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Diurnal IOP fluctuates more in primary angle-closure glaucoma, primary angle-closure Asian subjects

Ophthalmology. 2009;116(12):2300-2304.

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Subjects with primary angle-closure glaucoma and primary angle-closure had double the risk of the occurrence of IOP fluctuation of more than 3 mm Hg when compared with a combined group of primary angle-closure suspects and normal eyes, a study found.

The prospective, cross-sectional study looked at 98 eyes of 98 Asian angle-closure subjects and 21 eyes of 21 normal control subjects. Of the 98 subjects, 32 were primary angle-closure suspects (PACS), 34 had primary angle-closure (PAC) and 32 had primary angle-closure glaucoma (PACG). The majority of patients were Chinese (89.1%).

The study measured diurnal IOP measurements with a noncontact air-puff tonometry by hourly intervals from 8 a.m. to 5 p.m.

The highest IOP was recorded in the early morning, according to the study.

"The PACG and PAC eyes showed diurnal IOP fluctuation of 4 to 5 mm Hg, and this fluctuation was higher than in PACS subjects and normal controls," the authors said. "The degree of [peripheral anterior synechiae] and visual field loss were associated with IOP fluctuation in PAC and PACG eyes."