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Shravan Savant, Michael Waisbourd, Yi Sun, Patricia Martinez, Jonathan S Myers; Water drinking test in primary angle-closure suspects before and after laser peripheral iridotomy. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):107.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the response to the provocative water drinking test (WDT) before and after laser iridotomy in primary angle closure suspects (PACS).
In this prospective study PACS underwent WDT once before undergoing LPI and two weeks after the LPI. On each visit, after obtaining a baseline IOP, subjects underwent the WDT (10 ml water per kg body weight over 15 minutes followed by IOP measurements every 15 minutes for the following hour). Outcome measures were mean, range, peak and fluctuation of IOP.
Twenty patients (females (n=14, 70%)) were enrolled in the study. The mean age (±SD) was 58.1 (±10.2 SD) years. Figure 1 shows the mean baseline, peak and final IOP during the WDT, before and 2 weeks after performing LPI. Although Peak IOPs were similar, Average IOP range (maximum IOP - minimum IOP) during the WDT increased significantly from 2.6 mmHg (±1.1 SD) before the LPI to 3.5 mmHg (±1.5 SD) after the LPI (P=0.04). There was a trend toward a significant increase in the mean difference between peak IOP and the IOP at the end of the WDT at 60 minutes after the LPI, from 2.5 mmHg (±1.27 SD) to 3.3 mmHg (±1.66 SD), (P = 0.057). The WDT did not trigger acute angle closure in any patient.
PACS who underwent the WDT had a slightly more pronounced recovery of IOP after they had LPI performed. Differences in IOP curves before and after LPI were minimal, and therefore the WDT had limited value as a provocative test in this patient population.
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