Comparison between provocative test-based and long-term intraocular pressure parameters in patients with stable open-angle glaucoma.
PURPOSE
To compare provocative test-based and long-term intraocular pressure variation parameters in patients with stable open-angle glaucoma.


METHODS
A prospective observational study was carried out in which stable open-angle glaucoma patients (⩾3 years of follow-up without any changes on current medical regimen) were consecutively enrolled. All patients were submitted to a water-drinking test. Long-term intraocular pressure parameters were obtained from isolated intraocular pressure measurements from each visit (⩾5 visits). We investigated the correlation and agreement between the following water-drinking test and long-term intraocular pressure parameters: mean, peak, and fluctuation. In addition, the percentage of eyes with significant intraocular pressure peaks during the water-drinking test (defined as a difference ⩾25% between water-drinking test intraocular pressure peak and mean long-term intraocular pressure) was assessed.


RESULTS
Sixty-three eyes from 63 open-angle glaucoma patients (mean age, 60.7 ± 11.8 years) were included. Mean and water-drinking test intraocular pressure peak correlated significantly with mean (r = 0.67) and maximum long-term intraocular pressure (r = 0.52), respectively (p < 0.01). The correlation between water-drinking test intraocular pressure fluctuation and long-term intraocular pressure fluctuation was not significant (p = 0.45). Limits of agreement from Bland-Altman plots exceeded the maximum allowed difference between methods (3 mm Hg) for all the intraocular pressure parameters analyzed, suggesting poor agreement between water-drinking test-derived and long-term intraocular pressure values. Overall, significant water-drinking test intraocular pressure peaks were observed in 39.7% of these eyes with stable open-angle glaucoma.


CONCLUSION
Although some water-drinking test-based and long-term intraocular pressure parameters correlate significantly, water-drinking test results may not reflect the long-term intraocular pressure profile of stable open-angle glaucoma patients, as their agreement is poor. Many of these patients may experience significant water-drinking test intraocular pressure peaks, despite long-standing stable disease and unchanged medical regimen.
['Almeida|Izabela|I|', 'Scoralick|Ana Luiza B|ALB|', 'Dias|Diego T|DT|', 'Ushida|Michele|M|', 'Dorairaj|Syril|S|https://orcid.org/0000-0003-1830-3766', 'Gracitelli|Carolina Pb|CP|', 'Paranhos|Augusto|A|', 'Kanadani|Fábio N|FN|', 'Prata|Tiago S|TS|']
D000368:Aged D001082:Aqueous Humor D003941:Diagnostic Techniques, Ophthalmological D060766:Drinking Water D005260:Female D005500:Follow-Up Studies D005902:Glaucoma, Open-Angle D006801:Humans D007429:Intraocular Pressure D008297:Male D008875:Middle Aged D011446:Prospective Studies D014065:Tonometry, Ocular
open-angle glaucoma Glaucoma aqueous humor dynamics diagnostic techniques epidemiology/risk factors