Emerging perpective in glaucoma: optimizing 24-hour control of intraocular preure

PURPOE: To explore recent tudie and clinical experience involving the importance of 24-hour control of intraocular preure (IOP) in patient with glaucoma. METHOD: Roundtable dicuion. REULT: During the dicuion, the following concept were identified: 1. Although the effect of IOP i continuou, IOP i infrequently meaured in clinical practice. 2. Within an individual patient, meaurement of IOP have coniderable variability throughout 24 hour. 3. Recent tudie have hown that healthy ubject and glaucoma patient may experience their highet IOP at night once they have lain down to leep. 4. Low blood preure level related to an individual’ circadian rhythm can occur imultaneou with high IOP at night, reducing blood flow to the optic nerve head below critical level and thu reulting in optic nerve damage. 5. Glaucoma medication that can maximally reduce IOP over 24 hour and minimally influence blood preure hould have theoretical and practical advantage for glaucoma management. CONCLUION: The new knowledge about peak night-time IOP i changing how phyician manage their patient in term of drug election and targeted IOP level aimed at halting progreion of glaucomatou optic nerve damage and viual field lo. Phyician are alo taking into conideration the troubleome relationhip between lowered ytemic blood preure and elevated IOP during the nighttime period.