LAUSR

cific characteristics of this study population would be responsible for such findings (an uncommon high progression rate in a relative short period of time), and how representative of the general POAG population this sample is. Finally, we believe that a specific point related to the relationship between WDT results and study outcomes needs clarification. On study entry, all patients, deemed well controlled by their physician, underwent a WDT. A significant correlation between IOP peak during the WDT and baseline IOP was reported. In the Methods section, the authors stated that patients’ data were censored not only if visual field progression was confirmed, but also if any IOP-lowering intervention was necessary (changes on medical regimen, laser, or incisional glaucoma surgery). In this context, it seems reasonable to expect that eyes with higher baseline IOPs (and likely higher IOP peak values and a worse response to the WDT) would be more prone to undergo an IOP-lowering intervention (and being censored before reaching a visual field progression endpoint) during follow-up than those with a better response to the test. This fact would reduce the likelihood of visual field progression detection in these eyes during the study. The fact that the authors found the opposite results suggests that other factors (not investigated in the study) may have contributed to disease progression besides peak IOP. In conclusion, we believe that the role of provocative tests, such as the WDT, as independent risk assessment tools (as predictors of glaucoma progression) remains unclear. Although some clarifications are needed, we congratulate the authors for adding new information to this challenging topic.