Short- and long-term IOP fluctuations in patients with ocular hypertension, stable glaucoma and progressing glaucoma

Purpose:. To assess and compare short (STF) and long-term (LTF) IOP fluctuations in patients with glaucoma or ocular hypertension (OH). Methods:. This is a retrospective analysis of prospective data from a randomized clinical trial; it evaluated 19 patients with OH, 24 patients with stable primary open-angle glaucoma (SG), and 28 patients with progressing disease (PG). Patients underwent a circadian 24-h Goldmann IOP curve (measurements at 8 pm, midnight, 4 am, 8 am, noon, and 4 pm) at baseline, and follow-up visits with visual field repetitions every 6 months for at least 2 years. Each patient maintained the same IOP-lowering regimen throughout follow-up. Progression was based on perimetric changes: worsening of any index probability, development or deepening of scotomas. STF was calculated as the standard deviation of the 24-h IOP values; LTF as the standard deviation of IOP readings at follow-up visits. The percentage of follow-up IOP readings exceeding the individual upper-95%CI of STF was calculated. Results:. STF and LTF for OH, SG, and PG were respectively: 2.0±0.6 and 2.0±0.9, 2.3±1.2 and 1.8±0.8, and 1.6±0.6 and 2.1±0.8 (P>0.05 comparing STF and LTF between all groups). At follow-up, a mean of 44% IOP readings exceeded the upper-95%CI of STF for PG, compared to 15% for both OH and SG (P<0.001); mean IOP remained stable during the study for OH and SG, while it increased by 1 mmHg in PG (P<0.001). Conclusions:. At follow-up, PG showed both higher IOP readings and a higher number of IOP readings exceeding STF compared to OH and SG.