Visual Field Changes in Professional Wind versus Non-wind Musical Instrument Players in the Philadelphia Orchestra.

Ljay Katz,Cindyx Zheng,Josephi Markoff,Tingting Zhan,Anandv Mantravadi,Lisaa Hark,Michael Waisbourd,Marlener Moster,Jeanne Molineaux,Shuai-Chun Lin,Lichuan Zeng,Kamran Rahmatnejad,Georgel Spaeth,Arthur Resende

doi:10.4103/jovr.jovr_155_17

Abstract

Purpose:We compare the prevalence of glaucoma in professional wind versus non-wind instrument players in the Philadelphia Orchestra. Visual field changes in individuals with glaucoma and glaucoma suspects were evaluated, and the results were correlated with cumulative practice time.Methods:In this cross-sectional, observational study, fifty-one Philadelphia Orchestra musicians were enrolled and categorized as wind or non-wind instrument players. All study participants underwent screening fundus photography. Participants with optic discs suspicious for glaucoma underwent further evaluation, including standard automated visual field perimetry and a comprehensive eye examination by a glaucoma specialist.Results:Of the 51 musicians enrolled, 9 of the 21 wind instrument players (43%) and 8 of the 30 non-wind instrument players (27%) were suspected of developing glaucoma in at least one eye (P = 0.25), with examinations performed on 12 of the 17 returning musicians (71%) for further confirmation. Wind instrument players exhibited significantly higher Octopus visual field mean defect scores (1.08 ± 1.5 dB) than non-wind instrument players (−0.43 ± 0.7 dB; P < 0.001). There was a significant association between cumulative hours playing wind instruments and visual field mean defect (P < 0.001).Conclusion:Among members of the Philadelphia Orchestra, the difference in prevalence of glaucoma suspicious optic discs between wind and non-wind instrument players was not significant. The clinical significance of the greater visual field mean defect found in wind instrument players, and the association between the degree of visual field mean defect and the cumulative practice-time of playing wind instruments, needs further investigation.

Highlights

The prevalence of glaucoma and glaucoma suspects was compared in the professional wind and non‐wind instrument players in the Philadelphia Orchestra
It was discovered that the prevalence of glaucoma‐suspicious discs among wind instrument players was higher compared to non‐wind instrument players (43% versus 26.7%); this difference was statistically insignificant
Two wind instrument players were diagnosed with primary open‐angle glaucoma (POAG), while no cases were detected in non‐wind instrument players

Summary

Introduction

Glaucoma is a progressive optic neuropathy with corresponding vision loss, and elevated intraocular Visual Field Changes in Wind versus Non-wind Musical Instrument Players; Lin et al pressure (IOP) is the only modifiable risk factor.[1,2] Previous studies have reported the transient IOP elevations while playing wind instruments.[3,4,5,6] Professional wind‐instrument players who spend hours practicing daily may be subjected to repeated IOP elevations and the risk of developing glaucoma. Schuman et al found a significantly greater incidence of visual field (VF) loss associated with lifetime practicing hours among high‐resistance‐wind musicians compared with other musicians.[3]

Methods

Results

Conclusion