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Editors Selection IGR 23-3
Clinical examination methods: Monitoring IOP, in- and out-of-office+Q6
Comment by Kaweh Mansouri on:
106419 Clinical Outcomes of the Implementation of IOP Monitoring, in and Out of Office Time, to 1500 Patients-A Cohort Study, Tsironi S; Almaliotis D; Ntonti P et al., Vision (Basel, Switzerland), 2022; 6:
Despite many years of research, little data exist on the clinical impact of 24-h IOP monitoring in glaucoma patients. In this large database study, the authors reviewed charts of 1500 patients with ocular hypertension or glaucoma who had been hospitalized for IOP monitoring between November 2007 and December 2019 in Thessaloniki, Greece. The IOP measurements were made by Goldmann applanation tonometer in a 24 h period and specific hours during the day (7,00, 10,00, 13,00, 16,00, 19,00, and 22,00), with the patient in the sitting position. The main goal of the patient's IOP monitoring was to gain more information on IOP characteristics to assist with diagnostic and therapeutic decision-making.
Despite the fact that this was not a prospective clinical trial with defined end-points and uniform protocol, the findings of it are still of interest: In 45% of patients, IOP peaks occurred outside of office-hours.
Taking into consideration the IOP monitoring results, 49.6% of monitored patients had a change in their treatment. In 157 of these (10.4% of total 1500), treatment was newly introduced. The authors also reported that IOP monitoring revealed an adherence problem in 28% of medicated patients, without specifying how that was assessed. Finally, based on the results of the IOP monitoring, 'laser treatment' was performed in 1.2% of patients and surgery was proposed for another 7.2%.
Taken together, these reports suggest that continuous IOP monitoring could lead to more aggressive treatment of glaucoma and thereby improve the management of glaucoma
The findings from this database report confirm previous studies in which the availability of 24-h IOP data led to changes in therapy and more interventional treatment. Taken together, these reports suggest that continuous IOP monitoring could lead to more aggressive treatment of glaucoma and thereby improve the management of glaucoma.
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