ABSTRACT
PURPOSE: To assess intraocular pressure (IOP) changes after the water drinking test (WDT) in patients with primary congenital glaucoma (PCG). METHODS: In this prospective interventional study, 20 eyes of 20 patients with PCG were included. All patients had undergone trabeculotomy. Six out of twenty eyes had received a glaucoma drainage device (GDD) implantation. IOP was measured using an air-puff tonometer at baseline, and 15, 30, 45, and 60 min after WDT. The repeated-measures analysis of variance test was used to compare the mean IOPs at different time points. RESULTS: The mean ( ± standard deviation) of participants' age was 9.9 ± 2.7 years (range, 6 to 16 years), and 8 (40%) participants were male. The mean IOPs at baseline and 15, 30, 45, and 60 minutes after the WDT were 15.8 ± 3.7, 18.6 ± 3.4, 19.0 ± 3.8, 17.9 ± 3.8, and 16.9 ± 3.5 mmHg, respectively (P < 0.001). Pairwise comparisons revealed that the mean IOPs after 15 and 30 min were significantly greater than the baseline IOP (P < 0.001 and P = 0.002, respectively); however, the difference in mean IOPs after 45 and 60 min were not statistically significant from the baseline IOP. The averages of IOP peak and IOP fluctuation after the WDT were 20.0 ± 3.5 and 4.2 ± 2.9 mmHg, respectively. IOP fluctuation in those who underwent trabeculotomy alone was twice that of those with GDDs, but the difference was not statistically significant (5.0 vs 2.5 mmHg; P = 0.08). CONCLUSION: In patients with PCG, WDT induced significant IOP elevation 15 and 30 min after the test, which returned to pre-test values after 45 min.
ABSTRACT
PURPOSE: The purposes of this study were to validate the Persian translation of the Glaucoma Quality of Life-15 (GQL-15) questionnaire, evaluate its psychometric properties, and identify new composite items and item numbers. METHODS: This cross-sectional study was conducted from August to November 2016, at the Glaucoma Clinic of the Ophthalmology Department at Shiraz University of Medical Sciences, Iran. One hundred ninety patients with glaucoma were enrolled. Habitual-corrected visual acuity (HCVA), intraocular pressure (IOP), slit-lamp biomicroscopy, fundus exam, and mean deviation (MD) of the visual field were recorded in the course of clinical examination by glaucoma professional. Psychometric properties, i.e. test-retest reliability, internal consistency, content validity, and construct validity were evaluated with factor analysis. Based on the Disc Damage Likelihood Scale (DDLS), patients were stratified to mild, moderate, and severe disc damage. The association between the GQL-15 scores and disease severity (mild, moderate and severe) were evaluated by the analysis of variance (ANOVA). RESULTS: Of 190 eligible glaucoma patients, reliable clinical data were available for 140 participants. Mean age [standard deviation (SD)] of the patients was 58.7 (13.3) years. Cronbach's α coefficient ranged from 0.74 to 0.91, and the correlation coefficient for total score was 0.53. The content validity ratio (CVR) was 0.91 based on evaluations in expert panel. Exploratory factor analysis (EFA) based on eigenvalue higher than one identified two factors after varimax rotation for the GQL-15 which explained 66.5% of the total variance. Discriminant validity analysis disclosed statistically significant differences in mean quality of life scores between levels of disease severity. CONCLUSION: The Persian version of the GQL-15 is a reliable and valid questionnaire for use in glaucoma clinics as a complementary tool for evidence-based decision-making.
ABSTRACT
SIGNIFICANCE: Intraocular pressure and ocular biometric changes were similar before and after laser iridotomy in response to the water-drinking test in a cohort of patients at risk of angle closure. The water-drinking test does not seem to be a good provocative test to determine which eyes would benefit from a laser iridotomy. Our data call into question the preoperative predictive value of this test. PURPOSE: The aim of this study was to evaluate the effect of water-drinking test on intraocular pressure and ocular biometric parameters, before and after laser peripheral iridotomy, in patients with an occludable angle. METHODS: Twenty-seven patients, who met the inclusion criteria and had at least 180 degrees of iridotrabecular apposition, underwent a complete eye examination followed by the measurement of ocular biometric (using LenStar LS-900; Haag-Streit AG, Koeniz, Switzerland) and anterior chamber parameters (using Pentacam HR; Oculus Optikgerate GmbH, Wetzlar, Germany). All the measurements were repeated 30 minutes after the water-drinking test. Two weeks after laser peripheral iridotomy, all the measurements were repeated both before and after the water-drinking test. RESULTS: The mean ± SD of the age of the participants was 57 ± 9 years, and 23 (85.2%) were male. Intraocular pressure increased after the water-drinking test in both pre-laser peripheral iridotomy (17.0 vs. 19.3 mmHg, P < .001) and post-laser peripheral iridotomy (15.6 vs. 18.6 mmHg, P < .001) conditions. The thickness values of central cornea increased slightly after the water-drinking test in pre-laser peripheral iridotomy (535 vs. 538 µm, P = .001) compared with post-laser peripheral iridotomy (532 vs. 536 µm, P = .003). The water-drinking test had no significant effect on other biometric or anterior chamber parameters, before or after laser peripheral iridotomy. CONCLUSIONS: The water-drinking test increased intraocular pressure, both before and after laser peripheral iridotomy. Laser peripheral iridotomy had no significant effect on the amount of intraocular pressure change after the water-drinking test. The water-drinking test has no effect on other biometric or anterior chamber parameters.
