Long-term home monitoring of intraocular pressure in pediatric glaucoma
| Autor: | Derek P. Bitner, Sharon F. Freedman |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Intraocular pressure genetic structures Glaucoma Context (language use) Diurnal fluctuation Tonometry Ocular 03 medical and health sciences 0302 clinical medicine Ophthalmology Humans Medicine Prospective Studies Child Prospective cohort study Finland Intraocular Pressure business.industry Mean age medicine.disease eye diseases Pediatrics Perinatology and Child Health 030221 ophthalmology & optometry Female Pediatric glaucoma Electronic data sense organs business 030217 neurology & neurosurgery |
| Zdroj: | Journal of American Association for Pediatric Ophthalmology and Strabismus. 20:515-518 |
| ISSN: | 1091-8531 |
| Popis: | Diurnal fluctuation of intraocular pressure (IOP), implicated in progression of adult glaucoma, has been reported in children only in the context of office and short-term home monitoring. The purpose of this study was to evaluate long-term patterns of IOP fluctuation and changes resulting from outflow-enhancing intervention in pediatric glaucoma.Parent-measured home-based rebound tonometry (Icare, Finland Oy) in pediatric glaucoma patients was studied prospectively. IOP was monitored for more than 1 month, with requested measurements at least 3 times daily. Demographic and glaucoma-related information were collected for each participant. IOP was recorded at home on electronic data sheets. It was then evaluated for trends including mean overall IOP, IOP pre- and post-planned IOP-lowering interventions, and IOP spikes over determined time intervals.IOP was measured in 14 eyes of 7 children (mean age, 9.3 ± 2.4 years) over a mean of 164.3 days (range, 75-341), with a mean of 2.46 readings daily. Six eyes of 5 children underwent attempted outflow improvement, with improved mean IOP before versus after intervention (26.6 vs 15.5 mm Hg, P 0.0001) and decreased mean daily IOP fluctuation (8.4 vs 4.6 mm Hg, P 0.001) for each. An IOP reading 20% greater than mean for an individual eye over the entire period (a pressure "spike") occurred in 19.3 ± 6.7% over 1 day, 62.9 ± 18.0% over 3 days, 80.8 ± 12.2% over 7 days, and 92.9 ± 9.4% over 14 days.Long-term home monitoring in pediatric glaucoma proved feasible in this study population and often demonstrated large IOP fluctuations. A 14-day period of home monitoring provided90% chance of identifying an IOP spike. Successful outflow improvement lowered both mean IOP and mean daily IOP fluctuations. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect