Korean J Ophthalmol.  2017 Apr;31(2):132-137. 10.3341/kjo.2017.31.2.132.

Long-term Reliability of Diurnal Intraocular Pressure Patterns in Healthy Asians

• Chun YS
• Park IK
• Shin KU
• Kim JM

• KMID: 2373469
• DOI: http://doi.org/10.3341/kjo.2017.31.2.132

Abstract

PURPOSE
To determine the long-term repeatability of diurnal intraocular pressure (IOP) patterns in healthy Asian subjects without glaucoma.
METHODS
Twenty-three eyes in 23 healthy Asian subjects without glaucoma underwent diurnal IOP measurements using Goldmann applanation tonometry every 2 hours from 9 AM to 11 PM during two visits that were 8 weeks apart. To validate repeatability between visits, we calculated intra-class correlation coefficients (ICCs) mean IOP, peak IOP, minimum IOP, and IOP fluctuation at each time point and expressed the results as the difference between peak IOP and minimum IOP or as the standard deviation of all diurnal IOP values in the diurnal IOP curve.
RESULTS
IOP repeatability was excellent at all time points, with ICCs ranging from 0.812 to 0.946 (p < 0.001). The 9 AM IOP showed the best repeatability between visits (ICCs, 0.946). Repeatability of mean IOP, peak IOP, and minimum IOP was also excellent (ICCs ranging from 0.899 to 0.929). However, IOP fluctuations showed poor repeatability, with an ICC lower than 0.15.
CONCLUSIONS
Long-term repeatability of diurnal IOP patterns in healthy Asian subjects was excellent. These findings suggest that IOP measurements at standardized times of the day will be useful for assessing the effectiveness of glaucoma therapy.

Keyword

Diurnal rhythm; Intraocular pressure; Repeatability

MeSH Terms

Asian Continental Ancestry Group*
Circadian Rhythm
Glaucoma
Humans
Intraocular Pressure*
Manometry

Reference

1. Sommer A. Intraocular pressure and glaucoma. Am J Ophthalmol. 1989; 107:186–188.

2. The Advanced Glaucoma Intervention Study (AGIS): 7. the relationship between control of intraocular pressure and visual field deterioration. The AGIS Investigators. Am J Ophthalmol. 2000; 130:429–440.

3. Leske MC, Heijl A, Hussein M, et al. Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial. Arch Ophthalmol. 2003; 121:48–56.

4. Buguet A, Py P, Romanet JP. 24-Hour (nyctohemeral) and sleep-related variations of intraocular pressure in healthy white individuals. Am J Ophthalmol. 1994; 117:342–347.

5. Liu JH. Circadian rhythm of intraocular pressure. J Glaucoma. 1998; 7:141–147.

6. Liu JH, Kripke DF, Hoffman RE, et al. Nocturnal elevation of intraocular pressure in young adults. Invest Ophthalmol Vis Sci. 1998; 39:2707–2712.

7. Liu JH, Kripke DF, Twa MD, et al. Twenty-four-hour pattern of intraocular pressure in the aging population. Invest Ophthalmol Vis Sci. 1999; 40:2912–2917.

8. Mosaed S, Liu JH, Weinreb RN. Correlation between office and peak nocturnal intraocular pressures in healthy subjects and glaucoma patients. Am J Ophthalmol. 2005; 139:320–324.

9. Liu JH, Zhang X, Kripke DF, Weinreb RN. Twenty-four-hour intraocular pressure pattern associated with early glaucomatous changes. Invest Ophthalmol Vis Sci. 2003; 44:1586–1590.

10. Friberg TR, Sanborn G, Weinreb RN. Intraocular and episcleral venous pressure increase during inverted posture. Am J Ophthalmol. 1987; 103:523–526.

11. Lee JY, Yoo C, Jung JH, et al. The effect of lateral decubitus position on intraocular pressure in healthy young subjects. Acta Ophthalmol. 2012; 90:e68–e72.

12. Lee JY, Yoo C, Kim YY. The effect of lateral decubitus position on intraocular pressure in patients with untreated open-angle glaucoma. Am J Ophthalmol. 2013; 155:329–335.

13. Kim KN, Jeoung JW, Park KH, et al. Effect of lateral decubitus position on intraocular pressure in glaucoma patients with asymmetric visual field loss. Ophthalmology. 2013; 120:731–735.

14. Lee TE, Yoo C, Kim YY. Effects of different sleeping postures on intraocular pressure and ocular perfusion pressure in healthy young subjects. Ophthalmology. 2013; 120:1565–1570.

15. Weitzman ED, Henkind P, Leitman M, Hellman L. Correlative 24-hour relationships between intraocular pressure and plasma cortisol in normal subjects and patients with glaucoma. Br J Ophthalmol. 1975; 59:566–572.

16. Levi L, Schwartz B. Decrease of ocular pressure with oral metyrapone: a double-masked crossover trial. Arch Ophthalmol. 1987; 105:777–781.

17. Sheridan PT, Brubaker RF, Larsson LI, et al. The effect of oral dexamethasone on the circadian rhythm of aqueous humor flow in humans. Invest Ophthalmol Vis Sci. 1994; 35:1150–1156.

18. Sit AJ, Nau CB, McLaren JW, et al. Circadian variation of aqueous dynamics in young healthy adults. Invest Ophthalmol Vis Sci. 2008; 49:1473–1479.

19. Liu JH, Shieh BE. Suprachiasmatic nucleus in the neural circuitry for the circadian elevation of intraocular pressure in rabbits. J Ocul Pharmacol Ther. 1995; 11:379–388.

20. McLaren JW, Brubaker RF, FitzSimon JS. Continuous measurement of intraocular pressure in rabbits by telemetry. Invest Ophthalmol Vis Sci. 1996; 37:966–975.

21. Schnell CR, Debon C, Percicot CL. Measurement of intraocular pressure by telemetry in conscious, unrestrained rabbits. Invest Ophthalmol Vis Sci. 1996; 37:958–965.

22. Qureshi IA, Xiao RX, Yang BH, et al. Seasonal and diurnal variations of ocular pressure in ocular hypertensive subjects in Pakistan. Singapore Med J. 1999; 40:345–348.

23. Qureshi IA, Xi XR, Khan IH, et al. Monthly measurements of intraocular pressure in normal, ocular hypertensive, and glaucoma male subjects of same age group. Changgeng Yi Xue Za Zhi. 1997; 20:195–200.

24. Hatanaka M, Babic M, Susanna R Jr. Twenty-four-hour repeatability of diurnal intraocular pressure patterns in glaucomatous and ocular hypertensive individuals. Clinics (Sao Paulo). 2011; 66:1235–1236.

25. Hatanaka M, Babic M, Susanna R Jr. Reproducibility of the mean, fluctuation, and IOP peak in the diurnal tension curve. J Glaucoma. 2013; 22:390–392.

26. Mottet B, Chiquet C, Aptel F, et al. 24-Hour intraocular pressure of young healthy humans in supine position: rhythm and reproducibility. Invest Ophthalmol Vis Sci. 2012; 53:8186–8191.

27. Daubs JG. Patterns of diurnal variation in the intraocular pressure of airline pilots. Aerosp Med. 1973; 44:914–917.

28. Realini T, Weinreb RN, Wisniewski S. Short-term repeatability of diurnal intraocular pressure patterns in glaucomatous individuals. Ophthalmology. 2011; 118:47–51.

29. Realini T, Weinreb RN, Wisniewski SR. Diurnal intraocular pressure patterns are not repeatable in the short term in healthy individuals. Ophthalmology. 2010; 117:1700–1704.

30. Wilensky JT, Gieser DK, Dietsche ML, et al. Individual variability in the diurnal intraocular pressure curve. Ophthalmology. 1993; 100:940–944.

31. Rudnicka AR, Mt-Isa S, Owen CG, et al. Variations in primary open-angle glaucoma prevalence by age, gender, and race: a Bayesian meta-analysis. Invest Ophthalmol Vis Sci. 2006; 47:4254–4261.

32. Kim CS, Seong GJ, Lee NH, et al. Prevalence of primary open-angle glaucoma in central South Korea the Namil study. Ophthalmology. 2011; 118:1024–1030.

33. Stein JD, Kim DS, Niziol LM, et al. Differences in rates of glaucoma among Asian Americans and other racial groups, and among various Asian ethnic groups. Ophthalmology. 2011; 118:1031–1037.

34. Chylack LT Jr, Wolfe JK, Singer DM, et al. The Lens Opacities Classification System III: the longitudinal study of Cataract Study Group. Arch Ophthalmol. 1993; 111:831–836.

35. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977; 33:159–174.

36. de Venecia G, Davis MD. Diurnal variation of intraocular pressure in the normal eye. Arch Ophthalmol. 1963; 69:752–757.

37. Song YK, Lee CK, Kim J, et al. Instability of 24-hour intraocular pressure fluctuation in healthy young subjects: a prospective, cross-sectional study. BMC Ophthalmol. 2014; 14:127.

38. Asrani S, Zeimer R, Wilensky J, et al. Large diurnal fluctuations in intraocular pressure are an independent risk factor in patients with glaucoma. J Glaucoma. 2000; 9:134–142.

39. Wilensky JT. The role of diurnal pressure measurements in the management of open angle glaucoma. Curr Opin Ophthalmol. 2004; 15:90–92.

40. Suh W, Kee C. Namil Study Group and Korean Glaucoma Society. The distribution of intraocular pressure in urban and in rural populations: the Namil study in South Korea. Am J Ophthalmol. 2012; 154:99–106.