Less Evening Exercise is Associated with Progressive Visual Field Defect in POAG Patients

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PURPOSE: To investigate the exercise habits of those with primary open angle glaucoma (POAG) and its associations with the progression of glaucomatous visual field (VF) loss. METHODS: Daily PA was monitored by an accelerometer (ActiGraph wGT3x-BT), which patients wore for 24-hours on their waist (right) for 1 week. main outcome measures are daily PA, such as calories (kcal), light PA time, moderate PA time, vigorous PA time, moderate to vigorous physical activity (MVPA) and step counts.Progressive VF loss is defined as the same three or more points in pattern deviation change probability maps in at least two consecutive visits detected by Glaucoma Progression Analysis. RESULTS: No significant difference was found for daily PA between the 76 non-progressive and 22 progressive patients who wore the device for more than 10 hours per day (P>0.05 for all). Better eye VF mean deviation (MD) averaged -3.1 dB in non-progressive group and -4.1dB in progressive group. 88 (89.8%) participants who had worn an accelerometer for an entire day were analyzed for their 24-hour exercise habits. Patients with POAG preferred to exercise more during 07:00-09:00 am, 15:00-17:00 pm, and 18:00-20:00 pm. Additionally, MVPA time in the non-progressive group is significantly higher than the progressive group at 18:00-20:00 pm (25.0(34.3) min VS 18.9(17.6) min, P=0.002). Binary logistic regression analysis indicated that MVPA (18:00-20:00 pm) and other parameters, such as mean retinal nerve fiber layer (mRNFL), MD, mean arterial pressure (MAP), mean intro-ocular pressure (mIOP), age and gender were significantly correlated with POAG patients'progressive VF damage. Multivariate analysis showed that MVPA (odds ratio, OR (95% confidence intervals, CI) =0.96(0.94, 0.99), P=0.002), mRNFL (OR (95%CI) =0.97(0.94, 1.00), P=0.02),MAP (OR (95%CI) =0.88(0.83, 0.92), P<0.001), age (OR (95%CI) =1.10(1.06, 1.15), P<0.001) and gender (OR (95%CI) =0.44(0.22, 0.91), P=0.001) were still related to progressive VF loss after adjusting the other risk factors. CONCLUSIONS: Patients with POAG prefer to exercise more during 07:00-09:00 am, 15:00-17:00 pm and 18:00-20:00 pm. Less evening exercise is associated with glaucomatous progressive VF damage, with an increasing of one minute of MVPA time decreasing the progression of POAG about 4%.