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Cohort studyJournal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society · 2026

iCare HOME2 Monitoring of Diurnal Ocular Perfusion Pressure in Patients With Nonarteritic Ischemic Optic Neuropathy.

Benjamin V Packard, Meghan Sharma, Andy Renschler … Judith E A Warner

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OphthalmologyCohort study

Ocular perfusion pressure in eyes with ischemic optic neuropathy is lowest in early morning.

iCare HOME2 Monitoring of Diurnal Ocular Perfusion Pressure in Patients With Nonarteritic Ischemic Optic Neuropathy.

Benjamin V Packard … Judith E A Warner

Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society · 2026

Background

This study evaluated time-of-day differences in intraocular pressure (IOP), mean arterial pressure (mean arterial pressure), and ocular perfusion pressure (ocular perfusion pressure) in eyes affected by nonarteritic anterior ischemic optic neuropathy (nonarteritic anterior ischemic optic neuropathy), and compared these measures between nonarteritic anterior ischemic optic neuropathy-affected and unaffected eyes at each time period.

Methods

Were trained to measure blood pressure (blood pressure) and IOP using an automated blood pressure cuff and the iCare HOME2 rebound tonometer.

n = 27 eyes

1.69

Results

1.69

mm Hg

eye blood-flow pressure was higher at midday than in early morning

n = 27 eyes

More results

Among nonarteritic anterior ischemic optic neuropathy-affected eyes, mean ocular perfusion pressure and mean arterial pressure were lowest in the early morning.

No IOP elevations were noted in the early waking hours.

More results

In the evening, ocular perfusion pressure was 1.83 mm Hg higher and mean arterial pressure was 2.49 mm Hg higher than in the morning (both 95% CI).

Evening IOP was 0.31 mm Hg lower than in the morning, but this difference was not statistically significant ( P = 0.08).

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Conclusion · 1 of 2

Early morning low ocular perfusion pressure in nonglaucomatous eyes with nonarteritic anterior ischemic optic neuropathy seems to be correlated with low mean arterial pressure, rather than elevated IOP.

Conclusion · 2 of 2

These findings help support a role for impaired local perfusion in the early waking hours in the pathogenesis of nonarteritic anterior ischemic optic neuropathy and highlight the potential utility of IOP and blood pressure diurnal monitoring in at-risk patients.

Post

iCare HOME2 Monitoring of Diurnal Ocular Perfusion Pressure in Patients With Nonarteritic Ischemic Optic Neuropathy.

Ocular perfusion pressure in eyes with ischemic optic neuropathy is lowest in early morning.

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