Darkroom prone provocative testing in primary angle closure suspects and those with open angles

David S Friedman, Dolly Shuo Teh Chang, Yuzhen Jiang, Shengsong Huang, Xiangbin Kong, Beatriz Munoz, Tin Aung, Paul J. Foster, Mingguang He

Research output: Contribution to journalArticle

Abstract

Purpose: To describe the results of darkroom prone provocative testing (DRPPT) in primary angle closure suspects (PACS) and to compare the findings to controls with open angles. Methods: 889 subjects with PACS in the Zhongshan Angle Closure Prevention Trial (a randomised controlled trial to compare prophylactic laser iridotomy to no treatment in PACS) and 89 with open angles in the 5-year follow-up of Liwan Eye Study were placed in a darkroom face down for 15 min. Intraocular pressure (IOP) was measured immediately before and after DRPPT. Results: PACS participants were of similar age than controls (59.3 vs 60.5), more often female (82.9% vs 58.4%) and had lower IOP (14.3 vs 15.2 mm Hg). The average IOP increases after DRPPT was 4.3±3 mm Hg in PACS and 5.2±2.8 in controls (p<0.05). 20.5% of controls and 13.9 % of those with PACS developed an IOP spike ≥8 mm Hg after DRPPT (p<0.05). Among PACS, 15.8 % of those with all four quadrants closed had an IOP elevation of ≥ 8 mm Hg as opposed to 10.0%-12.4 % with two or three closed quadrants (p<0.05). DRPPT failed to predict who would reach a clinical trial endpoint over 6-year follow-up of those with PACS. Conclusions: A modified DRPPT failed to separate PACS from those with open angle. Although the test resulted in greater IOP elevation among those PACS participants with all four quadrants closed than in those with two or three closed quadrants, it did not offer any insight into the risk of developing acute or chronic angle closure disease over 6-year follow-up.

Original languageEnglish (US)
JournalBritish Journal of Ophthalmology
DOIs
StatePublished - Jan 1 2019

Fingerprint

Intraocular Pressure
Lasers
Randomized Controlled Trials
Clinical Trials

Keywords

  • glaucoma

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

Darkroom prone provocative testing in primary angle closure suspects and those with open angles. / Friedman, David S; Chang, Dolly Shuo Teh; Jiang, Yuzhen; Huang, Shengsong; Kong, Xiangbin; Munoz, Beatriz; Aung, Tin; Foster, Paul J.; He, Mingguang.

In: British Journal of Ophthalmology, 01.01.2019.

Research output: Contribution to journalArticle

Friedman, David S ; Chang, Dolly Shuo Teh ; Jiang, Yuzhen ; Huang, Shengsong ; Kong, Xiangbin ; Munoz, Beatriz ; Aung, Tin ; Foster, Paul J. ; He, Mingguang. / Darkroom prone provocative testing in primary angle closure suspects and those with open angles. In: British Journal of Ophthalmology. 2019.
@article{aac9bc0d9da8442bb3a3a57d02f10f53,
title = "Darkroom prone provocative testing in primary angle closure suspects and those with open angles",
abstract = "Purpose: To describe the results of darkroom prone provocative testing (DRPPT) in primary angle closure suspects (PACS) and to compare the findings to controls with open angles. Methods: 889 subjects with PACS in the Zhongshan Angle Closure Prevention Trial (a randomised controlled trial to compare prophylactic laser iridotomy to no treatment in PACS) and 89 with open angles in the 5-year follow-up of Liwan Eye Study were placed in a darkroom face down for 15 min. Intraocular pressure (IOP) was measured immediately before and after DRPPT. Results: PACS participants were of similar age than controls (59.3 vs 60.5), more often female (82.9{\%} vs 58.4{\%}) and had lower IOP (14.3 vs 15.2 mm Hg). The average IOP increases after DRPPT was 4.3±3 mm Hg in PACS and 5.2±2.8 in controls (p<0.05). 20.5{\%} of controls and 13.9 {\%} of those with PACS developed an IOP spike ≥8 mm Hg after DRPPT (p<0.05). Among PACS, 15.8 {\%} of those with all four quadrants closed had an IOP elevation of ≥ 8 mm Hg as opposed to 10.0{\%}-12.4 {\%} with two or three closed quadrants (p<0.05). DRPPT failed to predict who would reach a clinical trial endpoint over 6-year follow-up of those with PACS. Conclusions: A modified DRPPT failed to separate PACS from those with open angle. Although the test resulted in greater IOP elevation among those PACS participants with all four quadrants closed than in those with two or three closed quadrants, it did not offer any insight into the risk of developing acute or chronic angle closure disease over 6-year follow-up.",
keywords = "glaucoma",
author = "Friedman, {David S} and Chang, {Dolly Shuo Teh} and Yuzhen Jiang and Shengsong Huang and Xiangbin Kong and Beatriz Munoz and Tin Aung and Foster, {Paul J.} and Mingguang He",
year = "2019",
month = "1",
day = "1",
doi = "10.1136/bjophthalmol-2018-313362",
language = "English (US)",
journal = "British Journal of Ophthalmology",
issn = "0007-1161",
publisher = "BMJ Publishing Group",

}

TY - JOUR

T1 - Darkroom prone provocative testing in primary angle closure suspects and those with open angles

AU - Friedman, David S

AU - Chang, Dolly Shuo Teh

AU - Jiang, Yuzhen

AU - Huang, Shengsong

AU - Kong, Xiangbin

AU - Munoz, Beatriz

AU - Aung, Tin

AU - Foster, Paul J.

AU - He, Mingguang

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose: To describe the results of darkroom prone provocative testing (DRPPT) in primary angle closure suspects (PACS) and to compare the findings to controls with open angles. Methods: 889 subjects with PACS in the Zhongshan Angle Closure Prevention Trial (a randomised controlled trial to compare prophylactic laser iridotomy to no treatment in PACS) and 89 with open angles in the 5-year follow-up of Liwan Eye Study were placed in a darkroom face down for 15 min. Intraocular pressure (IOP) was measured immediately before and after DRPPT. Results: PACS participants were of similar age than controls (59.3 vs 60.5), more often female (82.9% vs 58.4%) and had lower IOP (14.3 vs 15.2 mm Hg). The average IOP increases after DRPPT was 4.3±3 mm Hg in PACS and 5.2±2.8 in controls (p<0.05). 20.5% of controls and 13.9 % of those with PACS developed an IOP spike ≥8 mm Hg after DRPPT (p<0.05). Among PACS, 15.8 % of those with all four quadrants closed had an IOP elevation of ≥ 8 mm Hg as opposed to 10.0%-12.4 % with two or three closed quadrants (p<0.05). DRPPT failed to predict who would reach a clinical trial endpoint over 6-year follow-up of those with PACS. Conclusions: A modified DRPPT failed to separate PACS from those with open angle. Although the test resulted in greater IOP elevation among those PACS participants with all four quadrants closed than in those with two or three closed quadrants, it did not offer any insight into the risk of developing acute or chronic angle closure disease over 6-year follow-up.

AB - Purpose: To describe the results of darkroom prone provocative testing (DRPPT) in primary angle closure suspects (PACS) and to compare the findings to controls with open angles. Methods: 889 subjects with PACS in the Zhongshan Angle Closure Prevention Trial (a randomised controlled trial to compare prophylactic laser iridotomy to no treatment in PACS) and 89 with open angles in the 5-year follow-up of Liwan Eye Study were placed in a darkroom face down for 15 min. Intraocular pressure (IOP) was measured immediately before and after DRPPT. Results: PACS participants were of similar age than controls (59.3 vs 60.5), more often female (82.9% vs 58.4%) and had lower IOP (14.3 vs 15.2 mm Hg). The average IOP increases after DRPPT was 4.3±3 mm Hg in PACS and 5.2±2.8 in controls (p<0.05). 20.5% of controls and 13.9 % of those with PACS developed an IOP spike ≥8 mm Hg after DRPPT (p<0.05). Among PACS, 15.8 % of those with all four quadrants closed had an IOP elevation of ≥ 8 mm Hg as opposed to 10.0%-12.4 % with two or three closed quadrants (p<0.05). DRPPT failed to predict who would reach a clinical trial endpoint over 6-year follow-up of those with PACS. Conclusions: A modified DRPPT failed to separate PACS from those with open angle. Although the test resulted in greater IOP elevation among those PACS participants with all four quadrants closed than in those with two or three closed quadrants, it did not offer any insight into the risk of developing acute or chronic angle closure disease over 6-year follow-up.

KW - glaucoma

UR - http://www.scopus.com/inward/record.url?scp=85062335228&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85062335228&partnerID=8YFLogxK

U2 - 10.1136/bjophthalmol-2018-313362

DO - 10.1136/bjophthalmol-2018-313362

M3 - Article

C2 - 30819689

AN - SCOPUS:85062335228

JO - British Journal of Ophthalmology

JF - British Journal of Ophthalmology

SN - 0007-1161

ER -