Abstract

The goal of this study was to quantify the association between sensory integration abilities relevant for standing balance and disease stage in glaucoma. The disease stage was assessed using both functional (visual field deficit) and structural (retinal nerve fiber layer thickness) deficits in the better and worse eye. Balance was assessed using an adapted version of the well-established Sensory Organization Test (SOT). Eleven subjects diagnosed with mild to moderate glaucoma stood for 3 min in 6 sensory challenging postural conditions. Balance was assessed using sway magnitude and sway speed computed based on center-of-pressure data. Mixed linear regression analyses were used to investigate the associations between glaucoma severity and balance measures. Findings revealed that the visual field deficit severity in the better eye was associated with increased standing sway speed. This finding was confirmed in eyes open and closed conditions. Balance was not affected by the extent of the visual field deficit in the worse eye. Similarly, structural damage in either eye was not associated with the balance measures. In summary, this study found that postural control performance was associated with visual field deficit severity. The fact that this was found during eyes closed as well suggests that reduced postural control in glaucoma is not entirely attributed to impaired peripheral visual inputs. A larger study is needed to further investigate potential interactions between visual changes and central processing changes contributing to reduced balance function and increased incidence of falls in adults with glaucoma.

Highlights

  • The goal of this study was to quantify the association between sensory integration abilities relevant for standing balance and disease stage in glaucoma

  • The main result of this study is that worse visual field deficit in the better eye was associated with increased speed of sway under four of the six postural conditions

  • Visual field deficits in the worse eye and structural damage in either eye were not associated with balance measures under the postural conditions

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Summary

Introduction

The goal of this study was to quantify the association between sensory integration abilities relevant for standing balance and disease stage in glaucoma. Reduced vision is one possible mechanism of falls where individuals with glaucoma are less likely to detect environmental hazards compared to their healthy counterparts Another potential mechanism is reduced postural control resulting in an impaired ability to centrally integrate sensory information relevant for balance. While impaired sensory integration abilities relevant for balance have not systematically been investigated in patients with glaucoma, several studies have reported worse balance when standing on foam, altering somatosensory information, in adults with glaucoma compared to ­controls[15,16,17]. These findings hint that balance impairments may be related to sensory integration deficits. A well-established balance testing paradigm, involving dynamic posturography and designed and validated for assessing sensory integration a­ bilities[18]

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