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.	赵欣, 郝云鹤, 田碧琪, 等. 北京市西长安街社区50岁以上人群青光眼调查. 眼科, 2010, 19(1): 37-42.
3.	李美玉. 青光眼学. 第一版. 北京: 人民卫生出版社, 2004: 688.
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5.	中华医学会眼科学分会青光眼学组. 我国原发性青光眼诊断和治疗专家共识. 中华眼科杂志, 2008, 44(9): 862-863.
6.	中华医学会眼科学分会青光眼学组. 我国原发性青光眼诊断和治疗专家共识(2014年). 中华眼科杂志, 2014, 50(5): 382-383.
7.	李媚, 肖辉, 钟毅敏, 等. 夜间眼压测量在原发性开角型青光眼诊断中的作用. 中山大学学报(医学科学版), 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.	张金顺, 彭寿雄, 林明楷, 等. 原发性开角型青光眼患者24小时眼压变动规律的临床研究. 眼科学报, 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.	北京医学会眼科学分会. 关于24小时眼压监测规范的探讨. 中华眼科杂志, 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, 孙兴怀, 孟樊荣, 等. 原发性开角型青光眼与正常眼24小时眼压波动规律. 中华医学杂志, 2011, 91(7): 441-444.
16.	彭丽辉, 曾庆梅, 林先轩, 等. 不同眼压计对可疑青光眼患者眼压测量的研究. 中华全科医学, 2010, 8(12): 1501-1502.
17.	甄毅, 王宁利, 郭彦, 等. 不同眼压计类型和测量体位对青光眼眼压测量值的影响. 眼科研究, 2009, 27(1): 55-58.
18.	肖思瑜, 李青, 刘华英, 等. 体位对青光眼患者眼压的影响. 国际眼科杂志, 2012, 12(5): 973-975.
19.	房召彬, 肖明. 24小时眼压监测中夜间眼压测量方法的探讨. 中国眼耳鼻喉科杂志, 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.	李雪静, 具尔提·哈地尔, 陈雪艺. 原发性青光眼OCT与FDT诊断准确性研究. 国际眼科杂志, 2010, 10(6): 1079-1081.
22.	靳琳, 原慧萍. 24小时眼压的研究进展. 医学综述, 2013, 19(10): 1816-1819.
23.	张磊, 戴萍萍, 王强, 等. 角膜厚度与高眼压症及正常人眼压的关系探讨. 滨州医学院学报, 2007, 30(3): 175-177.
24.	李斌, 苏法仁, 王为农. 角膜中央厚度对压平眼压的影响及其临床意义. 山东大学基础医学院学报, 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. 赵欣, 郝云鹤, 田碧琪, 等. 北京市西长安街社区50岁以上人群青光眼调查. 眼科, 2010, 19(1): 37-42.
3. 李美玉. 青光眼学. 第一版. 北京: 人民卫生出版社, 2004: 688.
4. 汪俊, 崔巍. 我国原发性青光眼流行病学研究进展. 国际眼科杂志, 2012, 12(4): 667-670.
5. 中华医学会眼科学分会青光眼学组. 我国原发性青光眼诊断和治疗专家共识. 中华眼科杂志, 2008, 44(9): 862-863.
6. 中华医学会眼科学分会青光眼学组. 我国原发性青光眼诊断和治疗专家共识(2014年). 中华眼科杂志, 2014, 50(5): 382-383.
7. 李媚, 肖辉, 钟毅敏, 等. 夜间眼压测量在原发性开角型青光眼诊断中的作用. 中山大学学报(医学科学版), 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. 张金顺, 彭寿雄, 林明楷, 等. 原发性开角型青光眼患者24小时眼压变动规律的临床研究. 眼科学报, 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. 北京医学会眼科学分会. 关于24小时眼压监测规范的探讨. 中华眼科杂志, 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, 孙兴怀, 孟樊荣, 等. 原发性开角型青光眼与正常眼24小时眼压波动规律. 中华医学杂志, 2011, 91(7): 441-444.
16. 彭丽辉, 曾庆梅, 林先轩, 等. 不同眼压计对可疑青光眼患者眼压测量的研究. 中华全科医学, 2010, 8(12): 1501-1502.
17. 甄毅, 王宁利, 郭彦, 等. 不同眼压计类型和测量体位对青光眼眼压测量值的影响. 眼科研究, 2009, 27(1): 55-58.
18. 肖思瑜, 李青, 刘华英, 等. 体位对青光眼患者眼压的影响. 国际眼科杂志, 2012, 12(5): 973-975.
19. 房召彬, 肖明. 24小时眼压监测中夜间眼压测量方法的探讨. 中国眼耳鼻喉科杂志, 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. 李雪静, 具尔提·哈地尔, 陈雪艺. 原发性青光眼OCT与FDT诊断准确性研究. 国际眼科杂志, 2010, 10(6): 1079-1081.
22. 靳琳, 原慧萍. 24小时眼压的研究进展. 医学综述, 2013, 19(10): 1816-1819.
23. 张磊, 戴萍萍, 王强, 等. 角膜厚度与高眼压症及正常人眼压的关系探讨. 滨州医学院学报, 2007, 30(3): 175-177.
24. 李斌, 苏法仁, 王为农. 角膜中央厚度对压平眼压的影响及其临床意义. 山东大学基础医学院学报, 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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