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  • Glaucoma Risk Stratification and 24-Hour IOP Monitoring

    By Lynda Seminara
    Selected By: Neil M. Bressler, MD, and Deputy Editors
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    Journal Highlights

    JAMA Ophthalmology, July 2018

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    Although 24-hour wireless monitor­ing of intraocular pressure (IOP) is practical and effective, it is currently unknown whether the information it yields is useful for glaucoma risk strat­ification. De Moraes et al. compared findings from recording sessions with data from visual field (VF) exams and noted that the recording patterns pro­vided a signature that was associated with previous VF progression.

    For this study, 445 patients (445 eyes) with open-angle glaucoma underwent a 24-hour recording session with a contact lens sensor (CLS) system. The researchers used the Triggerfish (Sen­simed AG) device, which captures 300 data points over a 30-second period every 5 minutes. Participants were re­quired to have undergone at least 3 re­liable VF tests before this study began. The primary outcome measure was the association between CLS-generated variables and the rates of VF change.

    At the time of CLS recording, mean deviation (MD) was −9.0 dB. The mean rate of MD change was −0.46 dB/year in 5.2 years of follow-up. After adjustment for baseline MD severity, age, and treatment, the following CLS variables were associated with rapid VF progression: mean peak ratio while awake (β = −0.021), number of long peaks during sleep (β = 0.036), night bursts ocular pulse frequency standard deviation (β = 0.027), and night bursts ocular pulse amplitude standard devia­tion (β = 19.739). For correlation with progression, CLS data were superior to the Goldmann measurements obtained during follow-up visits.

    Findings from this multicenter study corroborate those of a smaller single-site study and demonstrate that a 24-hour CLS recording session may assist in risk stratification. According to the authors, information generated by the CLS system may help to predict the risk of future functional loss, even for pa­tients whose historical VF information is insufficient.

    The original article can be found here.