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Early diagnosis of ocular hypertension using a low-intensity laser irradiation test.

OBJECTIVE
We investigated the potential use of low-intensity laser irradiation (LILI) as a diagnostic tool for identifying hypertensive eyes at risk of glaucoma.


BACKGROUND DATA
The diagnosis of early-stage ocular hypertension is particularly difficult to establish.


METHODS
This study of a case series included 123 healthy subjects with normal vision. The intraocular pressure (IOP) was determined before (baseline) and 30 min after a 30-sec irradiation of the limbus area with laser light (780 nm; 7.5 mW; 292 Hz modulation).


RESULTS
Baseline IOP was >21 mm Hg in 44 of 211 eyes (20.9%), consistent with ocular hypertension. LILI decreased the mean IOP by 6.2 mm Hg (-25.7%; p < 0.001; paired t test) in these eyes. The remaining 167 eyes (79.1%) exhibited a normotensive IOP <or=21 mm Hg. LILI reduced the mean IOP by 2.9 mm Hg (-17.1%; p < 0.001) in these eyes, but there were different response patterns: 1) the IOP did not change (27.0%); 2) the IOP was reduced by the same extent in both eyes (32.3%); 3) initial IOP differences between left and right eyes became level and the absolute IOP was reduced to a lower level that was identical in both eyes (18.0%); and 4) the initial difference in IOP between the left and right eye persisted despite LILI (22.7%).


CONCLUSION
LILI lowers IOP, even in normotensive eyes. This effect may be useful to determine the individual physiological IOP and to diagnose latent ocular hypertension in eyes with presumably normotensive IOP.