Abstract
To establish an intraocular pressure curve protocol that is safe for corneal health and detects harmful elevations of intraocular pressure outside normal clinic hours. To determine inter-user variability and if repeated measurements affect intraocular pressures. Intraocular pressures were measured in dogs with glaucoma using three protocols: Protocol 1 used applanation tonometry every 2 hours over a 24-hour period; Protocols 2 and 3 used applanation or rebound tonometry, respectively, and measured intraocular pressures every 3 hours over a 30-hour period. A total of 60 additional intraocular pressure curves from dogs with glaucoma and 20 from healthy dogs were then analysed for inter-user variability. A total of 128 intraocular pressure curves were determined in 30 dogs. Protocol 1 resulted in one ulcer in five pressure curves, Protocol 2 in one ulcer in 62 pressure curves and Protocol 3 in no ulcers in 61 pressure curves. Elevated intraocular pressures were detected on 61 occasions, of which 26 developed outside normal clinic hours. A total of 61 additional intraocular pressure curves revealed that repeated measurements had no effect on intraocular pressure. Protocol 3, using rebound tonometry every 3 hours for 30 hours is safe corneal health and identified elevated intraocular pressures outside normal clinic hours in 12 of 30 (40%) patients that single intraocular pressure measurement during consultation hours would not have identified. Intraocular pressure curves may be recommended for clinical practice and glaucoma studies.
Highlights
The objectives of antiglaucoma therapy in veterinary patients are preservation of vision and a painfree state through the control of intraocular pressure (IOP)
The aims of this study were to establish a standardized intraocular pressure curve (IOPC) protocol for use in dogs that is safe for corneal health, as determined by the study guidelines, and to determine if the use of an IOPC would detect a deleterious increase in IOP during the duration of the curve, that a single IOP measurement taken during regular consulting hours might fail to detect (Part I)
P1 was used in only 3 dogs (5 IOPCs) because it was associated with a superficial corneal ulcer in 1/5 IOPCs (1/3 dogs, case 19, with primary glaucoma)
Summary
The objectives of antiglaucoma therapy in veterinary patients are preservation of vision and a painfree state through the control of intraocular pressure (IOP). Additional limitations are that transient tell-tale ocular signs of episodes of raised intraocular pressure in dogs with a history of glaucoma (e.g. temporary blindness, and/or temporary corneal edema, and/or temporary episcleral vessel congestion) might develop outside consultation hours, that pet owners might not notice them, or that they might not have immediate access to an ophthalmologist if they did. These limitations might give the owner and/or clinician the false impression that antihypertensive treatment is effective when it is not, or that glaucoma is not rapidly progressing when it is
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