Abstract
PurposeTo investigate the effect of argon laser trabeculoplasty (ALT) on posture-induced intraocular pressure (IOP) changes in patients with open angle glaucoma (OAG).MethodsThirty eyes of 30 consecutive patients with OAG who underwent ALT were prospectively analyzed. The IOP was measured using Icare PRO in the sitting position, supine position, and dependent lateral decubitus position (DLDP) before ALT and at 1 week, 1 month, 2 months, and 3 months after ALT.ResultsCompared to the baseline values, the IOP in each position was significantly decreased after ALT (all P < 0.001). During follow-up, the mean percentage of IOP reduction was similar in the sitting and supine positions, but was significantly lower in DLDP than in the sitting or supine positions (all P < 0.05). In terms of postural IOP changes, the IOP in the supine position and DLDP was significantly higher than that in the sitting position at the same time points during the follow-up period (all P < 0.001). The difference between the IOP in the supine position and DLDP during follow-up was significant (all P < 0.001). The extent of IOP differences between any positions did not show significant changes during the follow-up period (all P > 0.05).ConclusionsALT appears to be effective in lowering the IOP in various body positions, but the degree of this effect was significantly lower in DLDP. In addition, ALT seemed to have limited effects on posture-induced IOP changes.
Highlights
Elevated intraocular pressure (IOP) has long been considered an important risk factor for the onset and progression of glaucoma [1,2,3]
Compared to the baseline values, the IOP in each position was significantly decreased after argon laser trabeculoplasty (ALT)
ALT appears to be effective in lowering the IOP in various body positions, but the degree of this effect was significantly lower in dependent lateral decubitus position (DLDP)
Summary
Elevated intraocular pressure (IOP) has long been considered an important risk factor for the onset and progression of glaucoma [1,2,3]. Kim et al.[15] reported that the preference of the open angle glaucoma (OAG) patients for LDP during sleep is associated with greater functional deterioration and visual field loss, which are more pronounced in the dependent eye than in the nondependent eye. When it comes to glaucoma management, IOP fluctuation due to postural changes should be taken into account and the ideal strategy would be to achieve target pressure with minimal IOP fluctuation
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