Journal of Current Glaucoma Practice

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VOLUME 10 , ISSUE 1 ( January-April, 2016 ) > List of Articles


A New Provocative Test for Glaucoma

Fabio N Kanadani, TCA Moreira, LF Campos, MP Vianello, J Corradi, SK Dorairaj, ALA Freitas, R Ritch

Keywords : Glaucoma, Provocative test, Water drinking test

Citation Information : Kanadani FN, Moreira T, Campos L, Vianello M, Corradi J, Dorairaj S, Freitas A, Ritch R. A New Provocative Test for Glaucoma. J Curr Glaucoma Pract 2016; 10 (1):1-3.

DOI: 10.5005/jp-journals-10008-1194

License: CC BY-NC 4.0

Published Online: 01-08-2019

Copyright Statement:  Copyright © 2016; The Author(s).


Purpose: To compare the effects of the water-drinking test (WDT) with the 30° inverted body position test on intraocular pressure (IOP) in normal patients, suspected glaucoma patients and glaucoma patients. Materials and methods: Based on clinical evaluation of the optic disk, IOP, and standard achromatic perimetry (SAP) of 71 eyes, 18 were “normal” (normal SAP and optic disk evaluation, and IOP < 21 mm Hg), 30 were “glaucoma suspect” (GS; normal SAP, cup/disk (C/D) ratio > 0.5 or asymmetry > 0.2 and/or ocular hypertension), and 31 had “early glaucoma” (MD < -6 dB, glaucomatous optic neuropathy). Standard achromatic perimetry was performed with the Octopus 3.1.1 Dynamic 24-2 program. Patients fasted before the WDT, and four measurements were performed at basal, 15’, 30, and 45’ after drinking 1 liter of water (WDT) in 5 minutes. In the 30° inverted position, IOP measurement with Perkins applanation tonometer was taken after 5 minutes lying down. Results: 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). Controls (p = 0.50), suspects (p = 0.41) and glaucoma patients (p = 1.0) did not exhibit a difference between WDT-IOP and inverted position IOP. Conclusion: The 30° inverted position test was as efficient 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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