Factors associated with the occurrence of a fall in subjects with primary open-angle glaucoma

Abstract

BackgroundThe aim of the study is to investigate risk factors for future falls in subject with primary open angle glaucoma (POAG).MethodsAll participants answered the following question at their baseline ophthalmic examination: Have you had any falls in the last year? (Yes/No). All study participants answered the same question every 12 months for 3 years. The means of total deviation values in the whole, superior peripheral, superior central, inferior central, and inferior peripheral visual fields (VF) were calculated. The relationship between these mean VF measurements, and various clinical factors against patients’ future falls was analyzed using multiple linear regression.ResultsTwo-hundred ninety four POAG patients answered the baseline and follow-up fall questionnaires over a period of three years. Among 294 subjects, 69 patients experienced a fall during the three-year follow-up. History of falls at baseline (coefficient = 1.22), history of fear of falling at baseline (0.53), best corrected visual acuity in the worse eye (7.37), prevalence of diabetes mellitus (0.60), prevalence of systemic hypertension (0.53) were selected in the optimal model.ConclusionsVisual acuity in the worse eye, history of falls, fear of falling, diabetes mellitus, and systemic hypertension are risk factors for falling in subjects with POAG.Electronic supplementary materialThe online version of this article (10.1186/s12886-017-0613-1) contains supplementary material, which is available to authorized users.

Somatosensory Impairments, Falls History and Fear of Falling in Glaucoma - A Survey Study Approach

“…Thus, these laboratory-based findings may explain why, in this present study, somatosensory impairments were found to alter the relationship between falls risk and visual field deficits in glaucoma. Interestingly, in a recent 3-year study by Adachi and colleagues, diabetes mellitus was found to be one of the risk factors for future falls in glaucoma [23], thus suggesting again that somatosensory impairments, a common side effect of diabetes mellitus, may be contributing to falls in persons living with glaucoma in addition to their visual field deficits.…”

Social determinants of health and health disparities in glaucoma: A review

“…57,58 Although social determinants contributing to this aspect of functional impairment in glaucoma have not been well studied, the factors mentioned above may also play some roles, since worse glaucoma severity/vision loss is generally associated with worse ADL function. 59,60 Among the few studies that looked into social factors affecting ADL function in glaucoma, 61 the prospective, observational study by Ramulu et al comparing 83 glaucoma subjects with bilateral VF loss versus 60 control subjects reported a greater fear of falling in individuals of female gender, with higher BMI, having other comorbidities and living with another adult, 62 while Glynn et al reported female sex and use of certain medications (cardiac medication, miotic eye medications, sedatives) to predict higher risk of actual falling. 63 Another cross-sectional analysis by Ramulu et al on data of 1135 ever-drivers from a longitudinal cohort also identified factors including bilateral glaucoma, older age, female gender, Black race, lower education, and physical and mental comorbidities to cause driving limitations and cessation among glaucoma patients.…”

The Romberg's sign: from walking in the dark to tests on the force plate

“…Из трех основных компонентов сенсорного обеспечения устойчивости вертикальной позы систематическое изучение роли зрения началось раньше всего [23]. Отмечена корреляция между нарушениями равновесия и некоторыми глазодвигательными нарушениями, а также остротой зрения и расстоянием между глазами и наблюдаемым объектом [24][25][26]. В норме при закрывании глаз (например, во второй фазе пробы Ромберга) существенных позных колебаний не возникает, что говорит о достаточных сочетанных компенсаторных возможностях проприоцепторов и вестибуляров [27,28].…”