Syed Abid Hassan Naqvi, Syeda Birjees Anwar Kazmi, Zamir Iqbal, Ayesha Hameed, Jawwad Ahmed.
Diagnostic value of water drinking test in primary open angle glaucoma.
Pak J Med Health Sci Jan ;6(1):242-5.

Background: Primary open angle glaucoma (POAG) is neurodegenerative disease of the optic nerve that presents to the practitioner at various stages of continuum characterized by accelerated ganglion cell death, subsequent axonal loss and optic nerve damage, and eventual visual loss. Aims: To determine diagnostic value of water drinking test in primary open angle glaucoma. Material and methods: This clinical trial was carried out in Department of Ophthalmology, CMH Malir Karachi between 1st July 2008 to 30th June 2010. A total of 100 patients were selected for this study. Fifty cases of POAG, raised IOP, open angles on gonioscopy. The findings were compared with 50 normal controls having IOP <20 mmHg, no visual fields (VF) defects, healthy discs, open angles on gonioscopy and no ocular pathology. POAG patients with glaucomatous visual fields defects, glaucomatous disc changes, raised IOP, open angles on gonioscopy, and normal controls with IOP<20 mmHg, included in the study. The patient was asked to drink 1 L of water in less than 5 minutes. IOP measurement was repeated three times with 15-minute intervals. A rise in IOP of 6 or more than 6mmHg was considered significant and test was declared positive. Results: The mean age of the patients in case group was 61.5±10.1 and in control group was 52.4±10.1 years. In case group, mean baseline IOP with medication was 15.0±5.0 mmHg, mean WDT IOP with medication was 19.4±7.9 mmHg, mean Baseline IOP without medication was 19.6±5.6 mmHg, mean WDT IOP without medication was 23.5±5.7 mmHg, mean IOP after 15 minutes of WDT was 26.4±6.9 mmHg and IOP after 30 minutes of WDT was 27.3±6.9 mmHg. In control group, the mean baseline IOP without medication was 13.8±1.8 mmHg, mean WDT IOP without medication was 15.7±2.3 mmHg, mean IOP after 15 minutes of WDT was 14.2±1.7 mmHg and mean IOP after 30 minutes of WDT was 15.9±2.3 mmHg. The significant difference was noted between the two groups. Conclusion: It is concluded from this study that in case group, there was significant difference between baseline IOP and IOP after 30 minutes of WDT and in control group there was not significant difference between baseline IOP and IOP after 30 minutes of WDT.

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