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FP885 Correlation of Water Drinking Test (WDT) and Glaucomatous visual field damage in Disc suspect. Rajas Eye Hospital, Indore. Purpose of Study. To demonstrate a lower capacity of eyes with worse glaucomatous lesion to respond to transitory IOP elevation during WDT
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FP885Correlation of Water Drinking Test (WDT) and Glaucomatous visual field damage in Disc suspect Rajas Eye Hospital, Indore
Purpose of Study • To demonstrate a lower capacity of eyes with worse glaucomatous lesion to respond to transitory IOP elevation during WDT • To demonstrate co-relation of WDT response and corresponding asymmetric visual field defect in Disc suspect
Material and Methods • Retrospective analysis of visual field and WDT response data of 15 disc suspect patients • Inclusion criteria : • Baseline IOP 12-18 mm Hg • Open angles on gonioscopy • Pupil size > 3 mm • Optic disc as evaluated by 90D lens suspicious of glaucoma • Exclusion criteria: • POAG on treatment • History of filtering surgery • History of laser trabeculoplasty • History of any other disease that could influence visual field examination results
Material and Methods • WDT performed in morning hours • Patient asked to drink 1 liter of water in 10 min. • IOP recorded at 15, 30 & 45 min. • Fields analyzed were those on Humphrey SAP – Strategy used was Central 30 – 2 SITA fast • Based on MD of visual field categorization into better & worse eye was done
Observations 30 eyes of 15 patients Age Group
Observations MD on SAP Report
Observations • Descriptive statistics of Basal IOP, Maximum IOP and fluctuation IOP for better and worse Eye • Comparison of Basal IOP between better and worse eye pairs using Wilcoxon Signed Ranks Test Asymp. Sig. / P value (2 tailed) 0.01
Observations • Comparison of maximum IOP between better and worse eye pairs • Comparison of Fluctuation in IOP between better and worse eye pairs
Results • Basal IOP of better & worse eye in a pair differed significantly • Mean max. IOP of better eye is less than the same of the worse eye • Mean fluctuation in IOP of better eye is less than the same of the worse eye
Discussion • Prospective study by Armaly et al • Change in IOP after water ingestion : One of the potential risk factors • Our study: IOP change significantly co-relates with field change • Study by Kumar R. S. • WDT may provide a satisfactory alternative measure of peak IOP in a clinic setting • Our study: Max. IOP on WDT – more in worse eye than the better one • In our study eye with worse MD as on field report presented higher IOP peaks and fluctuation after water ingestion. And the same has been reported in the study by Susanna Jr et al.
Conclusion Eyes with worse MDs presented higher IOP peaks and fluctuation after water ingestion Thus, WDT – A useful tool for assessingboth the status of eye’s outflow facility and the likelihood of glaucoma progression