TY - JOUR
T1 - Lack of association between provocative test-based intraocular pressure parameters and functional loss in treated glaucoma patients
AU - Scoralick, Ana Luiza Bassoli
AU - Gracitelli, Carolina Pelegrini Barbosa
AU - Dias, Diego Torres
AU - Almeida, Izabela
AU - Ushida, Michele
AU - Dorairaj, Syril
AU - Kanadani, Fábio Nishimura
AU - Paranhos, Augusto
AU - Prata, Tiago Santos
N1 - Publisher Copyright:
© 2019 Conselho Brasileiro De Oftalmologia.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Purpose: 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.
AB - Purpose: 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.
KW - Circadian rhythm
KW - Diagnostic techniques, ophthalmological
KW - Drinking
KW - Glaucoma
KW - Intraocular pressure/physiology
KW - Open-angle/physiopathology
KW - Water
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U2 - 10.5935/0004-2749.20190035
DO - 10.5935/0004-2749.20190035
M3 - Article
C2 - 31116300
AN - SCOPUS:85066266550
SN - 0004-2749
VL - 82
SP - 176
EP - 182
JO - Arquivos Brasileiros de Oftalmologia
JF - Arquivos Brasileiros de Oftalmologia
IS - 3
ER -