April 2010
Volume 51, Issue 13
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ARVO Annual Meeting Abstract  |   April 2010
Dark Room Prone Provocative Testing is Uninformative in Primary Angle Closure Suspects
D. S. Friedman; Y. Jiang; P. J. Foster; D. S. Chang; S. Huang; T. Aung; M. He
Author Affiliations & Notes
  • D. S. Friedman
    Ophthalmology, Johns Hopkins Wilmer Eye Inst, Baltimore, Maryland
  • Y. Jiang
    Preventive Ophthalmology, Zhongshan Ophthalmic Center, Guangzhou, China
  • P. J. Foster
    Biomedical Research Centre of Ophthalmology, UCL Institute of Ophthalmology and Moorfields Eye Hospital, London, United Kingdom
  • D. S. Chang
    Ophthalmology, Johns Hopkins Wilmer Eye Inst, Baltimore, Maryland
    Preventive Ophthalmology, Zhongshan Ophthalmic Center, Guangzhou, China
  • S. Huang
    Preventive Ophthalmology, Zhongshan Ophthalmic Center, Guangzhou, China
  • T. Aung
    Glaucoma, Singapore National Eye Center, Singapore, Singapore
  • M. He
    Preventive Ophthalmology, Zhongshan Ophthalmic Center, Guangzhou, China
  • Footnotes
    Commercial Relationships  D.S. Friedman, None; Y. Jiang, None; P.J. Foster, None; D.S. Chang, None; S. Huang, None; T. Aung, None; M. He, None.
  • Footnotes
    Support  Foundation Fighting Blindness
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 196. doi:
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      D. S. Friedman, Y. Jiang, P. J. Foster, D. S. Chang, S. Huang, T. Aung, M. He; Dark Room Prone Provocative Testing is Uninformative in Primary Angle Closure Suspects. Invest. Ophthalmol. Vis. Sci. 2010;51(13):196.

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Abstract
 
Purpose:
 

To describe the results of dark room prone provocative testing (DRPPT) in primary angle closure suspects [PACS] and to compare the findings to controls with open angles

 
Methods:
 

All eligible subjects in the ZAP Trial (a study to compare prophylactic laser iridotomy to no treatment in PACS) were placed in a dark room face down for 15 minutes. Eye pressure was measured immediately before and within one minute of sitting up. DRPPT was also performed on subjects with open angles participating in the Liwan Eye Study follow up study.

 
Results:
 

808 primary angle closure suspects and 89 persons with open angles underwent DRPPT. All subjects were Chinese residents of Guangzhou. PACS participants were slightly younger than open angle controls (59.5 versus 60.5) were more often female (81.6 versus 58.4%), and had lower IOP (14.1 versus 15.0, p < 0.05 for all). The average IOP increase after DRPPT was 4.2 mmHg (SD = 2.9) in PACS and 5.2 (SD = 2.8) in those with open angles (p < 0.05). In univariate analysis, IOP rose more in persons with open angles, males, lower baseline IOP, and greater axial length. Open angle status, baseline IOP and axial length remained significant predictors of a greater IOP rise in a multivariate model. 23.6% with open angles and 13.5% with PACS had an IOP increase of > 8 mmHg (p < 0.05).

 
Conclusions:
 

DRPPT fails to separate persons with angle closure from those with open angles. In fact, in this large study, IOP increase in response to DRPPT was greater in those with open angles. The DRPPT test was 15 minutes, shorter than in some previous reports. However, the findings indicate that DRPPT is uninformative in determining risk of angle closure.  

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Clinical Trial:
 

www.ISRCTN.org 45213099

 
Keywords: clinical (human) or epidemiologic studies: risk factor assessment • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • detection 
© 2010, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2025 Association for Research in Vision and Ophthalmology.
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