Razeghinejad Reza, Nowroozzadeh M Hossein
Glaucoma Service, Wills Eye Hospital, Philadelphia, PA, USA.
Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
J Ophthalmic Vis Res. 2019 Jul 18;14(3):267-274. doi: 10.18502/jovr.v14i3.4782. eCollection 2019 Jul-Sep.
To compare the water-drinking test (WDT) and pharmacologic mydriasis as provocative tests in patients with primary angle closure suspect (PACS).
This observational non-randomized comparative study evaluated changes in intraocular pressure (IOP) in 21 patients with PACS who underwent pharmacologic mydriasis and compared it with IOP changes in 26 patients given the WDT. Ocular biometric and anterior chamber parameters were also assessed. Tests were repeated on the same patient two weeks after performing laser peripheral iridotomy (LPI).
The mean age standard deviation was 60 7 and 57 9 years in the mydriasis and WDT groups, respectively ( = 0.201). Before LPI, both provocative tests were associated with a significant increase in IOP (mydriasis: 15.1 3.1 to 16.6 3.5 mmHg, = 0.025; WDT: 16.2 2.8 to 18.5 3.3 mmHg, < 0.001). However, the IOP changes were not statistically different between groups ( = 0.102). After LPI, only the WDT group showed a continued significant IOP elevation after the test (mydriasis: 16.4 3.3 to 16.7 3.5 mmHg, = 0.569; WDT: 14.9 3.0 to 17.8 4.1 mmHg, < 0.001). The post-test IOP change was significantly greater in the WDT than in the mydriasis group (3.0 versus 0.3 mmHg, respectively; = 0.002). Step-wise multiple regression analysis verified the type of provocative test as the only independent factor affecting the post-test IOP change after LPI (regression coefficient: 2.664; = 0.002).
Pharmacologic mydriasis and the WDT had similar IOP elevation before LPI, but after LPI, IOP elevation was much greater in the WDT group.
比较饮水试验（WDT）和药物性散瞳作为原发性闭角型青光眼可疑患者（PACS）激发试验的效果。
这项观察性非随机对照研究评估了21例接受药物性散瞳的PACS患者的眼压（IOP）变化，并与26例接受饮水试验患者的IOP变化进行比较。同时评估了眼部生物特征和前房参数。在进行激光周边虹膜切开术（LPI）两周后，对同一患者重复进行测试。
散瞳组和饮水试验组的平均年龄±标准差分别为60±7岁和57±9岁（P = 0.201）。在LPI之前，两种激发试验均与IOP显著升高相关（散瞳：15.1±3.1至16.6±3.5 mmHg，P = 0.025；饮水试验：16.2±2.8至18.5±3.3 mmHg，P < 0.001）。然而，两组之间的IOP变化无统计学差异（P = 0.102）。LPI后，仅饮水试验组在试验后IOP持续显著升高（散瞳：16.4±3.3至16.7±3.5 mmHg，P = 0.569；饮水试验：14.9±3.0至17.8±4.1 mmHg，P < 0.001）。饮水试验组试验后的IOP变化显著大于散瞳组（分别为3.0和0.3 mmHg；P = 0.002）。逐步多元回归分析证实激发试验类型是影响LPI后试验后IOP变化的唯一独立因素（回归系数：2.664；P = 0.002）。
在LPI之前，药物性散瞳和饮水试验引起的IOP升高相似，但LPI后，饮水试验组的IOP升高幅度更大。
