Applications of the water drinking test in glaucoma management

Susanna, Remo; Clement, Colin I; Goldberg, Ivan; Hatanaka, Marcelo

doi:10.1111/ceo.12925

Cited by 35 publications

(48 citation statements)

References 60 publications

(123 reference statements)

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“…Such a quick change yields risk for these people, especially in the case of presence glaucoma (9). Moreover, glaucoma patients are more sensitive to stress test, e.g., water-drinking test (43), than healthy subjects. Thus, the IOP changes induced by hypoxia in glaucoma patients may be greater that those we found.…”

Section: Discussionmentioning

confidence: 99%

Intraocular Pressure Response to Short-Term Extreme Normobaric Hypoxia Exposure

et al. 2019

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Purpose: The purpose of the study was to determine the intraocular pressure response to normobaric hypoxia and the consequent recovery under additional well-controlled ambient conditions. Second, the study attempted to determine if the intraocular pressure changes were dependent on its baseline, initial heart rate, sex and arterial oxygen saturation.Methods: Thirty-eight visually healthy volunteers (23 women and 15 men) of an average age 25.2 ± 3.8 years from 49 recruited participants met the inclusion criteria and performed the complete test. Initial intraocular pressure (baseline), heart rate, and arterial oxygen saturation were measured after 7 min of rest under normal ambient conditions at an altitude 250 m above sea level. Each subject then underwent a 10 min normobaric hypoxic exposure and a subsequent 7 min recovery under normoxic conditions. Within hypoxic period, subjects were challenged to breathe hypoxic gas mixture with fraction of inspired oxygen of 9.6% (~6.200 m above sea level). Intraocular pressure and arterial oxygen saturation were re-measured at 4 and 10 min during the hypoxia and at 7 min after hypoxia termination.Results: Intraocular pressure increased in 1.2 mmHg ± 1.9 mmHg and 0.9 mmHg ± 2.3 mmHg at 4 and 10 min during the hypoxic period and returned approximately to the baseline at 7 min of recovery. The influence of sex was not statistically significant. The arterial oxygen saturation decreased in 14.9 ± 4.2% at min 4 and 18.4 ± 5.8% at min 10 during hypoxia and returned to the resting value at 7 min of recovery. The decrease was slightly higher in the case of women if compared with men. The hypoxia induced changes in intraocular pressure were significantly correlated with the arterial oxygen saturation changes, whereas the relationship with intraocular pressure baseline and initial heart rate were insignificant.Conclusion: There was a significant increase in intraocular pressure as a response to short-term normobaric hypoxia, which returned to the baseline in 7 min after hypoxia. The increase was dependent on the induced oxygen desaturation.

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Section: Discussionmentioning

confidence: 99%

Intraocular Pressure Response to Short-Term Extreme Normobaric Hypoxia Exposure

et al. 2019

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“…The proposed mechanisms include choroidal expansion, plasma hypo-osmolalityenhanced aqueous ultrafiltration, autonomic nervous system stimulation, and increased episcleral venous pressure. [7,19] Compared to the 24-hour IOP curve measurement that requires the patient to stay in the hospital and involves the measurement of IOPs at night, the WDT could be an inexpensive and feasible alternative.…”

Section: Discussionmentioning

confidence: 99%

“…The Water Drinking Test (WDT) has been suggested as a practical and easyto-perform test to estimate the diurnal IOP profile in a more feasible and controlled fashion. [4,5] IOP changes after WDT have been evaluated in adult patients with various types of glaucoma, [6,7] but not in children with PCG. Previous studies also evaluated the WDT-IOP profile of adult glaucoma patients who were taking glaucoma medications or had undergone trabeculectomy, deep sclerectomy, and GDD implantation.…”

Section: Primary Congenital Glaucoma (Pcg) Is the Most Common Hereditmentioning

confidence: 99%

Intraocular Pressure Changes after Water Drinking Test in Surgically Treated Primary Congenital Glaucoma

Razeghinejad

Tajbakhsh

Masoumpour

et al. 2020

JOVR

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Purpose: To assess intraocular pressure (IOP) changes after the water drinking test (WDT) in patients with primary congenital glaucoma (PCG). Methods: In this prospective interventional study, 20 eyes of 20 patients with PCG were included. All patients had undergone trabeculotomy. Six out of twenty eyes had received a glaucoma drainage device (GDD) implantation. IOP was measured using an air-puff tonometer at baseline, and 15, 30, 45, and 60 min after WDT. The repeated-measures analysis of variance test was used to compare the mean IOPs at different time points. Results: The mean (± standard deviation) of participants’ age was 9.9 ± 2.7 years (range, 6 to 16 years), and 8 (40%) participants were male. The mean IOPs at baseline and 15, 30, 45, and 60 minutes after the WDT were 15.8 ± 3.7, 18.6 ± 3.4, 19.0 ± 3.8, 17.9 ± 3.8, and 16.9 ± 3.5 mmHg, respectively (P < 0.001). Pairwise comparisons revealed that the mean IOPs after 15 and 30 min were significantly greater than the baseline IOP (P < 0.001 and P = 0.002, respectively); however, the difference in mean IOPs after 45 and 60 min were not statistically significant from the baseline IOP. The averages of IOP peak and IOP fluctuation after the WDT were 20.0 ± 3.5 and 4.2 ± 2.9 mmHg, respectively. IOP fluctuation in those who underwent trabeculotomy alone was twice that of those with GDDs, but the difference was not statistically significant (5.0 vs 2.5 mmHg; P = 0.08). Conclusions: In patients with PCG, WDT induced significant IOP elevation 15 and 30 min after the test, which returned to pre-test values after 45 min.

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“…Each long-term parameter was assessed using a minimum of 5 IOP measurements. In order to acquire provocative test-based IOP parameters, all patients were submitted to a WDT, as proposed by Susanna et al, consisting of 1 baseline IOP measurement, followed by 3 other IOP measurements taken at 15-minute intervals after the patient ingests 800 mL of tap water in 5 minutes (11) . All participants were required to fast for 2 h before the test.…”

Section: Assessment Of Long-term and Provocative Test-based Iop Parammentioning

confidence: 99%

“…Long-term parameters are evaluated by longitudinal IOP measurements (based on different office visits), while short-term IOP parameters (daily IOP profile) are derived usually from tension curves (10) . In addition, patients' short-term IOP profiles may be estimated by provocative tests, such as the water drinking test (WDT) (11,12) .…”

Section: Introductionmentioning

confidence: 99%

Lack of association between provocative test-based intraocular pressure parameters and functional loss in treated glaucoma patients

Scoralick¹,

Gracitelli²,

Dias³

et al. 2019

Arquivos Brasileiros De Oftalmologia

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To correlate provocative test-based intraocular pressure (IOP) variation parameters (fluctuation and peak) with functional status, and to compare these IOP parameters between treated eyes with asymmetric primary open-angle glaucoma (POAG). Methods: A prospective observational study including consecutively treated patients with primary open-angle glaucoma was performed. Subjects with ocular diseases other than glaucoma or previous incisional glaucoma surgery were excluded. The primary inclusion criteria were ≥3 visual field tests and ≥2 years of follow-up, without any changes on current medical regimen. Long-term intraocular pressure parameters were acquired via isolated intraocular pressure measurements from the patients' last 5 office visits. To evaluate provocative test-based intraocular pressure parameters, all patients were submitted to a water drinking test. Initially, the partial correlation coefficients between each intraocular pressure variation parameter and visual field mean deviation were calculated, adjusting for the baseline intraocular pressure and number of antiglaucoma medications. In addition, each intraocular pressure parameter was compared between eyes with better visual field mean deviation and fellow eyes with worse visual field mean deviation in patients with asymmetric visual field loss (defined as an inter-eye visual field mean deviation difference of at least 3 dB). Results: A total of 87 eyes (87 patients; mean age, 61.9 ± 12.5 years; 59.8% women) with primary open-angle glaucoma were included. The patients underwent a median of 5 visual field tests, with a mean follow-up of 4.3 ± 1.4 years. Neither long-term nor water-drinking test intraocular pressure variation parameters were significantly associated with visual field mean deviation values (p≥0.117). In the subgroup with asymmetric visual field loss (64 eyes of 32 patients; mean age, 65.0 ± 11.4 years), neither long-term water-drinking test intraocular pressure variation parameters differed significantly between eyes with better and worse visual field mean deviation (p≥0.400). Conclusion: Our results indicate that neither long-term intraocular pressure variation parameters nor stress test-derived intraocular pressure metrics, as assessed by the water-drinking test, appear to correlate with the visual field status or differ significantly between eyes with asymmetric visual field damage, suggesting that other factors may explain such functional asymmetry, and that the water-drinking test does not add significant information to these cases.

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Applications of the water drinking test in glaucoma management

Cited by 35 publications

References 60 publications

Intraocular Pressure Response to Short-Term Extreme Normobaric Hypoxia Exposure

Intraocular Pressure Response to Short-Term Extreme Normobaric Hypoxia Exposure

Intraocular Pressure Changes after Water Drinking Test in Surgically Treated Primary Congenital Glaucoma

Lack of association between provocative test-based intraocular pressure parameters and functional loss in treated glaucoma patients

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