The impact of intraocular pressure fluctuations on the progression of glaucoma and associated factors

作者：Tong Liu, Yu Cai, Man Hu, Z Wang, Xin Liu, Min Chen, Kaijun Wang · 发表于：Advances in Ophthalmology Practice and Research · 年份：2025 · DOI：10.1016/j.aopr.2025.03.002 · 被引用次数：23 · 研究领域：Glaucoma and retinal disorders、Corneal surgery and disorders、Retinal Diseases and Treatments

Background: In recent years, remarkable advancements in the comprehension of glaucoma pathophysiology have highlighted the necessity of looking beyond the conventional focus on mean intraocular pressure (IOP) levels. IOP fluctuations have been identified as a potential factor that could exert a substantial impact on the progression of glaucoma. Main text: IOP exhibits dynamic variations throughout a 24-h cycle. Glaucoma patients exhibit substantially more pronounced IOP fluctuations compared to healthy individuals, even when the mean IOP remains within the normal range. This implies that IOP fluctuations may play a role in glaucoma progression through mechanisms independent of elevated mean IOP. In this review, an exhaustive examination of studies spanning the past decade was conducted to analyze the relationship between IOP fluctuations and disease progression in primary open-angle glaucoma (POAG), ocular hypertension (OHT), normal tension glaucoma (NTG), and primary angle-closure glaucoma (PACG). While a few studies present conflicting results, the majority of research supports the notion that elevated IOP fluctuations significantly contribute to disease progression in POAG patients. This association has also been confirmed in PACG patients. However, in NTG or OHT patients, other risk factors may outweigh IOP fluctuations in disease progression or glaucoma conversion. Additionally, we summarized common factors affecting IOP fluctuations to provide a basis for the identifica...