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Almeida I, Scoralick ALB, Dias DT, Ushida M, Dorairaj S, Gracitelli CP, Paranhos A, Kanadani FN, Prata TS. Comparison between provocative test-based and long-term intraocular pressure parameters in patients with stable open-angle glaucoma. Eur J Ophthalmol 2020; 31:453-459. [PMID: 32162542 DOI: 10.1177/1120672120911337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To compare provocative test-based and long-term intraocular pressure variation parameters in patients with stable open-angle glaucoma. METHODS A prospective observational study was carried out in which stable open-angle glaucoma patients (⩾3 years of follow-up without any changes on current medical regimen) were consecutively enrolled. All patients were submitted to a water-drinking test. Long-term intraocular pressure parameters were obtained from isolated intraocular pressure measurements from each visit (⩾5 visits). We investigated the correlation and agreement between the following water-drinking test and long-term intraocular pressure parameters: mean, peak, and fluctuation. In addition, the percentage of eyes with significant intraocular pressure peaks during the water-drinking test (defined as a difference ⩾25% between water-drinking test intraocular pressure peak and mean long-term intraocular pressure) was assessed. RESULTS Sixty-three eyes from 63 open-angle glaucoma patients (mean age, 60.7 ± 11.8 years) were included. Mean and water-drinking test intraocular pressure peak correlated significantly with mean (r = 0.67) and maximum long-term intraocular pressure (r = 0.52), respectively (p < 0.01). The correlation between water-drinking test intraocular pressure fluctuation and long-term intraocular pressure fluctuation was not significant (p = 0.45). Limits of agreement from Bland-Altman plots exceeded the maximum allowed difference between methods (3 mm Hg) for all the intraocular pressure parameters analyzed, suggesting poor agreement between water-drinking test-derived and long-term intraocular pressure values. Overall, significant water-drinking test intraocular pressure peaks were observed in 39.7% of these eyes with stable open-angle glaucoma. CONCLUSION Although some water-drinking test-based and long-term intraocular pressure parameters correlate significantly, water-drinking test results may not reflect the long-term intraocular pressure profile of stable open-angle glaucoma patients, as their agreement is poor. Many of these patients may experience significant water-drinking test intraocular pressure peaks, despite long-standing stable disease and unchanged medical regimen.
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Affiliation(s)
- Izabela Almeida
- Glaucoma Service, Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil.,Glaucoma Unit, Hospital Medicina dos Olhos, Osasco, Brazil
| | - Ana Luiza B Scoralick
- Glaucoma Service, Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil.,Glaucoma Unit, Hospital Medicina dos Olhos, Osasco, Brazil
| | - Diego T Dias
- Glaucoma Service, Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil.,Glaucoma Unit, Hospital Medicina dos Olhos, Osasco, Brazil
| | - Michele Ushida
- Glaucoma Unit, Hospital Medicina dos Olhos, Osasco, Brazil
| | - Syril Dorairaj
- Department of Ophthalmology, College of Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Carolina Pb Gracitelli
- Glaucoma Service, Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
| | - Augusto Paranhos
- Glaucoma Service, Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
| | - Fábio N Kanadani
- Department of Ophthalmology, College of Medicine, Mayo Clinic, Jacksonville, FL, USA.,Department of Ophthalmology, Instituto de Olhos Ciências Médicas, Belo Horizonte, Brazil
| | - Tiago S Prata
- Glaucoma Service, Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil.,Glaucoma Unit, Hospital Medicina dos Olhos, Osasco, Brazil.,Department of Ophthalmology, College of Medicine, Mayo Clinic, Jacksonville, FL, USA
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