Elsevier

Ophthalmology

Volume 117, Issue 9, September 2010, Pages 1700-1704
Ophthalmology

Original article
Diurnal Intraocular Pressure Patterns are Not Repeatable in the Short Term in Healthy Individuals

https://doi.org/10.1016/j.ophtha.2010.01.044Get rights and content

Purpose

To evaluate the short-term repeatability of diurnal intraocular pressure (IOP) patterns in eyes of subjects without glaucoma.

Design

Observational cohort study.

Participants

Forty healthy subjects without glaucoma.

Methods

Subjects underwent 12-hour diurnal IOP assessment sessions from 8:00 am to 8:00 pm on 2 visits 1 week apart. Intraocular pressure was assessed by Goldmann applanation tonometry. An analysis was performed to determine the agreement of individual diurnal IOP patterns from the first visit to the second visit. The intraclass correlation coefficient (ICC) was used to analyze both agreement of IOP values at each time point between visits and IOP change over periods between time points between visits.

Main Outcome Measures

Diurnal IOP patterns.

Results

Between-visit agreement of IOP values at each time point generally was fair to good, with ICCs ranging from 0.37 to 0.62 in right eyes and from 0.35 to 0.71 in left eyes. Between-visit agreement of IOP change over time between time points was uniformly poor and often below that expected by chance alone, with ICCs ranging from −0.25 to 0.15 in right eyes and from −0.40 to 0.22 in left eyes.

Conclusions

Eyes of healthy individuals do not manifest a sustained and reproducible diurnal IOP pattern when measured by Goldmann tonometry. A single-day assessment of IOP incompletely characterizes the diurnal IOP pattern.

Financial Disclosure(s)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Section snippets

Patients and Methods

This prospective study was reviewed and approved by the West Virginia University Institutional Review Board. The study was conducted in accordance with the tenets of the Declaration of Helsinki. All participating subjects provided written informed consent. Subjects were recruited between April 3, 2006, and April 16, 2007; the last subject exited the study on April 14, 2008. Participants were 18 years of age or older and were healthy. All subjects underwent a complete ophthalmologic examination

Results

Overall, 44 subjects without glaucoma were enrolled in this study, of whom 40 attended both visits 1 and 2 and were included in this analysis. All included subjects were white, 65% (26/40) were female, and the mean age±standard deviation was 66.5±12.9 years.

Mean IOP values by eye, time point, and visit are given in Table 1. Intraocular pressure values consistently were lower at visit 2 compared with visit 1, although the difference was not statistically significant at any time point in either

Discussion

These data show that individual eyes of healthy subjects do not follow a conserved IOP pattern from day to day. There was fair to good agreement for IOP at any given time on different days, but essentially no agreement for IOP change between time points on different days.

There are few data in the literature regarding the repeatability of IOP patterns in normal eyes over time. The evaluation by Daubs1 of a small group of airline pilots did not include a formal evaluation of IOP pattern

References (10)

There are more references available in the full text version of this article.

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Manuscript no. 2009-1295.

Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Supported by the National Eye Institute, Bethesda, Maryland (grant nos.: K23EY018859 and R03EY015682 [TR]); and by an unrestricted grant to West Virginia University from Research to Prevent Blindness, Inc., New York, New York.

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