Review Article

Role of 24-Hour Intraocular Pressure Monitoring in Glaucoma Management

Table 2

Summary of therapeutic efficacy of current glaucoma management modalities with respect to 24-hour IOP patterns.

Treatment modalitiesTherapeutic efficacy with respect to 24-hour IOP patterns

Prostaglandin analogues (e.g., travoprost, latanoprost, bimatoprost, tafluprost)(i) Achieve a uniform 24-hour IOP reduction of 24–29% [8386]
(ii) Reduce mean IOP, maximum and minimum IOP, and short-term IOPf in NTG [87]
(iii) Flatten the IOP increase at the transition of wake/sitting to sleep/supine period in POAG [89]
(iv) Evening administration was better than morning dosing to lower daytime IOP in POAG [19, 81, 83, 92]
(v) More effective than a beta-blocker and carbonic anhydrase inhibitor to lower IOP at multiple time points and reduce mean IOP and IOP fluctuations [19, 83, 90, 91]
(vi) Bimatoprost followed by travoprost were the two most effective IOP-reducing medications [51, 85]
(vii) More effective than selective laser trabeculoplasty in reducing 24-hour IOPf in POAG and NTG [70]

Beta-blocker (e.g., timolol)(i) Achieve a mean 24-hour IOP reduction of 19–24% [83, 85]
(ii) Low nocturnal efficacy in reducing IOP [83, 85, 98]
(iii) Timolol 0.5% solution and Timogel 0.1% demonstrated similar efficacy to decrease mean 24-hour IOP, diurnal, nocturnal, and individual time point IOP [99], and Timogel 0.1% was better tolerated [100, 101]

Carbonic anhydrase inhibitor (e.g., dorzolamide)(i) Achieve a mean 24-hour IOP reduction of 15–23% [83, 85, 90, 102]
(ii) Superior nocturnal efficacy when compared to timolol [83, 90]

Alpha-2 adrenergic agonist (e.g., brimonidine)(i) Achieve a mean 24-hour IOP reduction of 17.3% [83, 103]
(ii) Low nocturnal efficacy in reducing IOP [83, 103]

Drug combinations(i) Combination of prostaglandin analogues and beta-blockers was better than the combination of a carbonic anhydrase inhibitor or alpha-2 agonist and beta-blocker in reducing mean diurnal IOP [19, 106]
(ii) Fixed combination of prostaglandin analogues and beta-blockers can decrease IOP more than respective monotherapy [19, 107, 108]
(iii) Evening administration of prostaglandin-timolol fixed combination had a superior 24-hour efficacy in obtaining a better 24-hour IOP control than morning dosing in patients with POAG [19, 81, 83, 92, 93]

Laser trabeculoplasty(i) Effective in reducing IOP and IOPf during nocturnal period [33, 109, 110]
(ii) Could not significantly reduce mean, peak, or diurnal IOP [68, 111]

Trabeculectomy(i) Effective in reducing diurnal IOPf in POAG and PACG [15, 113, 114, 118]
(ii) Achieve a lower short-term IOPf, mean diurnal IOP, IOP peak than medical therapy [45, 68, 71, 74]

IOPf: IOP fluctuation.