Department of Ophthalmology, Sydney Eye Hospital.
Discipline of Ophthalmology, The University of Sydney, Sydney.
J Glaucoma. 2022 Jul 1;31(7):511-522. doi: 10.1097/IJG.0000000000002029. Epub 2022 Apr 6.
Hemoglobin video imaging (HVI) demonstrates increased aqueous outflow (AO) in response to the water drinking test (WDT) in patients with and without glaucoma. In glaucomatous eyes, increased AO was not sustained, and characteristic flow patterns were seen.
To observe how variations in intraocular pressure (IOP) correlate with the flow of aqueous in episcleral veins.
Prospective observational cohort study.
The WDT increased AO into the episcleral venous system in 30 eyes recruited from Sydney Eye Hospital. A comparison was made between glaucomatous (n=20) and nonglaucomatous eyes (n=10).
Each patient had baseline IOP and HVI before drinking 10 mL/kg body weight of water. IOP and HVI were then repeated every 15 minutes for 1 hour. Aqueous column cross-sectional area (AqCA) of the most prominent nasal and temporal aqueous veins was used to semi-quantify conventional AO.
Change in IOP and AqCA from baseline during the WDT. Aqueous flow characteristics were also observed.
Peak IOP elevation above baseline was significantly higher in the glaucoma group, with an average IOP rise of 39.7% on 1.6 1.1 medications, compared with 22.9% in the control group ( P =0.04). AqCA significantly increased for glaucomatous and nonglaucomatous eyes in response to water ingestion ( P <0.05). AqCA fell by 50% in glaucomatous eyes ( P =0.003) and 33% in nonglaucomatous eyes ( P =0.08) at study completion compared with the peak measurement. IOP remained >30% elevated in 8 glaucomatous eyes (40%) after 60 minutes and no control eyes. Variations in qualitative aqueous flow patterns were observed in glaucomatous eyes but not in controls.
AO volume, estimated by AqCA, increases in response to IOP elevation induced by an ingested water bolus in patients with and without glaucoma. The increase in aqueous drainage was not sustained in glaucomatous eyes and may have led to incomplete recovery of IOP. Using HVI in combination with the WDT may assist with clinical decision-making and facilitate the monitoring of responses to treatment.
血红蛋白视频成像（HVI）显示，在有和没有青光眼的患者中，水饮测试（WDT）会引起房水流出（AO）增加。在青光眼眼中，增加的 AO 不能维持，并且会出现特征性的流动模式。
观察眼压（IOP）的变化如何与巩膜静脉中的房水流动相关。
前瞻性观察队列研究。
从悉尼眼科医院招募了 30 只眼睛进行 WDT，增加了 AO 进入巩膜静脉系统。比较了青光眼（n=20）和非青光眼（n=10）眼。
每位患者在饮用 10 毫升/千克体重的水之前均进行基础 IOP 和 HVI。然后，在 1 小时内每 15 分钟重复测量 IOP 和 HVI。使用最突出的鼻侧和颞侧房水静脉的房水柱横截面积（AqCA）来半定量常规 AO。
WDT 期间 IOP 和 AqCA 从基线的变化。还观察了房水流动特征。
青光眼组的峰值 IOP 升高明显高于对照组，平均眼压升高 39.7%，使用 1.6 种 1.1 种药物，而对照组为 22.9%（P=0.04）。在青光眼和非青光眼眼中，AqCA 随着水的摄入而显著增加（P<0.05）。与峰值测量相比，青光眼眼在研究结束时 AqCA 下降了 50%（P=0.003），而非青光眼眼下降了 33%（P=0.08）。在 60 分钟后，8 只青光眼眼（40%）的 IOP 仍升高超过 30%，而无对照眼。在青光眼眼中观察到房水流动模式的定性变化，但在对照组中未观察到。
在有和没有青光眼的患者中，眼压升高会引起 AO 体积增加，通过摄入水负荷来估计，AqCA 增加。青光眼眼中增加的房水引流不能维持，可能导致眼压不完全恢复。使用 HVI 与 WDT 相结合，可能有助于临床决策，并有助于监测对治疗的反应。
