Document Detail


Emerging perspectives in glaucoma: optimizing 24-hour control of intraocular pressure.
MedLine Citation:
PMID:  12034167     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To explore recent studies and clinical experience involving the importance of 24-hour control of intraocular pressure (IOP) in patients with glaucoma. METHODS: Roundtable discussion. RESULTS: During the discussion, the following concepts were identified: 1. Although the effect of IOP is continuous, IOP is infrequently measured in clinical practice. 2. Within an individual patient, measurements of IOP have considerable variability throughout 24 hours. 3. Recent studies have shown that healthy subjects and glaucoma patients may experience their highest IOP at night once they have lain down to sleep. 4. Low blood pressure levels related to an individual's circadian rhythm can occur simultaneous with high IOPs at night, reducing blood flow to the optic nerve head below critical levels and thus resulting in optic nerve damage. 5. Glaucoma medications that can maximally reduce IOP over 24 hours and minimally influence blood pressure should have theoretical and practical advantages for glaucoma management. CONCLUSIONS: The new knowledge about peak night-time IOPs is changing how physicians manage their patients in terms of drug selection and targeted IOP levels aimed at halting progression of glaucomatous optic nerve damage and visual field loss. Physicians are also taking into consideration the troublesome relationship between lowered systemic blood pressure and elevated IOP during the nighttime period.
Authors:
Martin B Wax; Carl B Camras; Richard G Fiscella; Christopher Girkin; Kuldev Singh; Robert N Weinreb
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  American journal of ophthalmology     Volume:  133 Suppl     ISSN:  0002-9394     ISO Abbreviation:  Am. J. Ophthalmol.     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-05-29     Completed Date:  2002-06-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370500     Medline TA:  Am J Ophthalmol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S1-10     Citation Subset:  AIM; IM    
Affiliation:
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri 63110, USA. wax@vision.wustl.edu
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MeSH Terms
Descriptor/Qualifier:
Antihypertensive Agents / therapeutic use*
Blood Pressure
Circadian Rhythm
Disease Progression
Glaucoma, Open-Angle / drug therapy*,  physiopathology
Humans
Intraocular Pressure / drug effects*,  physiology
Optic Disk / blood supply
Optic Nerve Diseases / prevention & control
Practice Guidelines as Topic
Vision Disorders / prevention & control
Visual Fields
Chemical
Reg. No./Substance:
0/Antihypertensive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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