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Editors Selection IGR 19-1
Basic Research: Water drinking, eye length and IOP
Comment by Ivan Goldberg on:
26350 Water drinking influences eye length and IOP in young healthy subjects, Read SA; Collins MJ, Experimental Eye Research, 2010; 91: 180-185
Dynamic balance between aqueous inflow and outflow facility determines circadian fluctuations in intraocular pressure (IOP). As IOP reduction forms the basis of glaucoma therapy, knowing the peak IOP for an individual may be important both on and pre-therapy.1,2 Several studies suggest water loading allows this to be detected without the patient having tonometry 'around the clock', or even throughout the day.3-5 The physiology of the water drinking test is not understood. Neither vitreous hydration nor increased aqueous ultra-filtration explains the provoked rise in IOP. Autonomic stimulation and/or increased episcleral venous pressure remain possible mechanisms. Studies to find solutions promise identification of mechanisms that could underlie normal function, as well as glaucoma pathogenesis. Intriguingly, in normal young adults Read and Collins (1149) found an increased axial length on water drinking, an increase that was greater in myopes than in emmetropes. More studies are bound to follow and are awaited eagerly.
References
- Mossad S, Liu JHK, Weinreb RN. Correlation between office and peak nocturnal intraocular pressures in healthy patients and glaucoma patients. Am J Ophthalmol 2005; 139(2): 320-324.
- Nakakura S, Nomura Y, Ataka S, Shiraki K. Relation between office intraocular pressure and 24-hour intraocular pressure in patients with primary open-angle glaucoma treated with a combination of topical antiglaucoma eye drops. J Glaucoma 2007; 16(2):201-204.
- Malerbi FK, Hatanaka M, Vessani RM, Susanna R Jr. Intraocular pressure variability in patients who reached target intraocular pressure. Br J Ophthalmol 2005; 89(5):540-542.
- Susanna R Jr, Hatanaka M, Vessani RM et al. Correlation of asymmetric glaucomatous visual field damage and water-drinking test response. Invest Ophthalmol Vis Sci 2006; 47(2):641-644.
- Kumar RS, Pia de Guzman MH, Ong PY, Goldberg I. Does peak intraocular pressure measured by water drinking test reflect peak circadian levels? A pilot study. Clin Experiment Ophthalmol 2008; 36(4):312-315.
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