饮水试验在药物治疗的原发性开角型青光眼患者中的作用。

Role of the water-drinking test in medically treated primary open angle glaucoma patients.

作者信息

Salcedo H, Arciniega D, Mayorga M, Wu L

机构信息

Instituto de Ciencias de la Visión - Hospital Dr. Rodolfo Robles Valverde, Diagonal 21, 19-19 Zona 11, Anillo Periférico, Guatemala City, Guatemala.

出版信息

J Fr Ophtalmol. 2018 May;41(5):421-424. doi: 10.1016/j.jfo.2017.11.014. Epub 2018 May 16.

DOI:10.1016/j.jfo.2017.11.014

PMID:29778281

Abstract

PURPOSE

The water-drinking test (WDT) has recently re-emerged as a possible way to determine the competency of the trabecular meshwork. We performed a prospective interventional study to test the hypothesis that the WDT could be useful in assessing fluctuations in patients undergoing treatment for primary open angle glaucoma (POAG).

METHODS

We included 122 patients; 62 on medical treatment for POAG (n=123 eyes) and 60 controls (n=120 eyes). The study group had been on intraocular pressures (IOP) lowering treatment continuously for at least 3months with stable IOP. The WDT was performed during fasting and was considered positive if it fluctuated ≥6mmHg.

RESULTS

The patients on medical treatment had a mean age of 50.56±18.45 years vs. 51.35±11.22 for the controls (P=0.34); with 71% being female in the study group and 77% in the control group. In the study group; 52% were on beta blockers (n=64), 27% combination of two or more medications (n=33), 19% prostaglandin analogues (n=24) and 2% alpha agonists (n=2). The WDT was positive in 17.07% (n=21) in the study group and 2.5% (n=3) in the control group (P=0.0001). The mean fluctuation was 7.14±2.15mmHg in the study group and 6.00±0mmHg in the controls (P=0.33). A positive WDT was found in 33.33% (n=11) of those on combination therapy; 12.5% (n=3) prostaglandin analogues and 10.94% (n=7) beta blockers (P=0.03). Combination therapy had the highest positive WDT fluctuation (7.54±2.87) followed by prostaglandin analogues (7.00±1.00) and beta blockers (6.57±0.78) with a P value of 0.44.

CONCLUSIONS

The WDT can identify significant fluctuations in eyes with POAG that are medically treated.

摘要

目的

饮水试验（WDT）最近再次成为一种可能用于确定小梁网功能的方法。我们进行了一项前瞻性干预研究，以检验饮水试验在评估原发性开角型青光眼（POAG）治疗患者眼压波动方面是否有用的假设。

方法

我们纳入了122名患者；62名接受POAG药物治疗的患者（123只眼）和60名对照者（120只眼）。研究组持续接受降低眼压（IOP）治疗至少3个月，眼压稳定。饮水试验在空腹时进行，如果眼压波动≥6mmHg则被认为是阳性。

结果

接受药物治疗的患者平均年龄为50.56±18.45岁，而对照组为51.35±11.22岁（P = 0.34）；研究组71%为女性，对照组77%为女性。在研究组中，52%使用β受体阻滞剂（64例），27%使用两种或更多药物联合治疗（33例），19%使用前列腺素类似物（24例），2%使用α受体激动剂（2例）。研究组中17.07%（21例）饮水试验为阳性，对照组中为2.5%（3例）（P = 0.0001）。研究组平均波动为7.14±2.15mmHg，对照组为6.00±0mmHg（P = 0.33）。联合治疗组中33.33%（11例）饮水试验为阳性；前列腺素类似物组为12.5%（3例），β受体阻滞剂组为10.94%（7例）（P = 0.03）。联合治疗组饮水试验波动阳性率最高（7.54±2.87），其次是前列腺素类似物组（7.00±1.00）和β受体阻滞剂组（6.57±0.78），P值为0.44。