Changes in Chronorhythmologic Organization of Intraocular Pressure (IOP) in Case of Primary Open-Angle Glaucoma

 

Authors: Mykytiuk O.,Pirozhok I.,

 

Abstract:

Introduction: On the recent decades the problem of early diagnostics and appropriate treatment of primary open-angle glaucoma requires detailed research in clinical ophthalmology.  According to the results of previous studies IOP is characterized by expressed circadian periodicity, but the precise characteristics of its chrono-organization in case of various pathologic stages are not quite well defined.

Aim: The description of IOP rhythm in Norma and pathology with evaluation of differences in IOP chrono-organization in case of several clinical groups.

Materials and Methods: 119 patients (183 eyes) were observed. They were divided into 3 clinical groups: control group (normal IOP); glaucoma suspected group; glaucoma III-IV st. group. Each group included the equal quantity of males/females (50-70 years) without accompanying pathology. Each eye never received any surgical treatment.

 IOP was measured with 6-hour interval during 2 days with 3 hours-shifting (2nd day) employing standard methodics. The obtained results were processed using cosinor-analysis and statistically approved (t- quotient).


Results: We evaluated and described the parameters of IOP circadian chronorhythm in control group patients (mesor 18-25 mm. Hg., IOP peak- 11.00 a.m., 8.00 p.m., sinusoidal rhythm). According to obtained data in case of abovementioned groups we developed criteria scheme for differentiation of normal and pathologic IOP rhythm. Suspicious glaucoma group was characterized by 25% mesor increasing, shifting of IOP peaks to 8.00 a.m. and 5.00 p.m., new highest peak at 11.00 p.m. makes the rhythm ascending one. Glaucoma patients rhythm reflected: IOP increase during 8.00a.m.-2.00 p.m. period on the background of high mesor and amplitude fluctuations and possessed  descending character. 

Conclusions:

1.      Each clinical group has its own pathognomic sign IOP rhythm.

2.      These signs are recommended for adequate distribution of patients into different diagnostic clinical groups.

3.      We suppose the new time periods for appropriate IOP-deviations diagnostics and adequate treatment of primary open-angle glaucoma.