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Diurnal IOP curve more informative than single measurement

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DANA POINT, Calif. – A 24-hour pressure curve provides a better estimate of a patient’s IOP than a single measurement taken during an office visit, said Sameh Mosaed, MD.

IOP is a dynamic physiological parameter resulting from a complex interplay of multiple factors, Dr. Mosaed said at the annual Ocular Drug and Surgical Therapy Update meeting. A 24-hour IOP curve, on the other hand, provides information about the highest IOP and the extent of IOP fluctuation, she said.

IOP is often at its peak in the early morning hours from about 7 a.m. to 10 a.m. in both normal subjects and glaucoma patients, Dr. Mosaed said. The IOP is always higher when the subject is in a supine position than in a seated position, she said.

The diurnal curve usually does not include the nocturnal sleep period, which is roughly one-third of our daily life, she said.

Dr. Mosaed said sleep studies have shown that IOP peaks just after patients wake up. The IOP then decreases gradually throughout the day.

In estimating a 24-hour IOP, the diurnal curve may be modified using supine IOP measurements, she said.

The 24-hour monitoring technique may be clinically useful in estimating a baseline IOP in newly diagnosed patients and in determining the efficacy of IOP-lowering medications and treatments, according to Dr. Mosaed.

In the future, she said, she anticipates the development of user-friendly home tonometry devices that can record IOP for individual patients over 24-hour periods.