IOP-related patterns recorded over 24 hours with a contact lens sensor (CLS) may have a stronger association with previous rates of visual field (VF) progression than Goldmann mean intraocular pressure (IOP) measured multiple times during office hours, a recent study found. After collecting 24-hour IOP patterns with a CLS system, researchers assessed 445 open-angle glaucoma patients from 13 countries for associations between CLS variables and rates of VF mean deviation (MD) change.

Once the researchers adjusted for baseline MD severity, age and treatment, they found CLS variables associated with fast VF progression included mean peak ratio while awake, number of long peaks during sleep, mean night bursts ocular pulse frequency and mean night bursts ocular pulse amplitude. Additionally, regression models that included the CLS variables showed an improved fit for testing the association with rates of progression than Goldmann IOP measurements.

According to the study, because the CLS variable association with VF progression “appears to be better than Goldmann mean IOP measured multiple times during office hours […] the CLS may be useful to assess the risk of future functional loss, even in situations when insufficient historical visual field information is available.” Going forward, the study suggests, “future studies with prospective collection of visual field tests after CLS recording ought to be performed to evaluate its performance to possibly recognize the patients at highest risk of visual field progression.”

De Moraes CG, Kaweh Mansouri K, Liebmann JM, Ritch R. Association between 24-hour intraocular pressure monitored with contact lens sensor and visual field progression in older adults with glaucoma. JAMA Ophthalmol. May 24, 2018. [Epub ahead of print].