Xinghuai Sun MD.

 Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
Risk forecast shows IOP is the most important factor on optic nerve damage in glaucoma. Large IOP fluctuation is one of risk factors of glaucoma progress. Some cases with the normal diurnal IOP range but have still with glaucomatous progression. So evaluation 24hrs IOP may indicate the IOP curve periodicity and the definition of glaucoma, especially normal tension glaucoma (NTG). We have 72 cases with 144 eyes which clinical manifestation like NTG (typical optic nerve change, visual field damage with open angle, office IOPs in normal range). All these cases have been measured 24 hrs IOP by NCT per 2 hours at time points as 9:00, 11:00, 13:00, 15:00, 17:00, 19:00, 21:00, 23:00, 1:00, 3:00, 5:00 and 7:00. The results showed that 26 cases were diagnosed as primary open angle glaucoma and 62% eyes with IOP fluctuation≧8mmHg. The other 46 cases were really NTG and 83% eyes with IOP fluctuation<8mmHg. The peak IOPs of all cases were during 11:00pm-7:00am with 70% cases and during 1:00am-5:00am with 49% cases. We think it is necessary of 24hrs IOP examination, especially during the middle night for NTG diagnosis.

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