The Changes Of Anterior Chamber Volume For Primary Angle-closure Glaucoma After Water Drinking Test

ObjectiveObjective: 1. To observe the changes of the intraocular pressure,anterior chamber volum,anterior chamber angle,central anterior chamber depth and axis after the water drinking test in primary angle-clousre glaucoma. 2. To futher explore the mechanism of angle clouse in primary angle-closure glaucoma. Design Prospective case series. Subjects 32 primary angle-closure glaucoma (PACG) and 30 healthy volunteers.Methods32 primary angle-closure glaucoma as the test group,with eleven male and twenty female aged 50 to 62 years,the mean age was56.6±5.9(SD) years. 30 healthy volunteers as the normal control group,with fourteen male and sixteen female aged42 to 63years,the mean age was 52.2±7.7(SD) years. whom visited our hospital from January 2010 to october 2010 were enrolled. All subjects underwent baseline IOP,AV ,ACA,PACD,CACD,PD and Axis measurement by a single observer using Goldmann applanation tonometry,Pentacam three-dimensional anterior segment analyzer and A-ultrasound. Subjects were given 1000ml water to drink within 5min. Then IOP,AV,ACA,PACD,CACD,PD and Axis were measuered again at 30min after drinking, Using the SPSS17. 0 statistical analysis software for statistical analysis.Compara the change of parameters between the two groups (p <0. 05 indicated statistical significance). Results1. the IOP at 30 minutes after water-drinking tests were statistically different from before in both PACG and control groups(p<0.001),with the difference more significant in the former group(p<0.001);2. The AV and PACD at 30 minutes after water-drinking tests were statistically different from before in both groups(p<0.001); 3. ACA at 30 minutes after water-drinking tests was smaller than before in the control group with a statistical difference(p<0.001),no obvious differences was observed in the PACG group(p>0.1);4. no obvious changes of CACD,PD and Axis were observed in both groups(p>0.1).Conclusion 1. water-drinking test can lead to increase in IOP and shallower anterior chamber in both normal and PACG subjects.2. In our study,the cause of a shallower anterior chamber and a narrower angle may be the movement of lens-iris diaphragm pushed by the expansive choroids,but the axis did not change after the test,so the relation between the increase of IOP after water-drinking test,shallower anterior chamber and choroidal expansion could not be proved.ObjectiveTo observe the changes of the intraocular pressure,anterior chamber volum and anterior chamber angle after the water drinking test in healthy volunteers. To explore the mechanism of the water drinking test and wheter the water drinking test as a provocative test for angle-closure glaucoma. Design Prospective clinical trial. Subjects 23 healthy volunteers.MethodsA series of eleven male and twelve female healthy persons aged 20 to 31years,the mean age was 26.7±3.07(SD) years. Refraction of the subjects was -2.0D～-4.5D(without other ocular disease). All subjects underwent baseline IOP,AV and ACA measurement by a single observer. Subjects were then given 1000ml water to drink within 5min. Then IOP,AV and ACA was measuered every 15min for an hour. Each parameter measured 3 times and saved the mean value. Using the SPSS17.0statistical analysis software for statistical analysis. 1.To evaluate the repeatability of Pentacam three-dimensional anterior segment analyzer on anterior chamber volume and anterior chamber angle using intraclass correlation coefficient;2.Parameters at each follow-up time were analyzed using repeated measures analysis of variance. 3.The correlation was analyzed between the changes of IOP,AV and ACA.ResultsOne randomly selected eye from each of 23 persons was analyzed. 1.The ICC of pentacam in measuring AV and ACA were 0.95and0.96;95% confidence interval was (0.90,0.98),the CV of them were 1.20%and 0.92% respectively, 95% confidence interval was (-0.175% ,2.50%),indicating a high consistency. 2.The water drinking test produced a statistically significant rise in IOP from baseline at 15min,30min,45min,60min after water ingestion (p<0.001);the peak IOP was at 30min after water ingestion;The statistically significant decrease in AV from baseline at 15min,30min and 45min(p<0.001);the minimum of AV is 30min after water ingestion;The statistically significant decrease in ACA from baseline at 30min and 45min. 3.There was a negative correlation between the changes of IOP and AV(Spearman=-0.959,p=0.041).Conclusion1. Pentacam three-dimensional anterior segment analyzer had a good reproducibility; 2. The water drinking test can be used as angle-closure glaucoma provocation test; 3. Presum that the increased intraocular pressure caused by the decrease of the anterior chamber volume in the water drinking.