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February 1997

Diurnal Intraocular Pressure in Untreated Exfoliation and Primary Open-angle Glaucoma

Author Affiliations

From the University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece (Drs Konstas and Mantziris), the Pharmaceutical Research Corporation, Charleston, SC (Dr Stewart), and the University of South Carolina School of Medicine (Dr Stewart).

Arch Ophthalmol. 1997;115(2):182-185. doi:10.1001/archopht.1997.01100150184006

Objective:  To describe and compare the diurnal intraocular pressure (IOP) variation in patients with exfoliation glaucoma (EXG) and primary open-angle glaucoma (POAG).

Patients and Design:  We prospectively investigated consecutive Greek patients with newly diagnosed untreated EXG and POAG. All patients were admitted to our ophthalmology department for 24-hour IOP measurements according to a standard protocol. After matching for age, we compared 40 pairs of patients with these 2 glaucomas.

Results:  Patients with EXG showed a significantly higher mean range of IOP (13.5 vs 8.5 mm Hg for POAG; unpaired t test, P<.001), higher maximum IOP (mean, 38.2 vs 26.9 mm Hg for POAG; unpaired t test, P<.001), and higher minimum IOP (mean, 24.7 vs 18.4 mm Hg for POAG; unpaired t test, P<.001). Patients with EXG more often demonstrated an IOP range higher than 15 mm Hg (35% vs only 7.5% for POAG). Importantly, in 45% of patients with EXG and 22.5% of patients with POAG, the peak level of IOP was found outside office hours. There was no significant difference in visual function (visual acuity, cupping, visual field) at diagnosis between the 2 glaucoma groups.

Conclusion:  Significant fluctuation in the diurnal curve of the IOP distinguishes EXG from POAG and may be an important factor in predicting any subsequent poor response to medical therapy.

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