Comparison of intraocular pressure profiles during the water drinking test and the modified diurnal tension curve.
Yap Timothy E, Gao Yuan, Ahmad Hanif, Susanna Fernanda, Susanna Remo, Normando Eduardo M, Bloom Philip A, Cordeiro Maria Francesca
AI Summary
This study found a strong correlation between maximum IOP during WDT and mDTC in OAG patients, suggesting WDT is a time-efficient, clinically relevant alternative for assessing diurnal IOP.
Abstract
Objectives
To compare intraocular pressure (IOP) during the water drinking test (WDT) and modified diurnal tension curve (mDTC) in open-angle glaucoma (OAG) patients, using multimodal, observer-masked tonometry.
Methods
Open-angle glaucoma subjects were prospectively enroled, excluding those who had undergone glaucoma filtration or laser surgery. Two-hourly mDTC Goldmann applanation (GAT) and rebound tonometry (RT) was performed between 8:00 and 16:00, and every 15 min for 45 min after ingestion of 800mls of water. Blood pressure, heart rate, pupillometry measurements, and optical coherence tomography (AS-OCT) were also recorded.
Results
Forty-two subjects' right eyes were included. 48% were using topical glaucoma medication. Mean baseline IOP was 14.9 ± 4.52 mmHg, with mean visual field mean deviation (±SD) -5.05 ± 5.45 dB. Strong association was found between maximum IOP during mDTC and WDT (r = 0.90, 95% CI 0.82-0.95 p < 0.0001) with agreement (mDTC-WDT) bias -0.82 mmHg, 95% LoA -1.46 to -0.18. During the WDT, mean systolic blood pressure (±SD) increased from 140.0 ± 20.0 to 153.3 ± 24.0 mmHg (p < 0.0001), mean heart rate ( ± SD) reduced from 69.5 ± 11.3 bpm to 63.6 ± 10.0 bpm (p < 0.0001), and temporal iridocorneal angle increased from 29.2 ± 6.0° to 29.6 ± 5.2° (p = 0.04).
Conclusion
This study presents repeated, observer-masked IOP data showing strong correlation between maximum IOP during mDTC and WDT using multimodal tonometry. This supports WDT as a meaningful alternative to mDTC when investigating diurnal IOP characteristics in clinic, with reduced time requirements and associated costs.
MeSH Terms
Shields Classification
Key Concepts5
A strong association was found between maximum intraocular pressure (IOP) during the modified diurnal tension curve (mDTC) and the water drinking test (WDT) (r = 0.90, 95% CI 0.82-0.95, p < 0.0001) with agreement (mDTC-WDT) bias -0.82 mmHg, 95% LoA -1.46 to -0.18 in open-angle glaucoma subjects.
During the water drinking test (WDT) in open-angle glaucoma subjects, mean systolic blood pressure (±SD) increased from 140.0 ± 20.0 to 153.3 ± 24.0 mmHg (p < 0.0001).
During the water drinking test (WDT) in open-angle glaucoma subjects, mean heart rate (±SD) reduced from 69.5 ± 11.3 bpm to 63.6 ± 10.0 bpm (p < 0.0001).
During the water drinking test (WDT) in open-angle glaucoma subjects, the temporal iridocorneal angle increased from 29.2 ± 6.0° to 29.6 ± 5.2° (p = 0.04).
The water drinking test (WDT) is a meaningful alternative to the modified diurnal tension curve (mDTC) for investigating diurnal intraocular pressure characteristics in clinic, due to strong correlation between maximum IOP during mDTC and WDT and reduced time requirements and associated costs.
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