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Clinical Sciences | ONLINE FIRST

Continuous 24-Hour Monitoring of Intraocular Pressure Patterns With a Contact Lens Sensor:  Safety, Tolerability, and Reproducibility in Patients With Glaucoma

Kaweh Mansouri, MD, MPH; Felipe A. Medeiros, MD, PhD; Ali Tafreshi, BS; Robert N. Weinreb, MD
Arch Ophthalmol. 2012;130(12):1534-1539. doi:10.1001/archophthalmol.2012.2280.
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Objective  To examine the safety, tolerability, and reproducibility of intraocular pressure (IOP) patterns during repeated continuous 24-hour IOP monitoring with a contact lens sensor.

Methods  Forty patients suspected of having glaucoma (n = 21) or with established glaucoma (n = 19) were studied. Patients participated in two 24-hour IOP monitoring sessions (S1 and S2) at a 1-week interval (SENSIMED Triggerfish CLS; Sensimed AG). Patients pursued daily activities, and sleep behavior was not controlled. Incidence of adverse events and tolerability (visual analog scale score) were assessed. Reproducibility of signal patterns was assessed using Pearson correlations.

Results  The mean (SD) age of the patients was 55.5 (15.7) years, and 60% were male. Main adverse events were blurred vision (82%), conjunctival hyperemia (80%), and superficial punctate keratitis (15%). The mean (SD) visual analog scale score was 27.2 (18.5) mm in S1 and 23.8 (18.7) mm in S2 (P = .22). Overall correlation between the 2 sessions was 0.59 (0.51 for no glaucoma medication and 0.63 for glaucoma medication) (P = .12). Mean (SD) positive linear slopes of the sensor signal from wake to 2 hours into sleep were detected in both sessions for the no glaucoma medication group (S1: 0.40 [0.34], P < .001; S2: 0.33 [0.30], P < .01) but not for the glaucoma medication group (S1: 0.24 [0.60], P = .06; S2: 0.40 [0.40], P < .001).

Conclusions  Repeated use of the contact lens sensor demonstrated good safety and tolerability. The recorded IOP patterns showed fair to good reproducibility, suggesting that data from continuous 24-hour IOP monitoring may be useful in the management of patients with glaucoma.

Trial Registration  clinicaltrials.gov Identifier: NCT01319617

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Figures

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Grahic Jump Location

Figure. Intraocular pressure (IOP) patterns with the contact lens sensor in individual patients in 2 different 24-hour sessions spaced 1 week apart. Blue line indicates session 1, yellow line, session 2. A, Example of high IOP pattern reproducibility (r = 0.80): 53-year-old white man with glaucoma undergoing treatment with once-daily prostaglandin analogue and twice-daily combined carbonic anhydrase inhibitor/β-blocker eyedrops. B, Example of high IOP pattern reproducibility (r = 0.85): 52-year-old Asian woman suspected of having glaucoma. It is unknown whether the patient instilled her prostaglandin analogue eyedrops (not mentioned in the diary). C, Example of moderate IOP pattern reproducibility (r = 0.65): 59-year-old white woman suspected of having glaucoma. D, Example of poor IOP pattern reproducibility (r = 0.21): 20-year-old white man suspected of having glaucoma and irregular sleep behavior.

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Correspondence

May 1, 2013
Christoph Faschinger, MD, PhD; Georg Mossböck, MD, PhD
JAMA Ophthalmol. 2013;131(5):696-698. doi:10.1001/jamaophthalmol.2013.2874.
May 1, 2013
Kaweh Mansouri, MD, MPH; Felipe A. Medeiros, MD, PhD; Ali Tafreshi, BS; Robert N. Weinreb, MD
JAMA Ophthalmol. 2013;131(5):696-698. doi:10.1001/jamaophthalmol.2013.208.
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