| Objective:Glaucoma is a neurodegenerative eye disease,and is the leading cause of irreversible blindness.Primary open angle glaucoma is the most common eye disease in glaucoma,there is no clear pathogenesis,the main reason is the characteristic visual field and optic nerve damage caused by the pathological elevation of intraocular pressure.Intraocular pressure(IOP)is an important index in the diagnosis and evaluation of curative effect in patients with primary glaucoma.Although IOP is a biological indicator of dynamic changes,most of the patients' intraocular pressure is measured only once during the visit,which can not reflect the changing trend of intraocular pressure in one day.With the development of intraocular pressure measurement in 24 hours,accurate measurement of intraocular pressure at night becomes more and more important to the fluctuation of intraocular pressure in 24 hours,24-hour IOP changes may play an important role in the diagnosis,treatment and prognosis of glaucoma.Habitual posture(sitting during the day,lying at night)measuring intraocular pressure for 24 hours is more in line with daily physiological activities.The purpose of this study was to explore the difference and correlation between NCT and Accupen in measuring intraocular pressure in 24 hours under traditional posture;variation of 24-hour intraocular pressure measurement in traditional and habitual postures,to guide the diagnosis and treatment of clinical glaucoma diseases.Methods:From February 2016 to October 2016,we collected all suspected open-angle glaucoma patients who met the criteria of inclusion and exclusion in the ophthalmological outpatient clinic of the Second Hospital of Dalian Medical university,male and female,aged between 25 and 65,all participants sign informed consent.By using Accupen tonometer(24-3000,America)and non-contact tonometer(NCT,CT-80A,TOPCON Company,Japan)from 7:30 AM to 9:30 AM next day(oncein2hours).At7:30AM,9:30AM,11:30AM,13:30PM,15:30PM,17:30PM,19:30P M,21:30PM,all subjects were measured in a sitting position(using NCT for 5 minutes and then using Accupen tonometer),at 23:30PM,1:30AM,3:30AM,05:30AM,Accupen tonometer was used to measure the intraocular pressure in lying position and sitting position,and then NCT was used to measure IOP in sitting position.Results:1.Suspected open-angle glaucoma patients were collected from February 2016 to October 2016 in the ophthalmological outpatient clinic of ×× Hospital,in all of 96 eyes,26(54.17%)males and 22(45.83%)females were involved in our study with an average age of(44.90±15.84),Corneal thickness:right eyes 562.49 ±37.956um,left eyes566.98±40.187um.30-2 automatic visual field meter:right eyes-4.5632±4.31112dB,left eyes-2.9830±3.30184 dB.2.A morning peak of IOP was shown at7:30AM in traditional position by using two measures with(22.05±3.60)mmHg of NCT tonometer and(19.79±4.147)mmHg of Accupen tonometer,Valley IOP at 21:30pm,The results of NCT IOP were 18.92 ±2.951 mmHg,Accupen were 15.73 ±3.649 mmHg.3.Comparison of 24-hour intraocular pressure fluctuation curves measured by Accupen tonometer between traditional and habitual postures3.1 Comparative analysis of time points of peak intraocular pressure in two postures:Whether in traditional posture or habitual body,the peak of intraocular pressure appeared at 3:00AM-9:00AM.Both positions showed IOP trend of going up at night and then declining in the morning.The peak IOP in traditional position appeared in 7:30AMwith(19.79±4.147)mmHg in 35(36.5%)eyes,while the peak IOP in habitual position appeared in 5:30AM with(21.64±4.814)mmHg in 34(35.4%)eyes.3.2 Comparative analysis of time points of intraocular pressure in two kinds of postures:the 24-hour intraocular pressure trough values were found at 19:30 PM-21:30 PM for both body positions,the valley IOP in traditional position appeared in 21:30PM with(18.92±2.951)mmHg in 30(31.3%)eyes,while the valley IOP in habitual position appeared in 21:30PM with(15.73±3.649)mmHg in 31(32.3%)eyes.3.3 Accupen tonometer was used to measure the intraocular pressure in sitting position and lying position at night:The intraocular pressure of 24 hours was more fluctuating than that of the traditional position,and the lying IOP of sleep time was higher than that of sitting position.Conclusions:1.The peak IOP of suspected open-angle glaucoma patients mostly appeared at 05:30AM in the morning,and most of the valley IOP occurred at 21:30PM;there is a good correlation between non-contact tonometer and Accupen tonometer.2.Habitual posture can improve the positive rate of glaucoma patients better than traditional intraocular pressure measurement in 24 hours,Accupen tonometer is a good instrument for measuring IOP,it can be used to monitor IOP in clinical habitual posture for 24 hours. |
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