Diagnostic Value on 24-Hour Monitoring of Intraocular Pressure for Primary Open Angle Glaucoma_Chinese Journal of Evidence-Based Medicine

Authors：

 LIUJuan-juan ¹ , LIMan ¹ , MOUZhang-bing ¹ , CHENXiao-ming ² , WENHong ¹ , YINJian-ying ¹ ,  WANGYing-qiang ³

1. Department of Ophthalmology, 363 Hospital, Chengdu 610041, China;
2. Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, China;
3. Department of Administration, 363 Hospital, Chengdu 610041, China;

Corresponding?author：

WANGYing-qiang, Email: wyqchengdu@163.com

Keywords：

Glaucoma; Open angle; 24 hour intraocular pressure; Diagnosis; Sensitivity; Specificity

DOI：

10.7507/1672-2531.20160100

Video：

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Objective To explore the diagnostic value on 24 hour monitoring of intraocular pressure (IOP) for primary open angle glaucoma (POAG). Methods A prospective study was applied, and a total of 372 subjects through January 2012 to May 2015 for 24 hour IOP monitoring were collected successively, including 137 subjects (271 eyes) with glaucoma (glaucoma group) and 235 subjects (470 eyes) with non-glaucoma (Control group). Data was analyzed using SPSS 13.0 software, and the Kappa statistics was used to evaluate concordance between 24 hour monitoring of IOP and gold standard for POAG diagnosis. Results The mean value of IOP at all monitoring period in glaucoma group was significant higher than that in the control group (P < 0.001). The peak of IOP occurred at 6:00 am and 10:00 in the glaucoma group, and the fluctuation value of IOP in women patients at night (especially at 22:00 pm) was higher than that of men (t=2.064, P=0.04). The sensitivity and specificity of 24 hour IOP monitoring for POAG were 97% and 78.7%, respectively, and with a high consistency comparing to the result of gold standard for POAG diagnosis, with the Kappa values of 0.707 (P < 0.000?1). Conclusion 24 hour IOP monitoring is efficacy and convenient tool, which can be applied alone or combined with other tools to assist early diagnosis patients who are suspected with POAG, so as to improve the diagnostic accuracy.

Citation： LIUJuan-juan, LIMan, MOUZhang-bing, CHENXiao-ming, WENHong, YINJian-ying, WANGYing-qiang. Diagnostic Value on 24-Hour Monitoring of Intraocular Pressure for Primary Open Angle Glaucoma. Chinese Journal of Evidence-Based Medicine, 2016, 16(6): 646-650. doi: 10.7507/1672-2531.20160100 Copy

1.	?Cheng JW, Cheng SW, Ma XY, et al. The prevalence of primary glaucoma in mainland China: a systematic review and meta-analysis. J Glaucoma, 2013, 22(4): 301-306.
2.	趙欣, 郝云鶴, 田碧琪, 等. 北京市西長安街社區50歲以上人群青光眼調查. 眼科, 2010, 19(1): 37-42.
3.	李美玉. 青光眼學. 第一版. 北京: 人民衛生出版社, 2004: 688.
4.	汪俊, 崔巍. 我國原發性青光眼流行病學研究進展. 國際眼科雜志, 2012, 12(4): 667-670.
5.	中華醫學會眼科學分會青光眼學組. 我國原發性青光眼診斷和治療專家共識. 中華眼科雜志, 2008, 44(9): 862-863.
6.	中華醫學會眼科學分會青光眼學組. 我國原發性青光眼診斷和治療專家共識(2014年). 中華眼科雜志, 2014, 50(5): 382-383.
7.	李媚, 肖輝, 鐘毅敏, 等. 夜間眼壓測量在原發性開角型青光眼診斷中的作用. 中山大學學報(醫學科學版), 2009, 30(5): 585-590.
8.	Renard E, Palombi K, Gronfier C, et al. Twenty-four hour (Nyctohemeral) rhythm of intraocular pressure and ocular perfusion pressure in normal-tension glaucoma. Invest Ophth Vis Sci, 2010, 51(2): 882-889.
9.	張金順, 彭壽雄, 林明楷, 等. 原發性開角型青光眼患者24小時眼壓變動規律的臨床研究. 眼科學報, 2005, 21(4): 127-130.
10.	Fogagnolo P, Capizzi F, Orzalesi N, et al. Can mean central corneal thickness and its 24-hour fluctuation influence fluctuation of intraocular pressure? J Glaucoma, 2010, 19(6): 418-423.
11.	Smedowski A, Weglarz B, Tarnawska D, et al. Comparison of three intraocular pressure measurement methods including biomechanical properties of the cornea. Invest Ophth Vis Sci, 2014, 55(2): 666-673.
12.	Hollo G, Kothy P, Vargha P. Evaluation of continuous 24-hour intraocular pressure monitoring for assessment of prostaglandin-induced pressure reduction in glaucoma. J Glaucoma, 2014, 23(1): e6-12.
13.	北京醫學會眼科學分會. 關于24小時眼壓監測規范的探討. 中華眼科雜志, 2014, 50(5): 384-385.
14.	Barkana Y. Postural change in intraocular pressure: a comparison of measurement with a Goldmann tonometer, Tonopen XL, pneumatonometer, and HA-2. J Glaucoma, 2014, 23(1): e23-28.
15.	肖明, 孫興懷, 孟樊榮, 等. 原發性開角型青光眼與正常眼24小時眼壓波動規律. 中華醫學雜志, 2011, 91(7): 441-444.
16.	彭麗輝, 曾慶梅, 林先軒, 等. 不同眼壓計對可疑青光眼患者眼壓測量的研究. 中華全科醫學, 2010, 8(12): 1501-1502.
17.	甄毅, 王寧利, 郭彥, 等. 不同眼壓計類型和測量體位對青光眼眼壓測量值的影響. 眼科研究, 2009, 27(1): 55-58.
18.	肖思瑜, 李青, 劉華英, 等. 體位對青光眼患者眼壓的影響. 國際眼科雜志, 2012, 12(5): 973-975.
19.	房召彬, 肖明. 24小時眼壓監測中夜間眼壓測量方法的探討. 中國眼耳鼻喉科雜志, 2011, 11(2): 98-99.
20.	Hughes E, Spry P, Diamond J. 24-hour monitoring of intraocular pressure in glaucoma management: a retrospective review. J Glaucoma, 2003, 12(3): 232-236.
21.	李雪靜, 具爾提·哈地爾, 陳雪藝. 原發性青光眼OCT與FDT診斷準確性研究. 國際眼科雜志, 2010, 10(6): 1079-1081.
22.	靳琳, 原慧萍. 24小時眼壓的研究進展. 醫學綜述, 2013, 19(10): 1816-1819.
23.	張磊, 戴萍萍, 王強, 等. 角膜厚度與高眼壓癥及正常人眼壓的關系探討. 濱州醫學院學報, 2007, 30(3): 175-177.
24.	李斌, 蘇法仁, 王為農. 角膜中央厚度對壓平眼壓的影響及其臨床意義. 山東大學基礎醫學院學報, 2002, 16(5): 293-296.

1. ?Cheng JW, Cheng SW, Ma XY, et al. The prevalence of primary glaucoma in mainland China: a systematic review and meta-analysis. J Glaucoma, 2013, 22(4): 301-306.
2. 趙欣, 郝云鶴, 田碧琪, 等. 北京市西長安街社區50歲以上人群青光眼調查. 眼科, 2010, 19(1): 37-42.
3. 李美玉. 青光眼學. 第一版. 北京: 人民衛生出版社, 2004: 688.
4. 汪俊, 崔巍. 我國原發性青光眼流行病學研究進展. 國際眼科雜志, 2012, 12(4): 667-670.
5. 中華醫學會眼科學分會青光眼學組. 我國原發性青光眼診斷和治療專家共識. 中華眼科雜志, 2008, 44(9): 862-863.
6. 中華醫學會眼科學分會青光眼學組. 我國原發性青光眼診斷和治療專家共識(2014年). 中華眼科雜志, 2014, 50(5): 382-383.
7. 李媚, 肖輝, 鐘毅敏, 等. 夜間眼壓測量在原發性開角型青光眼診斷中的作用. 中山大學學報(醫學科學版), 2009, 30(5): 585-590.
8. Renard E, Palombi K, Gronfier C, et al. Twenty-four hour (Nyctohemeral) rhythm of intraocular pressure and ocular perfusion pressure in normal-tension glaucoma. Invest Ophth Vis Sci, 2010, 51(2): 882-889.
9. 張金順, 彭壽雄, 林明楷, 等. 原發性開角型青光眼患者24小時眼壓變動規律的臨床研究. 眼科學報, 2005, 21(4): 127-130.
10. Fogagnolo P, Capizzi F, Orzalesi N, et al. Can mean central corneal thickness and its 24-hour fluctuation influence fluctuation of intraocular pressure? J Glaucoma, 2010, 19(6): 418-423.
11. Smedowski A, Weglarz B, Tarnawska D, et al. Comparison of three intraocular pressure measurement methods including biomechanical properties of the cornea. Invest Ophth Vis Sci, 2014, 55(2): 666-673.
12. Hollo G, Kothy P, Vargha P. Evaluation of continuous 24-hour intraocular pressure monitoring for assessment of prostaglandin-induced pressure reduction in glaucoma. J Glaucoma, 2014, 23(1): e6-12.
13. 北京醫學會眼科學分會. 關于24小時眼壓監測規范的探討. 中華眼科雜志, 2014, 50(5): 384-385.
14. Barkana Y. Postural change in intraocular pressure: a comparison of measurement with a Goldmann tonometer, Tonopen XL, pneumatonometer, and HA-2. J Glaucoma, 2014, 23(1): e23-28.
15. 肖明, 孫興懷, 孟樊榮, 等. 原發性開角型青光眼與正常眼24小時眼壓波動規律. 中華醫學雜志, 2011, 91(7): 441-444.
16. 彭麗輝, 曾慶梅, 林先軒, 等. 不同眼壓計對可疑青光眼患者眼壓測量的研究. 中華全科醫學, 2010, 8(12): 1501-1502.
17. 甄毅, 王寧利, 郭彥, 等. 不同眼壓計類型和測量體位對青光眼眼壓測量值的影響. 眼科研究, 2009, 27(1): 55-58.
18. 肖思瑜, 李青, 劉華英, 等. 體位對青光眼患者眼壓的影響. 國際眼科雜志, 2012, 12(5): 973-975.
19. 房召彬, 肖明. 24小時眼壓監測中夜間眼壓測量方法的探討. 中國眼耳鼻喉科雜志, 2011, 11(2): 98-99.
20. Hughes E, Spry P, Diamond J. 24-hour monitoring of intraocular pressure in glaucoma management: a retrospective review. J Glaucoma, 2003, 12(3): 232-236.
21. 李雪靜, 具爾提·哈地爾, 陳雪藝. 原發性青光眼OCT與FDT診斷準確性研究. 國際眼科雜志, 2010, 10(6): 1079-1081.
22. 靳琳, 原慧萍. 24小時眼壓的研究進展. 醫學綜述, 2013, 19(10): 1816-1819.
23. 張磊, 戴萍萍, 王強, 等. 角膜厚度與高眼壓癥及正常人眼壓的關系探討. 濱州醫學院學報, 2007, 30(3): 175-177.
24. 李斌, 蘇法仁, 王為農. 角膜中央厚度對壓平眼壓的影響及其臨床意義. 山東大學基礎醫學院學報, 2002, 16(5): 293-296.

Chinese Journal of Evidence-Based Medicine

Diagnostic Value on 24-Hour Monitoring of Intraocular Pressure for Primary Open Angle Glaucoma

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