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Ibopamine challenge testing differentiates glaucoma suspect, stable glaucoma and progressive glaucoma cases.

John Landers1,2, Katja Ullrich1, Jamie E Craig1,2

  • 1Department of Ophthalmology, Flinders Medical Centre, Adelaide, South Australia, Australia.

Clinical & Experimental Ophthalmology
|July 4, 2015
PubMed
Summary

The ibopamine challenge test can help differentiate glaucoma stages. Intraocular pressure (IOP) changes distinguish glaucoma suspects from stable or progressive glaucoma, while optic cup volume (OCV) changes differentiate stable from progressive cases.

Keywords:
challenge testglaucomaibopamineprogressionsuspect

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Area of Science:

  • Ophthalmology
  • Glaucoma diagnostics
  • Pharmacological testing

Background:

  • Glaucoma diagnosis relies on intraocular pressure (IOP) and optic cup volume (OCV) assessment.
  • A novel ibopamine challenge test uses topical ibopamine to temporarily increase aqueous production.
  • This test's utility in differentiating glaucoma stages is under investigation.

Purpose of the Study:

  • To evaluate the ibopamine challenge test's effectiveness in distinguishing between glaucoma suspects (GS), stable glaucoma (SG), and progressive glaucoma (PG) patients.
  • To determine if changes in IOP and OCV after an ibopamine challenge correlate with glaucoma severity.

Main Methods:

  • A non-randomized clinical trial involved 61 patients (24 GS, 24 SG, 13 PG).
  • Baseline IOP and OCV were measured using optical coherence tomography.
  • Two drops of ibopamine 2% were administered, followed by repeat IOP and OCV measurements after 45 minutes.
  • Changes in IOP and OCV from baseline were compared across the three patient groups.

Main Results:

  • IOP significantly increased post-ibopamine challenge: 1.8 mmHg (GS), 4.5 mmHg (SG, P=0.003), and 8.1 mmHg (PG, P<0.0001).
  • OCV increased post-challenge: 0.2% (GS), 0.6% (SG), and 5.5% (PG).
  • OCV changes were not significantly different between GS and SG but were significantly different between GS and PG (P<0.0001) and between SG and PG (P=0.001).

Conclusions:

  • The ibopamine challenge test shows potential for differentiating glaucoma patient groups.
  • IOP response to ibopamine can distinguish glaucoma suspects from those with stable or progressive disease.
  • OCV changes following the ibopamine challenge can differentiate between stable and progressive glaucoma patients.