Abstract
BackgroundExercise is widely known to lower intraocular pressure and increase ocular blood flow, which may be beneficial for glaucoma management. However, there are few studies that have reported on the relationship between exercise and glaucoma progression. The aim of our study was to investigate the exercise habits of those with primary open angle glaucoma (POAG) and its association with the progression of visual field (VF) loss.MethodsDaily physical activity (PA) was monitored by an accelerometer (ActiGraph wGT3x-BT) which patients wore for more than 10 h of being awake on their right wrists for 1 week.ResultsSeventy-one non-progressive and 27 progressive patients were enrolled in the study. 24-h moderate to vigorous physical activity (MVPA) exercise showed that POAG patients had similar variation trends consisting of 3 wave peaks and 2 wave hollows. Minutes spent in MVPA was 19.89 ± 15.81 and 21.62 ± 15.10 during 07:00–09:00 h (p = 0.204), 15.40 ± 14.49 and 15.67 ± 12.43 during 15:00–17:00 h (p = 0.822) and 17.26 ± 21.11 and 11.42 ± 11.58 during 18:00–20:00 h (p = 0.001) in the non-progressive and progressive group, respectively. Univariate analysis indicated that 10 min of MVPA (18:00–20:00 h) [odds ratio, OR (95% CI) = 0.82 (0.73, 0.92)], average mean arterial pressure [OR (95% CI) = 0.96 (0.94, 0.98)], age [OR (95% CI) = 1.06 (1.03, 1.08)], male [OR (95% CI) = 0.67 (0.48, 0.96)], spherical equivalent [OR (95% CI) = 1.14 (1.07, 1.22)] and IOP-lowering medications [OR (95% CI) = 1.54 (1.16, 2.05)] were significantly correlated with having progressive VF damage. Multivariable analysis showed that 10 min of MVPA (18:00–20:00 h) [OR (95% CI) = 0.85 (0.75, 0.97)] was associated with progressive VF loss even after adjusting for other risk factors.ConclusionsEvening exercise may lower the odds of VF progression, suggesting that exercise habits possibly play an important role in glaucoma progression.
Highlights
Exercise is widely known to lower intraocular pressure and increase ocular blood flow, which may be beneficial for glaucoma management
Seventy-one non-progressive and 27 progressive patients were enrolled in the study. 24-h moderate to vigorous physical activity (MVPA) exercise showed that primary open angle glaucoma (POAG) patients had similar variation trends consisting of 3 wave peaks and 2 wave hollows
Univariate analysis indicated that 10 min of MVPA (18:00–20:00 h) [odds ratio, Odds ratio (OR) = 0.82 (0.73, 0.92)], average mean arterial pressure [OR = 0.96 (0.94, 0.98)], age [OR = 1.06 (1.03, 1.08)], male [OR = 0.67 (0.48, 0.96)], spherical equivalent [OR = 1.14 (1.07, 1.22)] and intraocular pressure (IOP)-lowering medications [OR = 1.54 (1.16, 2.05)] were significantly correlated with having progressive visual field (VF) damage
Summary
Exercise is widely known to lower intraocular pressure and increase ocular blood flow, which may be beneficial for glaucoma management. The aim of our study was to investigate the exercise habits of those with primary open angle glaucoma (POAG) and its association with the progression of visual field (VF) loss. The Early Manifest Glaucoma Trial (EMGT) showed that 56% of untreated NTG patients progressed during the 6-year follow up [3]. In the Collaborative Normal-Tension Glaucoma Study (CNTGS), about one third of untreated subjects had localized progression within a three-year span, and up to 50% within 5 to 7 years [4]. A comparison of the spontaneous untreated group and lowered-IOP group (decreased by 30% from baseline) in the CNTGS study found that 35% of control eyes and 12% of treated eyes showed optic disk progression or VF loss [6]. It is clear that non-IOP factors played an important role in the development of the disease since glaucomatous progression was only slowed, rather than halted in subjects with normal IOP levels
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