研究目的
To analyze the 24-hour ocular dimensional profile in normal-tension glaucoma (NTG) patients on medical treatment.
研究成果
Continuous 24-hour ocular dimensional profiles recorded in NTG patients on medical treatment revealed that the profile increased during sleep and decreased upon waking. There was a 50% reduction in both the variability from the mean and number of peaks during sleep as compared to daytime.
研究不足
There was no sample size calculation, and the relatively small sample size of the study did not allow for evaluation of differences in IOP-related pattern nor stratification by the type of treatment. Furthermore, only one 24-hour measurement with the CLS was performed, therefore we could not ascertain the reproducibility of the 24-hour IOP profile. At present, the ocular dimensional profile is something that cannot be translated into IOP and therefore has no validation for use in clinical practice.
1:Experimental Design and Method Selection:
A prospective cohort study was conducted from July 2012 to June 2013 at a university hospital in Hong Kong. The study used a contact lens-based sensor (CLS) device to record ocular dimensional profiles continuously for 24 hours, with measurements taken every 5 minutes. Statistical analyses included Wilcoxon signed-rank test, Mann-Whitney U-test, and Fisher's exact test to compare parameters such as variability and number of peaks between diurnal and nocturnal periods.
2:Sample Selection and Data Sources:
Consecutive, medically treated NTG subjects aged 18 years or older were recruited. NTG was defined based on open angle on gonioscopy, progressive thinning of the retinal nerve fiber layer on optical coherence tomography, glaucomatous visual field changes, and IOP ≤21 mmHg on all clinical visits. Exclusions included previous glaucoma surgery or laser treatment, corneal disease, and subjects with only one functional eye.
3:List of Experimental Equipment and Materials:
The SENSIMED Triggerfish? contact lens-based sensor (CLS) device (Sensimed AG, Lausanne, Switzerland) was used, along with Goldmann applanation tonometry (GAT) for IOP measurements, slit-lamp examination equipment, and lubricating eyedrops.
4:Experimental Procedures and Operational Workflow:
The CLS was placed on the subject's eye by an ophthalmologist after slit-lamp examination and GAT. Subjects wore the device for 24 hours, recording sleep times in a logbook, and continued their antiglaucoma medication regimen. After 24 hours, the CLS was removed, and another slit-lamp examination and GAT were performed. Data were uploaded to a computer for analysis.
5:Data Analysis Methods:
Data were smoothed using locally weighted polynomial regression. Parameters extracted included variability from mean, number of peaks, and slopes for wake-to-sleep and sleep-to-wake transitions. Statistical tests were performed with significance set at P<0.05.
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