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Study: Latent asymmetric IOP may predict glaucoma, visual field defects

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Latent asymmetric IOP may be both a predictor of undiagnosed open-angle glaucoma and a risk factor for visual field deterioration, according to a study.

Samin Hong, MD, and colleagues examined the relationship between latent asymmetric IOP and visual field defects among 53 patients with open-angle glaucoma who were enrolled in a sleep laboratory during a 24-hour period. All IOP measurements were obtained while patients were in the sitting or supine position.

Of these 53 patients, sitting IOP was measured in 42 patients, of which 16 were identified as having asymmetric supine IOP.

After analyzing IOP fluctuations and visual field indexes in these 16 eyes with latent asymmetric IOP, the investigators identified a trend for greater IOP fluctuations in the supine position than in the sitting position (P < .001).

Subsequently, they compared IOP asymmetry, monocular diurnal IOP fluctuation, and visual field indexes between patients with and without latent asymmetric IOP.

They found that eyes in patients with latent asymmetric IOP experienced higher IOP fluctuations in the sitting and supine positions and had more aggressive visual field defects than patients with symmetric IOP.

"Further investigation in a larger, more diverse group of patients is needed to assess the diagnostic implications of latent asymmetric IOP relative to glaucoma therapy," the study authors said in the September issue of Archives of Ophthalmology.