Purpose: It was the aim of this study to determine any possible correlation between the peaks and changes in intraocular pressure (IOP) of a water drinking test and intravenous methylprednisolone pulse therapy (IVMPT) IOP response. Methods: Patients with rheumatic disorders scheduled for IVMPT with normal ocular examination received a WDT before and after 3 days of IVMPT. The maximum value of IOPs detected during the WDT or IVMPT was regarded as peak IOP, and IOP change was defined as the difference between peak IOP and baseline IOP. Results: The mean ± standard deviation (SD) IOPs on the first (21.9 ± 4.6 mm Hg; p = 0.04), second (21.9 ± 4.1 mm Hg; p = 0.03) and third (21.3 ± 4.2 mm Hg; p = 0.01) days of 20 enrolled patients were greater than that at baseline (19.3 ± 2.8 mm Hg). The mean ± SD of peak IVMPT IOP response was 23.9 ± 3.7 mm Hg, and IVMPT IOP change was 4.6 ± 3.7 mm Hg. These values for the first and second WDTs were 22.9 ± 4.9 and 3.9 ± 4.07 as well as 24.1 ± 4.6 and 3.00 ± 2.9 mm Hg, respectively. A significant correlation was observed between the first WDT and IVMPT IOP changes (r = 0.5, p = 0.007) and peak IOPs (r = 0.6, p = 0.001). Conclusion: WDT, a low-cost and feasible test in clinical practice, may be a useful tool in determining the IOP peak and change following IVMPT.

Keywords:
Intraocular pressure, Intravenous methylprednisolone, Water drinking test
1.
Woods AC: Clinical and experimental observation on the use of ACTH and cortisone in ocular inflammatory disease. Am J Ophthalmol 1950;33:1325-1349.
2.
Armaly MF, Becker B: Intraocular pressure response to topical corticosteroids. Fed Proc 1965;24:1274-1278.
3.
Razeghinejad MR, Katz LJ: Steroid-induced iatrogenic glaucoma. Ophthalmic Res 2012;47:66-80.
4.
Francois J: Corticosteroid glaucoma. Ann Ophthalmol 1977;9:1075-1080.
5.
Gupta SR, Suhler EB, Rosenbaum JT: Intravenous methylprednisolone can cause an acute, vision-threatening rise in intraocular pressure. J Clin Rheumatol 2010;16:397-398.
6.
Acar M, Gedizlioglu M, Koskderelioglu A, Ozturk F, Kilinc S, Talay N: Effect of high-dose intravenous methyl-prednisolone treatment on intraocular pressure in multiple sclerosis patients with relapse. Eur Neurol 2012;68:20-22.
7.
Susanna R Jr, Vessani RM, Sakata L, Zacarias LC, Hatanaka M: The relation between intraocular pressure peak in the water drinking test and visual field progression in glaucoma. Br J Ophthalmol 2005;89:1298-1301.
8.
Medeiros FA, Pinheiro A, Moura FC, Leal BC, Susanna R Jr: Intraocular pressure fluctuations in medical versus surgically treated glaucomatous patients. J Ocul Pharmacol Ther 2002;18:489-498.
9.
Miller D: The relationship between diurnal tension variation and the water-drinking test. Am J Ophthalmol 1964;58:243-246.
10.
Kumar RS, 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;36:312-315.
11.
Goldberg I, Clement CI: The water drinking test. Am J Ophthalmol 2010;150:447-449.
12.
Spaeth GL: The water drinking test. Indications that factors other than osmotic considerations are involved. Arch Ophthalmol 1967;77:50-58.
13.
Brubaker RF: Importance of outflow facility. Int Glaucoma Rev 2001;3:5.
14.
Clark AF, Wordinger RJ: The role of steroids in outflow resistance. Exp Eye Res 2009;88:752-759.
15.
Gehlen M, Canto AP, Skare TL, Araujo F, Haider O: Short-term, high-dose systemic steroids and intraocular pressure. Can J Ophthalmol 2009;44:465.
16.
Jones R 3rd, Rhee DJ: Corticosteroid-induced ocular hypertension and glaucoma: a brief review and update of the literature. Curr Opin Ophthalmol 2006;17:163-167.
17.
Razeghinejad MR, Myers JS, Katz LJ: Iatrogenic glaucoma secondary to medications. Am J Med 2011;124:20-25.
18.
Kersey JP, Broadway DC: Corticosteroid-induced glaucoma: a review of the literature. Eye (Lond) 2006;20:407-416.
19.
Llobet A, Gasull X, Gual A: Understanding trabecular meshwork physiology: a key to the control of intraocular pressure? Physiology 2003;18:205-209.
20.
Mansouri K, Orguel S, Mermoud A, Haefliger I, Flammer J, Ravinet E, Shaarawy T: Quality of diurnal intraocular pressure control in primary open-angle patients treated with latanoprost compared with surgically treated glaucoma patients: a prospective trial. Br J Ophthalmol 2008;92:332-336.
21.
Shemesh G, Waisbourd M, Varssano D, Michaeli A, Lazar M, Kurtz S: Measurements of intraocular pressure by Goldmann tonometry, Tonopen XL, and the transpalpebral tonometer, TGDc-01, after penetrating keratoplasty: a comparative study. Cornea 2009;28:724-727.
© 2013 S. Karger AG, Basel
2013
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.