Posture related IOP change in patients with primary open angle and pseudoexfoliation glaucoma

Abstract

Abstract Purpose To compare IOP in the sitting, supine and Trendelenburg position in controls, primary open angle glaucoma (POAG) and pseudoexfoliation glaucoma (PXG) patients. Methods 20 POAG, 18 PXG patients and 21 controls were included. Exclusion criteria were: diabetes, severe cardiovascular disease and previous ocular pathology or surgery. IOP was measured with a Perkins tonometer and arterial pressure (AP) with a sphygmomanometer consecutively in the sitting, supine and Trendelenburg positions, allowing for a period of 5 minutes between positions. The IOP and AP differences between the baseline sitting position and the supine and Trendelenburg positions were calculated. Results There was no age difference between the groups (p=0.3). Mean sitting IOP for the control, XFG and POAG groups were: 13.6±1.9mmHg, 12.9±2.1mmHg and 13.9±2.9mmHg, respectively (one way ANOVA, p=0.4). There was a bigger IOP increase from the sitting to the Trendelenburg position, compared to the supine position in all groups (1.7±1.6 versus 0.9±1.3mmHg in the control group, 4.6±2.4 versus 2.7±1.5mmHg in the PXG and 4.4±2.2 versus 2.2±1.7mmHg in the POAG group, repeated measures ANOVA, p<0.05). Post‐hoc pairwise comparisons revealed significant differences between each glaucoma group and the control group (p<0.01), whereas no difference was observed in IOP change between POAG and PXG patients (p=0.5). There was no difference in mean AP in different body positions for any group (repeated measures ANOVA, p>0.1) Conclusion POAG and PXG patients exhibit an exaggerated posture‐related IOP change compared to controls, especially when assuming the Trendelenburg position.