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F. N. Kanadani, T. C. A. Moreira, F. H. Melo, A. C. Nery, J. N. Dias, V. C. Barbosa, S. K. Dorairaj, J. A. Netto; A New Provocative Test for Glaucoma?. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1059.
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To compare the water-drinking test with the 30-degree inverted body position test on intraocular pressure (IOP) in normal, suspects, and glaucoma patients.
Based on clinical evaluation of the optic disc, IOP, and standard achromatic perimetry (SAP) of 71 eyes, 18 were "normal" (normal SAP and optic disc evaluation, and IOP < 21 mmHg), 30 were "glaucoma suspect" (GS; normal SAP, C/D ratio > 0.5 or asymmetry > 0.2 and/or ocular hypertension), and 31 had "early glaucoma" (MD < -6 dB, glaucomatous optic neuropathy). SAP was performed with the Octopus 3.1.1 Dynamic 24-2 program. Patients fasted before water drinking test, and four measurements were performed at basal, 15', 30' and 45' after drinking 1 liter of water (WDT) in 5 minutes. In the 30-degree inverted position, IOP measurement with Perkins applanation tonometer was taken after five minutes lying down.
There was a statistical difference in all groups between the basal IOP and peak IOP during the WDT (p<0,001) and in the inverted position IOP (p<0,001). There were no difference among controls (p=0,50), suspects (p=0,41) and glaucoma patients (p=1,0) between WDT IOP and inverted position IOP.
The 30-degree inverted position test was as good as WDT in detecting peak IOP. This new provocative test is easier, faster and more comfortable for both patients and doctors.
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