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Effect of glaucoma medications on 24‐hour intraocular pressure‐related patterns using a contact lens sensor
Author(s) -
Mansouri Kaweh,
Medeiros Felipe A,
Weinreb Robert N
Publication year - 2015
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/ceo.12567
Subject(s) - medicine , intraocular pressure , ophthalmology , glaucoma , contact lens , optometry
Background The aim of this article was to study the circadian intraocular pressure ( IOP )‐related effects of ocular hypotensive medications using a contact lens sensor ( CLS ). Design This is a university‐based prospective, randomized, crossover trial. Participants A total of 23 patients with primary open‐angle glaucoma participated. Methods Patients underwent ambulatory recording of IOP ‐related patterns for 24 h in one eye during 3 monthly sessions using a CLS . Patients were untreated in session 1 ( S1 ), were randomized to one of four classes of glaucoma drops for S2 and had a prostaglandin analogue add‐on for S3 . Main Outcome Measures Changes in IOP ‐related patterns were defined using (i) slopes from wake/sitting to sleep/supine; (ii) cosinor rhythmometry modelling; and (iii) area under receiver operating curve ( AUC ) of sleep period. Results Mean patient age was 63.8 ± 11.8 years. Positive linear slopes were seen from wake/sitting to sleep/supine at S1 (17.1 ± 14.2 mVeq /h) and S2 (5.5 ± 23.9 mVeq /h) and negative slopes at S3 (−1.9 ± 29.4 mVeq /h) ( S1 – S2 , P = 0.01; S1 – S3 , P = 0.02). In the prostaglandin group, slopes changed significantly with introduction of drops ( S1 – S2 , P < 0.024), whereas they did not in a mixed group combining the three other classes ( S1 – S2 , P = 0.060). Overall, cosinor amplitudes were 98.4 ± 46.5 mVeq ( S1 ), 113.0 ± 35.6 mVeq ( S2 ) and 109.6 ± 58.3 mVeq ( S3 ) ( S1 – S2 , P = 0.23; S1 – S3 , P = 0.66; S2 – S3 , P = 0.93). AUC were 91.8 ± 63.0 mVeq ( S1 ), 76.3 ± 102.7 mVeq (S2) and 19.9 ± 135.8 mVeq ( S3 ). Differences between sessions were not statistically significant ( S1 – S2 , P = 0.541; S1 – S3 , P = 0.083; S2 – S3 , P = 0.092). Conclusions Prostaglandin analogues, but not other medications, seem to flatten the IOP ‐related increase at transition of the wake/sitting to the sleep/supine period, but do not seem to have an effect on acrophase and amplitude.