Elevated IOP following a bladder filling protocol: A case report.
Elevated IOP following a bladder filling protocol: A case report.
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DOI：
10.1016/j.ajoc.2022.101786
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发表时间：
2023-03
影响因子：
--
通讯作者：
Cui, Qi N
中科院分区：
文献类型：
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作者：
Qin, Vivian L;Nguyen, Brian J;Tripp, Patrick;Lehman, Amanda;Addis, Victoria M;Cui, Qi N
我们描述了一名因口服水丸而继发眼压 (IOP) 升高的患者，并检查了饮水测试的效用。一名 66 岁男性，有高血压病史，表现为头痛、双侧眼眶后疼痛、视力模糊。他在接受前列腺癌放射治疗后不久就开始出现症状，为此他在治疗开始前 30 分钟服用了水丸来填充膀胱。检查时，他的双侧眼压升高，局部降眼压药物有反应。房角镜检查显示开角，眼底检查显示非青光眼视神经，伴有明显的视网膜静脉迂曲。饮水测试显示，右眼的峰值眼压为 20 mmHg（较基线增加 5 mmHg），左眼为 23 mmHg（较基线增加 8 mmHg），表明与右眼相比，左眼的流出系统受损。他开始接受局部降眼压治疗，并作为青光眼嫌疑人在我们的诊所进行随访。水丸的消耗可能与眼压升高有关，对于眼压正常但有青光眼风险的患者来说，这可能是一个危险因素。饮水试验历来被用作开角型青光眼的激发试验，并且可能在评估无高眼压症的高危患者方面具有更新的作用。
We describe a patient with elevated intraocular pressure (IOP) secondary to an oral water bolus and examine the utility of the water-drinking test. A 66-year-old male with a history of hypertension presented with headache, bilateral retro-orbital ache, and blurry vision. Symptoms began shortly after his radiation treatment for prostate cancer, for which he consumed a water bolus to fill his bladder 30 minutes prior to treatment initiation. On exam, he had bilateral elevated IOP that responded to topical IOP-lowering medications. Gonioscopy demonstrated open angles and fundus exam showed non-glaucomatous optic nerves with pronounced retinal venous tortuosity. The water-drinking test showed a peak intraocular pressure of 20 mmHg in the right eye (5 mmHg increase from baseline) and 23 mmHg in the left eye (8 mmHg increase from baseline), suggesting impairment of the outflow system in the left compared to the right eye. He was started on topical IOP-lowering therapy and followed in our clinic as a glaucoma suspect. Consumption of a water bolus can be associated with IOP elevation and may be a risk factor in patients with otherwise normal IOPs at risk for glaucoma. The water-drinking test was historically used as provocative testing for open-angle glaucoma and may have an updated role in evaluating at-risk patients without ocular hypertension.