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Long-term home monitoring of intraocular pressure in pediatric glaucoma

Derek P Bitner1, Sharon F Freedman1

  • 1Duke University Department of Ophthalmology, Durham, North Carolina.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|October 6, 2016
PubMed

Insights

Long-term home monitoring of intraocular pressure (IOP) is feasible in pediatric glaucoma, revealing significant diurnal fluctuations. Outflow-enhancing interventions effectively reduced both mean IOP and its daily variability in children.

Area of Science:

  • Ophthalmology
  • Pediatric Medicine
  • Glaucoma Research

Background:

  • Diurnal fluctuation of intraocular pressure (IOP) is a known factor in adult glaucoma progression.
  • Previous studies on pediatric glaucoma have limited data on IOP fluctuations, mostly from short-term monitoring.
  • Understanding long-term IOP patterns is crucial for managing pediatric glaucoma.

Purpose of the Study:

  • To evaluate long-term intraocular pressure (IOP) fluctuation patterns in children with glaucoma.
  • To assess the impact of outflow-enhancing interventions on IOP variability in pediatric glaucoma.
  • To establish the feasibility of home-based IOP monitoring in this population.

Main Methods:

  • Prospective study utilizing parent-measured, home-based rebound tonometry in pediatric glaucoma patients.
  • Monitoring IOP for over a month with at least three daily measurements.
  • Collecting demographic and glaucoma-specific data, and evaluating IOP trends, including spikes and pre/post-intervention changes.

Main Results:

  • Feasible long-term home monitoring of IOP in 14 eyes of 7 children over a mean of 164 days.
  • Significant reduction in mean IOP (26.6 to 15.5 mm Hg) and daily fluctuation (8.4 to 4.6 mm Hg) after outflow improvement.
  • A 14-day monitoring period offered a >90% chance of detecting an intraocular pressure spike.

Conclusions:

  • Long-term home IOP monitoring is a viable method for pediatric glaucoma patients.
  • Pediatric glaucoma patients exhibit substantial IOP fluctuations.
  • Outflow-enhancing interventions successfully decrease both mean IOP and its daily fluctuations in children.
Abstract

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