DOI: 10.1097/ijg.0000000000002762 ISSN: 1057-0829

Association Between 24-Hour Intraocular Pressure Fluctuation and Retinal Nerve Fiber Layer Thickness Measured by Optical Coherence Tomography

Artur W. Veloso, Sebastião Cronemberger, Camilo Brandão de-Resende, Alessandro A. Jammal, Alberto Diniz-Filho

Purpose:

To evaluate the relationship between 24-hour fluctuation of intraocular pressure (IOP F ) and RNFL thickness measured by spectral-domain optical coherence tomography (SD-OCT).

Material and Methods:

The study included 153 eyes of 80 patients. Seventy-five eyes (49%) were considered glaucoma suspects and 78 (51%) had a diagnosis of POAG. All eyes underwent peripapillary RNFL imaging with SD-OCT, standard automated perimetry (SAP), and 24-hour IOP measurements. Generalized linear mixed models were used to investigate the relationship between IOP F and RNFL thickness adjusting for potential confounding factors such as age, diagnosis of glaucoma, central corneal thickness, number of medications, mean IOP during the 24 hours, and disease severity.

Results:

Mean age was 60.0±18.7 years for glaucoma suspects and 64.7±12.4 years for POAG patients. In univariable analyses, IOP F was associated with global RNFL thickness ( P =0.012), but mean and peak IOP during the 24-hour were not ( P =0.492 and P =0.229, respectively). When adjusted for confounding factors in the multivariable analysis, each 1 mmHg increase in IOP F was associated with a 2.30 µm thinner global RNFL (95% confidence interval: −4.25 to −0.36 µm, P =0.021).

Conclusion:

Higher IOP F was associated with thinner global RNFL thickness measured by SD-OCT. This finding corroborates a potential role for IOP fluctuation as a risk factor for structural loss in glaucoma.

Précis:

Abnormal short-term fluctuation of intraocular pressure is associated with thinner global retinal nerve fiber layer thickness in subjects with primary open angle glaucoma and glaucoma suspects.

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