title: A New Provocative Test for Glaucoma.
abstract: OBJECTIVE
  To compare the effects of the water-drinking test (WDT) with the 30° inverted body position test on intraocular pressure (IOP) in normal patients, suspected glaucoma patients and glaucoma patients.
  
  
  METHODS
  Based on clinical evaluation of the optic disk, IOP, and standard achromatic perimetry (SAP) of 71 eyes, 18 were "normal" (normal SAP and optic disk evaluation, and IOP < 21 mm Hg), 30 were "glaucoma suspect" (GS; normal SAP, cup/disk (C/D) ratio > 0.5 or asymmetry > 0.2 and/or ocular hypertension), and 31 had "early glaucoma" (MD < -6 dB, glaucomatous optic neuropathy). Standard achromatic perimetry was performed with the Octopus 3.1.1 Dynamic 24-2 program. Patients fasted before the WDT, and four measurements were performed at basal, 15', 30, and 45' after drinking 1 liter of water (WDT) in 5 minutes. In the 30° inverted position, IOP measurement with Perkins applanation tonometer was taken after 5 minutes lying down.
  
  
  RESULTS
  There was a statistical difference in all groups between the basal IOP and peak IOP during the WDT (p < 0.001) and in the inverted position IOP (p < 0.001). Controls (p = 0.50), suspects (p = 0.41) and glaucoma patients (p = 1.0) did not exhibit a difference between WDT-IOP and inverted position IOP.
  
  
  CONCLUSIONS
  The 30° inverted position test was as efficient as WDT in detecting peak IOP. This new provocative test is easier, faster and more comfortable for both patients and doctors. How to cite this article: Kanadani FN, Moreira TCA, Campos LF, Vianello MP, Corradi J, Dorairaj SK, Freitas ALA, Ritch R. A New Provocative Test for Glaucoma. J Curr Glaucoma Pract 2016;10(1): 1-3.
authors.affiliation: Chief, Department of Ophthalmology, Medical Science Ophthalmology Institute, Belo Horizonte, Brazil.
authors.forename: Fabio N
authors.initials: FN
authors.lastname: Kanadani
authors.affiliation: Assistant Professor, Department of Retina, Medical Science Ophthalmology Institute, Belo Horizonte, Brazil.
authors.forename: Tca
authors.initials: T
authors.lastname: Moreira
authors.affiliation: Assistant Professor, Department of Glaucoma, Medical Science Ophthalmology Institute, Belo Horizonte, Brazil.
authors.forename: L F
authors.initials: LF
authors.lastname: Campos
authors.affiliation: Assistant Professor, Department of Glaucoma, Medical Science Ophthalmology Institute, Belo Horizonte, Brazil.
authors.forename: M P
authors.initials: MP
authors.lastname: Vianello
authors.affiliation: Assistant Professor, Department of Glaucoma, Medical Science Ophthalmology Institute, Belo Horizonte, Brazil.
authors.forename: J
authors.initials: J
authors.lastname: Corradi
authors.affiliation: Assistant Professor, Department of Ophthalmology/Glaucoma, Mayo Clinic Jacksonville, Florida, USA.
authors.forename: S K
authors.initials: SK
authors.lastname: Dorairaj
authors.affiliation: Assistant Professor, Department of Glaucoma, Medical Science Ophthalmology Institute, Belo Horizonte, Brazil.
authors.forename: Ala
authors.initials: A
authors.lastname: Freitas
authors.affiliation: Assistant Professor, Department of Ophthalmology/Glaucoma, Mayo Clinic Jacksonville, Florida, USA.
authors.forename: R
authors.initials: R
authors.lastname: Ritch
keywords: Glaucoma; Provocative test; Water drinking test.