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Mehmet Mocan, Burcu Kasım, Ersin Muz, Mehmet Orhan, Murat Irkec, Dimitrios Mikropoulos, Anastasios-Georgios Konstas; Intraocular pressure characteristics of subjects with either exfoliation syndrome or exfoliative glaucoma as determined with the Water Drinking Test: preliminary findings. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5617. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate intraocular pressure (IOP) characteristics of subjects with either untreated exfoliation syndrome (XFS), or treated exfoliative glaucoma (XFG) undergoing the Water Drinking Test (WDT).
Prospective observational study undertaken at a university setting. We investigated subjects with untreated XFS with in-office IOP measurements of <21 mmHg (group A), medically treated XFG patients whose in-office IOP levels were <21 mmHg (group B), and normal controls (group C). All subjects underwent a standard WDT test. The IOP was measured before and four times after water ingestion at 15 minute intervals. Maximum IOP (IOPmax), mean IOP (IOPmean), the IOP increase (IOPinc) from baseline IOP to IOPmax and percentage of IOP fluctuation (IOPfluct) during the WDT were calculated and compared across the 3 groups. The one-way analysis of variance (ANOVA) test or the Kruskal-Wallis test was used for comparisons. The study was powered to detect an IOP difference of 1.0±1.0 mmHg with a β error of 0.10 an α error of 0.05.
Sixty eyes of sixty age-matched subjects (20 eyes per group) were recruited for the study. There were no differences between the 3 groups for age, sex, visual acuity, central corneal thickness and in-office IOP level. All IOP measurements evaluated at 15 min intervals as well as IOPmax (25.2±4.3 mmHg; 18.2±3.1 mmHg; 19.6±2.5 mmHg), IOPmean (22.7±3.6 mmHg; 16.5±3.0 mmHg; 18.1±2.5 mmHg), IOPinc (9.3±3.6 mmHg; 4.1±1.8 mmHg; 3.8±1.3 mmHg) and IOPfluct (60.4±25.1 %; 31.5±17.8 %; 24.8±9.7 %) were significantly greater in the XFG group (p<0.001 for all parameters studied) compared to the XFS and the control groups. None of the IOP parameters evaluated in the study were found to be significantly different in XFG patients who were treated with monotherapy compared with those on multiple medications (p>0.1 for all parameters). WDT results of patients treated with prostaglandin analogues were similar to those treated with other agents (p>0.5 for all parameters).
Medically treated XFG patients, but not XFS subjects, demonstrate significant IOP elevation during WDT indicative of impaired trabecular outflow facility. WDT may be of clinical value in assessing IOP characteristics in XFG.
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