Skip to main navigation menu Skip to main content Skip to site footer

Review article: Biomedical intelligence

Vol. 142 No. 1314 (2012)

Continuous 24 hour intraocular pressure monitoring for glaucoma with a contact lens sensor – time for a paradigm change

  • Kaweh Mansouri
  • Robert N Weinreb
DOI
https://doi.org/10.4414/smw.2012.13545
Cite this as:
Swiss Med Wkly. 2012;142:w13545
Published
25.03.2012

Summary

Glaucoma is the main cause of irreversible blindness and intraocular pressure (IOP) is its only modifiable risk factor. The importance of robust lowering of IOP for prevention of glaucoma onset and progression is well established. Although IOP is a dynamic parameter with individual circadian rhythms, current management usually relies on single IOP measurements during regular clinic hours performed a few times a year. Recent technological advances have provided clinicians with tools for continuous IOP monitoring during a 24 hour period in an ambulatory setting. There are two approaches being investigated. The first is permanent IOP monitoring through an implantable sensor and the other is temporary monitoring through a contact lens sensor. In this article, we discuss the shortcomings of the current gold standard for tonometry (Goldmann Applanation Tonometry) and the current experience with the first commercially available continuous 24 hour IOP monitoring technology (SENSIMED Triggerfish®); a telemetric contact lens sensor produced by a Swiss start-up company (Sensimed AG, Lausanne, Switzerland). Recent studies suggest that 24 hour continuous monitoring of IOP can be integrated into clinical practice and have the potential to contribute to the reduction of glaucoma-related vision loss.

References

  1. Resnikoff S, Pascolini D, Etya'ale D, Kocur I, Pararajasegaram R, et al. Global data on visual impairment in the year 2002. Bull World Health Organ. 2004;82(11):844–51.
  2. Weinreb RN, Khaw PT. Primary open-angle glaucoma. Lancet. 2004;363(9422):1711–20.
  3. Mansouri K, Orgul S, Meier-Gibbons F, Mermoud A. Awareness about glaucoma and related eye health attitudes in Switzerland: a survey of the general public. Ophthalmologica. 2006;220(2):101–8.
  4. Sommer A. Ocular hypertension and normal-tension glaucoma: time for banishment and burial. Arch Ophthalmol. 2011;129(6):785–7.
  5. The effectiveness of intraocular pressure reduction in the treatment of normal-tension glaucoma. Collaborative Normal-Tension Glaucoma Study Group. Am J Ophthalmol. 1998;126(4):498–505.
  6. The Advanced Glaucoma Intervention Study (AGIS): 7. The relationship between control of intraocular pressure and visual field deterioration.The AGIS Investigators. Am J Ophthalmol. 2000;130(4):429–40.
  7. Kass MA, Heuer DK, Higginbotham EJ, Johnson CA, Keltner JL, Miller JP, et al. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol. 2002;120(6):701–13; discussion 829–30.
  8. Bengtsson B, Leske MC, Hyman L, Heijl A. Fluctuation of intraocular pressure and glaucoma progression in the early manifest glaucoma trial. Ophthalmology. 2007;114(2):205–9.
  9. Goldmann H. [Not Available]. Bull Mem Soc Fr Ophtalmol. 1954;67:474–7; discussion, 7–8.
  10. Whitacre MM, Stein R. Sources of error with use of Goldmann-type tonometers. Surv Ophthalmol. 1993;38(1):1–30.
  11. Ehlers N, Bramsen T, Sperling S. Applanation tonometry and central corneal thickness. Acta Ophthalmol (Copenh). 1975;53(1):34–43.
  12. Liu J, Roberts CJ. Influence of corneal biomechanical properties on intraocular pressure measurement: quantitative analysis. J Cataract Refract Surg. 2005;31(1):146–55.
  13. Barkana Y, Anis S, Liebmann J, Tello C, Ritch R. Clinical utility of intraocular pressure monitoring outside of normal office hours in patients with glaucoma. Arch Ophthalmol. 2006;124(6):793–7.
  14. Liu JH, Zhang X, Kripke DF, Weinreb RN. Twenty-four-hour intraocular pressure pattern associated with early glaucomatous changes. Invest Ophthalmol Vis Sci. 2003;44(4):1586–90.
  15. Liu JH, Kripke DF, Twa MD, Hoffman RE, Mansberger SL, Rex KM, et al. Twenty-four-hour pattern of intraocular pressure in the aging population. Invest Ophthalmol Vis Sci. 1999;40(12):2912–7.
  16. Konstas AG, Mantziris DA, Stewart WC. Diurnal intraocular pressure in untreated exfoliation and primary open-angle glaucoma. Arch Ophthalmol. 1997;115(2):182–5.
  17. Mansouri K, Orguel S, Mermoud A, Haefliger I, Flammer J, Ravinet E, et al. Quality of diurnal intraocular pressure control in primary open-angle patients treated with latanoprost compared with surgically treated glaucoma patients: a prospective trial. Br J Ophthalmol. 2008;92(3):332–6.
  18. Mansouri K, Medeiros FA, Weinreb RN. Letter to the editor: 24-hour versus daytime intraocular pressure phasing in the management of patients with treated glaucoma. Br J Ophthalmol. 2011 Jan 26.
  19. Liu JH, Weinreb RN. Monitoring intraocular pressure for 24 h. Br J Ophthalmol. 2011;95(5):599–600.
  20. Liang SY, Lee GA, Shields D. Self-tonometry in glaucoma management – past, present and future. Surv Ophthalmol. 2009;54(4):450–62.
  21. Liu JH, Medeiros FA, Slight JR, Weinreb RN. Diurnal and nocturnal effects of brimonidine monotherapy on intraocular pressure. Ophthalmology. 2010 Jul 20.
  22. Weinreb RN, Liu JH. Nocturnal rhythms of intraocular pressure. Arch Ophthalmol. 2006;124(2):269–70.
  23. Maurice DM. A recording tonometer. Br J Ophthalmol. 1958;42(6):321–35.
  24. Schnell CR, Debon C, Percicot CL. Measurement of intraocular pressure by telemetry in conscious, unrestrained rabbits. Invest Ophthalmol Vis Sci. 1996;37(6):958–65.
  25. Akaishi T, Ishida N, Shimazaki A, Hara H, Kuwayama Y. Continuous monitoring of circadian variations in intraocular pressure by telemetry system throughout a 12-week treatment with timolol maleate in rabbits. J Ocul Pharmacol Ther. 2005;21(6):436–44.
  26. Mansouri K, Shaarawy T. Continuous intraocular pressure monitoring with a wireless ocular telemetry sensor: initial clinical experience in patients with open angle glaucoma. Br J Ophthalmol. 2011;95(5):627–9.
  27. Leonardi M, Leuenberger P, Bertrand D, Bertsch A, Renaud P. First steps toward noninvasive intraocular pressure monitoring with a sensing contact lens. Invest Ophthalmol Vis Sci. 2004;45(9):3113–7.
  28. Leonardi M, Pitchon EM, Bertsch A, Renaud P, Mermoud A. Wireless contact lens sensor for intraocular pressure monitoring: assessment on enucleated pig eyes. Acta Ophthalmol. 2009;87(4):433–7.
  29. De Smedt S, Mermoud A, Schnyder C. 24-hour intraocular pressure fluctuation monitoring using an ocular telemetry sensor: tolerability and functionality in healthy subjects. J Glaucoma. 2011 May 19.
  30. du Toit R, Vega JA, Fonn D, Simpson T. Diurnal variation of corneal sensitivity and thickness. Cornea. 2003;22(3):205–9.
  31. Kida T, Liu JH, Weinreb RN. Effect of 24-hour corneal biomechanical changes on intraocular pressure measurement. Invest Ophthalmol Vis Sci. 2006;47(10):4422–6.
  32. Kida T, Liu JH, Weinreb RN. Effects of aging on corneal biomechanical properties and their impact on 24-hour measurement of intraocular pressure. Am J Ophthalmol. 2008;146(4):567–72.
  33. Caprioli J, Varma R. Intraocular pressure: modulation as treatment for glaucoma. Am J Ophthalmol. 2011;152(3):340-4 e2.
  34. Mansouri K, Iliev ME, Rohrer K, Shaarawy T. Compliance and knowledge about glaucoma in patients at tertiary glaucoma units. Int Ophthalmol. 2011 Oct 7.
  35. Mansouri K, Shaarawy T. Will improvement of knowledge lead to improvement of compliance with glaucoma medication? Acta Ophthalmol. 2009;87(4):468–9; author reply 9–71.