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Water drinking test could assess progression risk in POAG
IOP peaks detected during the water drinking test can predict future visual field progression in patients with treated open-angle glaucoma in office-based IOP measurements of no more than 18mm Hg, according to researchers.
The stress test could be a useful tool for regular risk assessment, they said.
In the prospective, longitudinal study, all 96 study patients were on topical antiglaucoma medications or had undergone trabeculoplasty or trabeculectomy before enrollment.
All IOP measurements were no more than 18 mmHg in office-based measurements.
For the water drinking test (WDT), researchers obtained a baseline IOP followed by ingestion of 800 mL (27 oz.) of water in 5 minutes. IOP was then measured three times at 15-minute intervals by the same examiner and the same tonometer.
A total of 144 eyes of 96 patients were analyzed.
Early glaucoma was present in 54 eyes (37.5%), moderate glaucoma in 45 (31.2%) and advanced glaucoma in 45 eyes (31.2%).
As researchers expected, the rate of visual field mean deviation (MD) change between progressing vs. stable eyes was statistically significant.
There was a significant correlation between baseline and peak IOP during the WDT.
Researchers found a significant predictive value on future progression when investigating the WDT peak as a predictor.
Researchers concluded that WDT peak was an independent predictor of progression, whereas office-based IOP measurements failed to show a significant association with visual field progression.
Notably, each mm Hg higher WDT peak at baseline increased the risk of progression by 11%. – by Abigail Sutton
Disclosures: De Moraes is a consultant for Sensimed, AG, Lausanne, Switzerland, and receives honoraria from Allergan. Please see the full study for remaining authors’ financial disclosures.
Perspective
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Fashion is cyclical, and I’m certain that one day my old bell-bottom jeans and wide collar shirts will be back in style. Might the same cyclical phenomena affect glaucoma care?
If you remember the water drinking test (WDT) for glaucoma, you are an old timer. I’m no spring chicken, but this test was passé when I received my clinical training way back in the early 1990s. Well, it’s back, and there is a growing body of literature suggesting that the ol’ WDT might be worth dusting off for contemporary use.
De Moraes and colleagues prospectively determined that the IOP elevation in patients who drink a large quantity of water (800 mL) in a short period of time (5 min.) is predictive of future field loss.
As an ocular hypertensive, I’ve personally submitted to this test. Seeing my IOP spike to 32 mm Hg helped me decide to make my resident prescribe IOP-lowering treatment. Do some research and see if this easy-to-administer test might complement your routine work-up.
Enough about glaucoma – time to try on a pair of those old bell-bottoms. I’m not confident they will fit, but they are sure to be back in style soon.