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TIME to discuss the optic nerve?

Eye volume 37, page 3691 (2023)Cite this article

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The recent large-scale randomized control trial ‘Treatment in Morning versus Evening’ (TIME) clearly demonstrated that the time of antihypertensive dosing administration does not affect the occurrence of adverse cardiovascular outcomes in patients suffering from arterial hypertension (AHT) [1].

Accumulating evidence implicates nocturnal blood pressure dipping in glaucoma progression, especially in glaucoma patients with normal intraocular pressure [2, 3]. The TIME trial reports no significant difference between evening and morning dosing, with regards to hospitalization due to glaucoma. However, glaucoma is essentially treated in an outpatient setting, i.e., without hospitalization. Even glaucoma surgery is usually performed in an outpatient setting and, if hospitalization is needed, this is often related to comorbidity. Therefore, using hospitalization as a glaucoma proxy could result in underreporting and bias.

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References

  1. Mackenzie IS, Rogers A, Poulter NR, Williams B, Brown MJ, Webb DJ, et al. Cardiovascular outcomes in adults with hypertension with evening versus morning dosing of usual antihypertensives in the UK (TIME study): a prospective, randomised, open-label, blinded-endpoint clinical trial. Lancet. 2022;400:1417–25.

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  2. Charlson ME, de Moraes CG, Link A, Wells MT, Harmon G, Peterson J, et al. Nocturnal systemic hypotension increases the risk of glaucoma progression. Ophthalmology. 2014;121:2004–12.

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Funding

Funding

Supported by Stichting Oogfonds Nederland. The funding organization had no role in the design, conduct, analysis, or publication of this research.

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Authors and Affiliations

  1. Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Konstantinos Pappelis & Nomdo M. Jansonius

  2. Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, Groningen, The Netherlands

    Konstantinos Pappelis & Nomdo M. Jansonius

  3. First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece

    Anastasios Apostolos, Konstantinos Konstantinou & Konstantinos Toutouzas

Authors
  1. Konstantinos Pappelis
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  2. Anastasios Apostolos
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  3. Konstantinos Konstantinou
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  4. Konstantinos Toutouzas
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  5. Nomdo M. Jansonius
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Contributions

KP: conceptualisation, writing. AA: conceptualisation, review & editing. KK: conceptualisation, review & editing. KT: conceptualisation, review & editing. NJ: conceptualisation, supervision, review & editing.

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Correspondence to Konstantinos Pappelis.

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Pappelis, K., Apostolos, A., Konstantinou, K. et al. TIME to discuss the optic nerve?. Eye 37, 3691 (2023). https://doi.org/10.1038/s41433-023-02555-3

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  • DOI: https://doi.org/10.1038/s41433-023-02555-3

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