Results for Water-drinking Test, before and after Laser Iridotomy, in Primary Angle-closure Suspects

Purpose: To compare the water-drinking test (WDT) and pharmacologic mydriasis as provocative tests in patients with primary angle closure suspect (PACS). Methods: This observational non-randomized comparative study evaluated changes in intraocular pressure (IOP) in 21 patients with PACS who underwent pharmacologic mydriasis and compared it with IOP changes in 26 patients given the WDT. Ocular biometric and anterior chamber parameters were also assessed. Tests were repeated on the same patient two weeks after performing laser peripheral iridotomy (LPI). Results: The mean age ± standard deviation was 60 ± 7 and 57 ± 9 years in the mydriasis and WDT groups, respectively (P = 0.201). Before LPI, both provocative tests were associated with a significant increase in IOP (mydriasis: 15.1 ± 3.1 to 16.6 ± 3.5 mmHg, P = 0.025; WDT: 16.2 ± 2.8 to 18.5 ± 3.3 mmHg, P < 0.001). However, the IOP changes were not statistically different between groups (P = 0.102). After LPI, only the WDT group showed a continued significant IOP elevation after the test (mydriasis: 16.4 ± 3.3 to 16.7 ± 3.5 mmHg, P = 0.569; WDT: 14.9 ± 3.0 to 17.8 ± 4.1 mmHg, P < 0.001). The post-test IOP change was significantly greater in the WDT than in the mydriasis group (3.0 versus 0.3 mmHg, respectively; P = 0.002). Step-wise multiple regression analysis verified the type of provocative test as the only independent factor affecting the post-test IOP change after LPI (regression coefficient: 2.664; P = 0.002). Conclusion: Pharmacologic mydriasis and the WDT had similar IOP elevation before LPI, but after LPI, IOP elevation was much greater in the WDT group.

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Intraocular pressure fluctuation after water drinking test in primary angle-closure glaucoma and primary open-angle glaucoma

Indian Journal of Ophthalmology ◽

10.4103/0301-4738.198851 ◽

2016 ◽

Vol 64 (12) ◽

pp. 919 ◽

Cited By ~ 2

Author(s):

Ing-Chou Lai ◽

Yi-Chieh Poon ◽

Mei-Ching Teng ◽

Pei-Wen Lin ◽

Jen-Chia Tsai

Keyword(s):

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Angle Closure ◽

Open Angle ◽

Water Drinking ◽

Primary Angle Closure ◽

Primary Angle Closure Glaucoma ◽

Drinking Test ◽

Intraocular Pressure Fluctuation ◽

Water Drinking Test

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Darkroom prone provocative testing in primary angle closure suspects and those with open angles

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-313362 ◽

2019 ◽

pp. bjophthalmol-2018-313362

Author(s):

David S Friedman ◽

Dolly Shuo-Teh Chang ◽

Yuzhen Jiang ◽

Shengsong Huang ◽

Xiangbin Kong ◽

...

Keyword(s):

Controlled Trial ◽

Angle Closure ◽

Laser Iridotomy ◽

Primary Angle Closure ◽

Before And After ◽

Iop Elevation ◽

Provocative Testing ◽

Randomised Controlled ◽

Trial Endpoint

PurposeTo describe the results of darkroom prone provocative testing (DRPPT) in primary angle closure suspects (PACS) and to compare the findings to controls with open angles.Methods889 subjects with PACS in the Zhongshan Angle Closure Prevention Trial (a randomised controlled trial to compare prophylactic laser iridotomy to no treatment in PACS) and 89 with open angles in the 5-year follow-up of Liwan Eye Study were placed in a darkroom face down for 15 min. Intraocular pressure (IOP) was measured immediately before and after DRPPT.ResultsPACS participants were of similar age than controls (59.3 vs 60.5), more often female (82.9% vs 58.4%) and had lower IOP (14.3 vs 15.2 mm Hg). The average IOP increases after DRPPT was 4.3±3 mm Hg in PACS and 5.2±2.8 in controls (p<0.05). 20.5% of controls and 13.9 % of those with PACS developed an IOP spike ≥8 mm Hg after DRPPT (p<0.05). Among PACS, 15.8 % of those with all four quadrants closed had an IOP elevation of ≥ 8 mm Hg as opposed to 10.0%–12.4 % with two or three closed quadrants (p<0.05). DRPPT failed to predict who would reach a clinical trial endpoint over 6-year follow-up of those with PACS.ConclusionsA modified DRPPT failed to separate PACS from those with open angle. Although the test resulted in greater IOP elevation among those PACS participants with all four quadrants closed than in those with two or three closed quadrants, it did not offer any insight into the risk of developing acute or chronic angle closure disease over 6-year follow-up.

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