Main morphofunctional correlations between indicators of intraocular pressure fluctuations and glaucomatous optic neuropathy progression

According to established data, intraocular pressure (IOP) level is a substantiated risk factor for the development and progression of primary open-angle glaucoma. However, the progression of glaucoma despite achieving the 'controlled' IOP, as measured by traditional one- or two-time tonometry, has confirmed the possibility of other IOP characteristics that prevent the stabilization of the glaucomatous process.The review summarizes commonly used and describes newly emerging techniques for IOP monitoring, and analyzes studies that refute and confirm the presence of correlations between IOP fluctuations and the progression of glaucomatous optic neuropathy. An assessment of traditional and prospective data on the qualitative and quantitative indicators of IOP allows the conclusion that its most informative characteristic is fluctuation. A concept is formed where the main goal is to dampen modulations in IOP levels and achieve consistently 'stable' values, in contrast to routine quantitative reduction in IOP. This, in turn, determines the nature of disease progression and allows for the optimization of primary open-angle glaucoma treatment regimens.