The Clinical Application Of Mydriasis Water-drinking Dark-room Lower-head-position Provocative Test In Glaucoma Suspects

ObjectiveTo investigate and value the clinical application of the mydriasis water-drinking dark-room lower-head-position provocative test (MWDLPT,PT) in glaucoma suspects (GS).MethodsMedical records were reviewed of 74 eyes in 37 patients who were diagnosed with GS at Glaucoma Clinic in the First Hospital of China Medical University from February 2004 to January 2010.The age ranged from 15 to 78 years,and the average age was 50.7±19.3 (mean±SD) years.All the individuals received PT and daytime intraocular pressure (DIOP) measurement on different days.The fluctuation of intraocular pressure (ΔIOP) induced by PT and recorded by DIOP measurement were obtained and compared. An increase in IOP of at least 8mmHg from baseline was considered a positive result for both of the two methods.Statistical analysises were performed by Chi-square test and linear regression analysis to assess the distinction of the results between different methods and between different peripheral anterior chamber depths (PACD),the correlations and agreements ofΔIOP and Peak IOP by different methods,and ofΔIOP in different ages.P<0.05 was considered to be statistical significance. ResultsThe PT results were positive in 37 eyes of 21 patients.None of the severe complications (such as obvious pain in eyes or head,impaired vision,nausea and vomiting)was observed during and after PT.After PT, the IOP returned to near-baseline level within 1-2 hours in all patients; some patients were treated with miotic agent.There was significant positive correlation between the Peak IOP by the PT and DIOP,and the positive rate of PT was higher than DIOP.Furthermore,the positive rate of PT was rather higher when PACD<1/4 corneal thickness (CT) than>1/4CT.There was no correlation between theΔIOP of PT and age.ConclusionsMWDLPT could be a new provocative test for GS.It is better than DIOP in measuring the IOP fluctuation,maybe especially for the angle-closure glaucoma (ACG).Since the results are not affected by the age,PT has extensive use.In conclusion, PT is safe and effective in patients with GS.