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Medication use for glaucoma, ocular hypertension affected by variable IOP
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Day-to-day variability of IOP in glaucoma and ocular hypertension patients weakens the estimation of medication effectiveness, according to a study.
A prospective cohort study of 30 patients examined the daily repeatability of IOP measurements. Patients in the study were taking bilateral antihypertensive medication for either primary open-angle glaucoma or ocular hypertension with IOP higher than 21 mm Hg in both eyes.
IOP measurements were taken at 8 a.m., 11 a.m. and 4 p.m. at three weekly visits for 7 weeks. The mean of the three IOP readings defined diurnal IOP. Measurements were taken by masked Goldmann tonometry, and the right eye was always measured first.
Both eyes were left untreated during the first three visits. After the third visit, patients were given travoprost in the eye with higher IOP, and travoprost was used in both eyes after the fourth visit.
Using the mean IOP vs. data from a single time improved the precision of repeatability of diurnal measurements. Before treatment, precision improved from ±18.4% to ±13.3%; after treatment, precision improved from ±20.9% to ±16.1%.
“Within these constraints, it is clear that even under ideal conditions, day-to-day variability significantly undermines the precision of IOP measurement and of the estimation of medication effectiveness even when the time of day is standardized,” the study authors said.
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Br J Ophthalmol. 2012;96(7):967-970.
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