Home Tonometry Diurnal Intraocular Pressure Patterns, Patient Adherence, and Measurement Reliability in a Prospective...

Area of Science:

• Ophthalmology
• Medical Devices
• Patient Monitoring

Background:

• Intraocular pressure (IOP) monitoring is crucial for managing glaucoma.
• Understanding diurnal IOP patterns and out-of-office fluctuations is essential for effective treatment.
• Home-based IOP monitoring offers a potential solution for capturing these variations.

Purpose of the Study:

• To assess patient adherence to home IOP monitoring using the iCare HOME2 tonometer (ICH2).
• To analyze diurnal IOP patterns and their fluctuations over a 24-hour period.
• To evaluate the correlation between home-recorded IOP and in-office tonometry measurements.

Main Methods:

• A prospective cohort study involving 75 patients with open-angle disease.
• Patients used the iCare HOME2 tonometer (ICH2) for self-monitoring, taking 6 measurements daily for 10 days.
• Statistical analysis was performed on adherence data, diurnal IOP patterns, and correlation with in-office IOP readings.

Main Results:

• Good adherence was observed in 65% of patients, with a median of 7.4 measurements/day; however, 19% showed poor adherence.
• Significant diurnal IOP patterns were identified, with a peak in the early morning (3 AM) and a decrease throughout the day.
• Out-of-office IOP variations were significant, with 36% of patients experiencing maximum IOP outside clinic hours.
• Home IOP measurements showed a significant positive correlation with in-office Goldman applanation (r² = 0.35) and iCare IC100 (r² = 0.48) tonometry.

Conclusions:

• The iCare HOME2 tonometer (ICH2) is clinically usable and effective for monitoring intraocular pressure at home.
• The device successfully detects out-of-office IOP spikes and diurnal IOP variations.
• Home IOP monitoring provides valuable data that correlates with traditional in-office measurements.