24h眼压在青光眼诊断和治疗中的意义

Significance of IOP for 24 hours in diagnosis and treatment of glaucoma

目的评价24h眼压在青光眼诊断和治疗中的意义。方法选择疑似及确诊青光眼患者76例(149眼),进行24h眼压测量。结果进入研究的149眼中,单峰眼压124眼,双峰眼压17眼,多峰眼压8眼。单峰眼压峰值分布于非工作时间为85眼(68.55%),其中早晨5:00-8:0051眼,中午12:00-14:0020眼,晚间18:00-23:0014眼,峰值分布于工作时间为39眼(31.45%),其中上午8:00-12:0019眼,下午14:00-18:0020眼。149眼中,工作时间眼压正常而非工作时间异常为92眼(61.74%),眼压峰值位于睡眠状态(22:00/23:00至第2天清晨5:00/6:00)为33眼(22.15%)。结论24h眼压测量能更好发现高眼压,避免漏诊、误诊、延误治疗,且对临床抗青光眼药物种类选择具有指导意义。

Objective To investigate the significance of intraocular pressure（IOP） for 24 hours in diagnosis and treatment of glaucoma.Methods A total of 76 cases（149 eyes） be suspicious of or diagnosed with glaucoma,were enrolled,and IOP for 24 hours were measured.Results In 149 eyes,124 eyes were with single-peaked wave,17 eyes with double-peaked wave and 8 eyes with peaky wave.Peaks of patients with single-peaked wave were at non-working time in 85 eyes（68.55%）,including 51 eyes at 5 am to 8 am,20 eyes at 12 am to 2 pm and 14 eyes at 6 pm to 11 pm;Peaks of patients with single-peaked wave were at working time in 39 eyes（31.45%）,including 19 eyes at 8 am to 12 am and 20 eyes at 2 pm to 6 pm.In 149 eyes,IOP of 92 eyes（61.74%） were normal at working time,but abnormal at non-working time,and the IOP peaks of 33 eyes（22.15%） were at sleeping time（10 pm or 11 pm to 5 am or 6 am at the next day）.Conclusions IOP measurement for 24 hours is a better way to find ocular hypertension.Missed diagnosis,misdiagnosis and delayed treatment can be avoided.And it can provide reference to selecting drugs for glaucoma.