Predictive Value of the Water Drinking Test and the Risk of Glaucomatous Visual Field Progression

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20
Tipo de produção
article
Data de publicação
2017
Editora
LIPPINCOTT WILLIAMS & WILKINS
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JOURNAL OF GLAUCOMA, v.26, n.9, p.767-773, 2017
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Resumo
Purpose: The purpose of this is to test the hypothesis the intraocular pressure (IOP) peaks during a stress test [the water drinking test (WDT)] can estimate the risk of future visual field progression in treated primary open- angle glaucoma (POAG) patients. Patients and Methods: Design: Prospective, longitudinal study. Setting: Clinical practice. Study population: Treated POAG patients whose IOP was <= 18mmHg and who had no IOPlowering interventions between the date of the WDT and the last eligible visual field. Intervention: At baseline examination, patients underwent the WDT and were then followed at regular intervals with office-based IOP measurements and visual field testing. Main outcome measure: Cox-proportional hazards survival analysis testing the predictive value of IOP peaks during the WDT versus IOP measurements during office hours on visual field progression. Results: A total of 144 eyes of 96 patients with baseline visual field damage ranging from mild to severe followed for a mean of 28 months were analyzed. In the multivariable analysis adjusting for potential confounders, higher IOP peaks during the WDT were predictive of future visual field progression (hazard ratio=1.11; 95% confidence interval, 1.02 to 1.21; P= 0.013). The average and peak IOP during office hours over the same follow-up period were not significantly associated with progression (P= 0.651 and 0.569, respectively). Conclusions: IOP peaks detected with the WDT were predictive of future visual field progression in a treated POAG population. This stress test could be a useful tool for risk assessment in daily practice.
Palavras-chave
glaucoma, water drinking test, visual fields, progression, risk factors
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