturnal/sleep acrophase with the peak occurring at 6:30 a.m. The mean amplitude of the 24‐h curves was 102.2 ± 52.6 a.u. Conclusions In patients with TED , the CLS provides a safe and well‐tolerated approach to 24‐h IOP monitoring. After modelling the 24‐h IOP curves, TED patients were found to have a morning acrophase.