Abstract
Glaucoma is increasingly recognized as a multifactorial disease influenced by both ocular and systemic factors. Among systemic parameters, blood pressure (BP) has been reported to affect intraocular pressure (IOP), although the relationship is complex and may vary among individuals. This report describes the case of a 51-year-old Japanese male physician without glaucoma who voluntarily performed self-monitoring of IOP, BP, and body weight (BW) over a 24-month period using home tonometry, a wearable sphygmomanometer, and a digital scale. A total of 1,243 right-eye and 1,240 left-eye IOP measurements, 1,210 BP recordings, and 629 BW records were collected. Time series analysis using an AutoRegressive Integrated Moving Average with eXogenous variables (ARIMAX) model, configured as SARIMAX(0,1,1), revealed that systolic BP (SBP) was significantly and positively associated with IOP (IOP changed by 0.27 mmHg for every 10 mmHg change in SBP), whereas diastolic BP (DBP) and BW showed no significant associations. Right- and left-eye IOP fluctuations occurred in phase, suggesting the influence of systemic or environmental factors beyond local ocular determinants. This case illustrates the potential utility of N = 1 analyses and personalized health monitoring in elucidating the role of systemic factors in IOP regulation and highlights future possibilities for incorporating continuous systemic and ocular measurements into individualized glaucoma management strategies.