原発開放隅角緑内障患者の眼圧変動昼間測定の臨床的意義

Clinical value of measurement of daytime diurnal variation of intraocular pressure in primary open angle glaucoma

　緑内障外来に通院する原発開放隅角緑内障患者34例62眼を対象として，その眼圧変動昼間測定を行い，それ以前に外来で測定された眼圧と比較検討した。両者の最高値について，眼圧昼間変動における最高値の方が有意に低いという結果が得られたが，最低値，平均値は両者間で差がなかった。また，ほぼ1か月に一度の眼圧測定で常に21mmHg以下の症例では眼圧変動昼間測定を行って最高眼圧が22mmHg以上となった症例は7％にすぎず，むしろ眼圧コントロール不良例で，患者が指示通り眼圧降下剤の点眼内服を行っているか否かが正確に把握できた症例が多かった。

We evaluated the daytime diurnal variation ofintraocular pressure (IOP) and the IOP measuredat daytime visits at the clinic in 62 eyes of 34patients with primary open angle glaucoma. Theobserved peak value for IOP in the daytime diurnalvariation was significantly lower than that at day-time visit (p＜0.01). There were no significantdifferences in the minimum or mean IOP valuesbetween the two methods. The findings seemed todeny the expectation that otherwise undetectedhigh IOP can be detected by measuring the daytimediurnal variation of IOP in patients with primaryopen angle glaucoma under fair control. The day-time diurnal variation of IOP would be of value inpatients with borderline control, particularly con-cerning the adequacy of the treatment during theoff-visit hours.