Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Department of Surgery, Tan Tock Seng Hospital, Singapore, Singapore.
Eye (Lond). 2024 Oct;38(14):2688-2700. doi: 10.1038/s41433-024-03107-z. Epub 2024 May 7.
This systematic review and meta-analysis examines the relationship between intraocular pressure (IOP) parameters derived from the water drinking test (WDT) and diurnal IOP monitoring, and evaluates the reproducibility of the WDT and its association with future glaucomatous visual field (VF) loss. A literature search was performed on PubMed, EMBASE, and Cochrane Library from inception to 31 March 2023. Cohort, cross-sectional and observational studies reporting WDT results in glaucoma patients were included. Meta analysis with random-effect model was performed using "metafor" package in R version 3.2.1. 641 studies were identified on initial literature search. 38 studies (2479 subjects) were included in final analysis. Meta-analytic estimates of 5 studies (310 subjects) found strong positive correlation in peak IOP between the WDT and diurnal IOP monitoring (r = 0.92, 95% CI = 0.75, 1.08, p < 0.0001). However, there was only weak positive correlation for IOP fluctuation between both methods (r = 0.26, 95% CI = 0.06,0.47, p < 0.0001). Meta-analytic estimates of 3 studies (189 subjects) suggested a trend of the diurnal peak IOP being lower than that derived from the WDT (MD = -2.37 mmHg, 95% Limit of Agreement (LOA) =-5.58,0.84, p = 0.147). Two studies found that a higher WDT peak IOP was associated with greater future VF progression. Two studies demonstrated good reproducibility in peak IOP measurements for WDTs conducted across different days. In conclusion, there was a strong positive correlation between IOP peak measurements from the WDT and diurnal IOP monitoring in glaucoma patients. The WDT peak IOP demonstrated good reproducibility and may be associated with greater future VF progression.
这篇系统评价和荟萃分析研究了饮水试验（WDT）得出的眼压（IOP）参数与日间眼压监测之间的关系，并评估了 WDT 的可重复性及其与未来青光眼视野（VF）损失的关系。我们在 PubMed、EMBASE 和 Cochrane Library 上进行了文献检索，检索时间从建库至 2023 年 3 月 31 日。纳入了报告青光眼患者 WDT 结果的队列研究、横断面研究和观察性研究。使用 R 版本 3.2.1 中的“metafor”包进行随机效应模型荟萃分析。初步文献检索共确定了 641 项研究。最终分析纳入了 38 项研究（2479 名受试者）。5 项研究（310 名受试者）的荟萃分析结果表明，WDT 与日间眼压监测的峰值 IOP 之间存在很强的正相关（r=0.92，95%CI=0.75，1.08，p<0.0001）。然而，两种方法之间的 IOP 波动只有微弱的正相关（r=0.26，95%CI=0.06，0.47，p<0.0001）。3 项研究（189 名受试者）的荟萃分析结果表明，日间峰值 IOP 呈下降趋势，低于 WDT 得出的结果（MD=-2.37mmHg，95%LOA=-5.58，0.84，p=0.147）。两项研究发现，WDT 峰值 IOP 越高，未来 VF 进展越大。两项研究表明，WDT 多次测量的峰值 IOP 具有良好的可重复性。总之，青光眼患者的 WDT 峰值 IOP 与日间眼压监测之间存在很强的正相关。WDT 峰值 IOP 具有良好的可重复性，可能与未来 VF 进展有关。
