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      Evaluation of Intraocular Pressure After Water Drinking Test in Patients with Unilateral Hemifacial Spasm

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          Abstract

          Purpose

          The aim of the study is to examine the baseline intraocular pressure (IOP) and its changes after performing a water drinking test (WDT) in patients with unilateral hemifacial spasm (HFS).

          Patients and Methods

          In this prospective observational study, patients aged 21 years and above diagnosed with unilateral HFS were recruited from the Singapore National Eye Centre between January 2015 and August 2016. The unaffected eye of each patient served as a matched control. An interviewer-administered standardized questionnaire on HFS symptoms and ophthalmic examination was performed. Automated perimetry, optical coherence tomography (OCT) of the optic nerve head, color disc stereophotography and water drinking test (WDT) were done. The primary outcome measure was the difference in IOP between eyes affected by HFS and fellow eyes at baseline and at 15, 30 and 45 minutes of the WDT.

          Results

          Fifty-four patients with unilateral HFS were included. Mean age was 59.8±9.9 years (range, 37.0–84.0). Of these, 54% were female and 94% were Chinese. Mean baseline IOP was significantly higher in eyes with HFS (13.9±3.1mmHg) compared to fellow eyes (13.3±2.8mmHg) (p=0.008). There was no significant difference in absolute or percentage change in IOP from baseline between the 2 groups at 15, 30 and 45 minutes of the WDT. Mean vertical cup–disc ratio (VCDR) on clinical examination was significantly higher in eyes with HFS (0.5±0.2) compared to fellow eyes (0.4±0.2) (p=0.02). There was no significant difference between the groups for visual field parameters and mean retinal nerve fiber layer thickness on OCT.

          Conclusion

          Hemifacial spasm is associated with a small but significant difference in mean baseline IOP and VCDR between affected and fellow eyes. However, when eyes affected by HFS and fellow eyes were challenged with the WDT, both responded in similar ways.

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          Most cited references21

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          Predictive factors for glaucomatous visual field progression in the Advanced Glaucoma Intervention Study.

          Kouros Nouri-Mahdavi, Douglas Hoffman, Anne L. Coleman … (2004)
          To investigate the risk factors associated with visual field (VF) progression in the Advanced Glaucoma Intervention Study (AGIS) with pointwise linear regression (PLR) analysis of serial VFs. Prospective, multicenter, randomized clinical trial. Five hundred nine eyes of 401 patients from the AGIS with a baseline VF score of or=7 VF examinations, and >or=3 years of follow-up were selected. Visual field progression. This is a cohort study of patients enrolled in a prospective randomized clinical trial (AGIS). Worsening of a test location on PLR analysis was defined as a change of threshold sensitivity of >or=1.00 decibels a year, with P
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            Fluctuation of intraocular pressure and glaucoma progression in the early manifest glaucoma trial.

            M. Leske, Anders Heijl, … (2007)
            To investigate whether increased fluctuation of intraocular pressure (IOP) is an independent factor for glaucoma progression. A cohort of patients was followed up in a randomized clinical trial. Two hundred fifty-five glaucoma patients from the Early Manifest Glaucoma Trial (EMGT; 129 treated and 126 control patients). Study visits, conducted every 3 months, included ophthalmologic examinations, IOP measurements, and standard automated perimetry, with fundus photography every 6 months. Intraocular pressure values were included only until the time of progression in those eyes that showed such progression. Individual mean follow-up IOP and IOP fluctuation, calculated as the standard deviation of IOP at applicable visits, were the variables of main interest. Cox regression with time-dependent variables was used to evaluate the association between IOP fluctuation and time to progression, both with and without IOP mean in the models. These analyses also controlled for other significant variables. Glaucoma progression, as defined by a predetermined visual field criterion, worsening of the disk, assessed by an independent disc reading center, or both. Median follow-up time was 8 years (range, 0.1-11.1 years). Sixty-eight percent of the patients progressed. When considering mean follow-up IOP and IOP fluctuation in the same time-dependent model, mean IOP was a significant risk factor for progression. The hazard ratio (HR) was 1.11 (95% confidence interval [CI], 1.06-1.17; P<0.0001). Intraocular pressure fluctuation was not related to progression, with an HR of 1.00 (95% CI, 0.81-1.24; P = 0.999). These results confirm our earlier finding that elevated IOP is a strong factor for glaucoma progression, with the HR increasing by 11% for every 1 mmHg of higher IOP. Intraocular pressure fluctuation was not an independent factor in our analyses, a finding that conflicts with some earlier reports. One explanation for the discrepancy is that our analyses did not include postprogression IOP values, which would be biased toward larger fluctuations because of more intensive treatment. In contrast, in this EMGT report, no changes in patient management occurred during the period analyzed.
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              Assessment: Botulinum neurotoxin for the treatment of movement disorders (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology.

              D.M. Simpson, A Blitzer, A Brashear … (2008)
              To perform an evidence-based review of the safety and efficacy of botulinum neurotoxin (BoNT) in the treatment of movement disorders. A literature search was performed including MEDLINE and Current Contents for therapeutic articles relevant to BoNT and selected movement disorders. Authors reviewed, abstracted, and classified articles based on American Academy of Neurology criteria (Class I-IV). The highest quality literature available for the respective indications was as follows: blepharospasm (two Class II studies); hemifacial spasm (one Class II and one Class III study); cervical dystonia (seven Class I studies); focal upper extremity dystonia (one Class I and three Class II studies); focal lower extremity dystonia (one Class II study); laryngeal dystonia (one Class I study); motor tics (one Class II study); and upper extremity essential tremor (two Class II studies). Botulinum neurotoxin should be offered as a treatment option for the treatment of cervical dystonia (Level A), may be offered for blepharospasm, focal upper extremity dystonia, adductor laryngeal dystonia, and upper extremity essential tremor (Level B), and may be considered for hemifacial spasm, focal lower limb dystonia, and motor tics (Level C). While clinicians' practice may suggest stronger recommendations in some of these indications, evidence-based conclusions are limited by the availability of data.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Ophthalmol
                Journal ID (iso-abbrev): Clin Ophthalmol
                Journal ID (publisher-id): OPTH
                Journal ID (pmc): clinop
                Title: Clinical Ophthalmology (Auckland, N.Z.)
                Publisher: Dove
                ISSN (Print): 1177-5467
                ISSN (Electronic): 1177-5483
                Publication date (Electronic): 18 June 2020
                Publication date Collection: 2020
                Volume: 14
                Pages: 1675-1680
                Affiliations
                [1 ]Department of Cataract and Comprehensive Ophthalmology, Singapore National Eye Centre , Singapore
                [2 ]Department of Glaucoma, Singapore National Eye Centre , Singapore
                [3 ]Singapore Eye Research Institute , Singapore
                [4 ]Department of Surgical Retina, Singapore National Eye Centre , Singapore
                [5 ]Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School , Singapore
                [6 ]Department of Ophthalmology, National University of Singapore , Singapore
                [7 ]Department of Neuro-Ophthalmology, Singapore National Eye Centre , Singapore
                [8 ]Neuroscience and Behavioral Disorders Program, Duke-NUS Medical School , Singapore
                [9 ]Department of Training and Education, Singapore National Eye Centre , Singapore
                Author notes
                Correspondence: Sharon Lee Choon Tow Tel +65 6322 7443Fax +65 6333 8339 Email sharon.tow.l.c@singhealth.com.sg
                Author information
                http://orcid.org/0000-0002-1419-9482
                Article
                Publisher ID: 249943
                DOI: 10.2147/OPTH.S249943
                PMC ID: 7308145
                SO-VID: 3119b531-5804-4bc0-90da-3dd3caf2f3f2
                Copyright © © 2020 Low et al.
                License:

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                Date received : 15 February 2020
                Date accepted : 15 April 2020
                Page count
                Tables: 2, References: 24, Pages: 6
                Categories
                Subject: Original Research

                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: glaucoma,hemifacial spasm,intraocular pressure,water drinking test
                Data availability:
                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: glaucoma, hemifacial spasm, intraocular pressure, water drinking test

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