IOP elevation can occur outside of eye care practitioners’ regular office hours and contribute to glaucoma progression, a recent study in Ophthalmology reports. The research team from Australia also found that IOP polygenic risk scores (PRS) helped predict higher early-morning IOP and escalated readings outside of office hours, suggesting more detailed clinical phenotyping could be useful in home tonometry.

The cross-sectional investigation enrolled 334 eyes of 176 participants with suspected or established POAG. Participants, who were an average of 64 years old, used home tonometers to measure their IOP four times a day for five days. The study used previously-validated IOP PRS from 146 common IOP-associated variants in a linear regression model, adjusting for central corneal thickness and age.

Eyes in the highest IOP PRS group had an early-morning increase of 4.3mm Hg and an elevation of 2.7mm Hg outside of office hours, both of which were independently significant after accounting for a recent in-clinic IOP measurement taken by Goldmann applanation tonometry. Also of note, eyes in the highest PRS group were about five times more likely to have higher early-morning IOP spikes.

These findings may guide additional interventions to improve IOP control, the researchers concluded.

Qassim A, Mullany S, Awadalla MS, et al. A polygenic risk score predicts intraocular pressure readings outside office hours and early morning spikes as measured by home tonometry. Ophthalmology. December 11, 2020. [Epub ahead of print].