Posters

The effect of therapeutic IOP-lowering interventions on the twenty-four hour ocular dimensional profile recorded with a sensing contact lens

Poster Details

First Author: C.Cutolo ITALY

Co Author(s):    C. De Moraes   J. Liebmann   K. Mansouri   C. Traverso   R. Ritch        

Abstract Details

Purpose:

Many glaucoma patients experience visual field (VF) deterioration despite intraocular pressure (IOP) measurements within normal limits during office-hours. Parameters derived from a contact lens-based system (CLS, SENSIMED Triggerfish ) have recently been shown to correlate better with VF progression than office-hour Goldmann applanation tonometry (GAT). We investigated the effect of different IOP-lowering interventions on CLS parameters and their relationship with GAT-measured IOP reduction.

Setting:

The Triggerfish Consortium includes data from 50 centers in 13 countries in which CLS recording was performed as part of different prospective studies or registries.

Methods:

Data from glaucoma patients, ocular hypertensives, and glaucoma suspects with sufficient, reliable CLS recordings performed before and after IOP-lowering interventions were analyzed. Three interventions were evaluated: topical medications, laser trabeculoplasty, and incisional surgery. A set of 115 different CLS parameters were derived from 24-hour curves. We compared before vs after values for each parameter with Wilcoxon test. Linear regression was performed using the percentage change of each CLS parameter as the outcome variable and the type of IOP-lowering procedure as the predictor after adjusting age and race. Finally, we investigated the relationship between changes in CLS parameters and GAT IOP.

Results:

182 eyes of 182 patients were included in the analyses: 60 (33%) drugs, 69 (38%) laser, and 53 (29%) surgery. The mean GAT IOP change was 3.6±6.5 mmHg (P<0.001). Overall, more CLS parameters had a significant change after surgery than in the other groups (surgery>laser=drug). Linear regression showed that, for 23 CLS parameters, surgery was the most predictive of greatest percentage change in CLS signals. 10 (8.6%) of CLS parameters were significantly correlated with GAT changes, all of which associated with nocturnal signals.

Conclusions:

The CLS can detect changes in IOP-related patterns resulting from IOP-lowering interventions beyond day-time GAT IOP. This device could potentially be used to assess treatment efficacy in glaucoma. Incisional glaucoma surgery had a more pronounced effect on GAT and CLS parameters than laser and drugs. Nocturnal CLS-patterns were most sensitive to all types of interventions.

Financial Disclosure:

travel has been funded, fully or partially, by a competing company