Modifiable factors in the management of glaucoma: a systematic review of current evidence

Hecht, Idan; Achiron, Asaf; Man, Vitaly; Burgansky-Eliash, Zvia

doi:10.1007/s00417-016-3518-4

Cited by 47 publications

(19 citation statements)

References 50 publications

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“…5,9 Based on the fact that abrupt IOP peaks may have adverse consequences in humans, the practice of this type of physical efforts could be discouraged, especially in glaucoma patients. 12,24 The IOP changes found at volitional exhaustion may be considered modest (1.1 and 3.0 mmHg for the trained and untrained groups, respectively). However, subtle IOP increments have been associated with greater risk of conversion to glaucoma in healthy individuals, 25 which highlights the significance of our findings for potential glaucoma prevention.…”

Section: Discussionmentioning

confidence: 99%

Effect of a maximal treadmill test on intraocular pressure and ocular perfusion pressure: The mediating role of fitness level

Vera

Jiménez

Redondo

et al. 2019

European Journal of Ophthalmology

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Objectives: We compared the impact of a maximal treadmill test on intraocular pressure and ocular perfusion pressure between trained and untrained individuals. Methods: Based on the maximal aerobic capacity (relative VO2 max), 31 military helicopter pilots were divided into groups of trained (n = 16; VO2 max = 57.06 ± 1.66) and untrained (n = 15; VO2 max = 43.42 ± 1.19) individuals. Intraocular pressure and blood pressure were collected before effort, just after volitional exhaustion and after 5 and 15 min of recovery. Results: The maximal treadmill test induced significant changes on intraocular pressure (p < 0.001, η2 = 0.52) and ocular perfusion pressure (p < 0.001, η2 = 0.60). Intraocular pressure and ocular perfusion pressure increased just after volitional exhaustion (effect size = 0.88 and 1.59, respectively), and these values returned to baseline levels after 5 (effect size = 0.87 and 1.26, respectively) and 15 (effect size = 1.23 and 1.91, respectively) min of recovery. The untrained group exhibited higher intraocular pressure and ocular perfusion pressure values in comparison with the trained group just after volitional exhaustion (effect size = 1.43 and 0.11 for intraocular pressure and effect size = 2.81 and 0.96 for ocular perfusion pressure). Five minutes of recovery was insufficient to reach baseline intraocular pressure and ocular perfusion pressure values only for the untrained group (effect size = 0.91 and 0.72, respectively). Conclusion: Our findings reveal that fitness level modulates the intraocular pressure and ocular perfusion pressure responses to a maximal treadmill test, being high fitness levels desirable in order to attenuate the impact of maximal efforts on these indices. These outcomes may be of clinical relevance for the management of glaucoma patients or those at risk, although future studies are needed to test these results in a clinical population.

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Section: Discussionmentioning

confidence: 99%

Effect of a maximal treadmill test on intraocular pressure and ocular perfusion pressure: The mediating role of fitness level

Vera

Jiménez

Redondo

et al. 2019

European Journal of Ophthalmology

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“…Although several studies have investigated the relationship between exercise and IOP and/or glaucoma [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29], there are scant data about exercise and OBF parameters. Investigating exercise-induced changes in OBF-related parameters in treated patients with POAG, we found a significant increase in both OPA and OPP values immediately after exercise, which persisted for at least 30 min.…”

Section: Discussionmentioning

confidence: 99%

Exercise-Induced Changes in Ocular Blood Flow Parameters in Primary Open-Angle Glaucoma Patients

et al. 2019

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Purpose: To evaluate exercise-induced changes in ocular blood flow (OBF) parameters in primary open-angle glaucoma (POAG) patients. Methods: A prospective observational study was carried out, in which medically treated patients with POAG were enrolled. Following inclusion, all patients performed a 40-min cycloergometry in a standardized fashion. The following parameters were measured and compared immediately before and 1 and 30 min after the exercise: intraocular pressure (IOP; Goldman applanation tonometry), mean arterial pressure (MAP), ocular pulse amplitude (OPA; assessed by dynamic contour tonometry), and ocular perfusion pressure (OPP; 2/3 MAP -IOP). In addition, we investigated possible factors associated with OBF parameter changes immediately after exercise. Results: A total of 30 eyes (30 patients; mean age was 62.9 ± 1.7 years) were included. Most patients were women (53%), and median visual field mean deviation index was -3.5 dB. Both MAP (mean change, 21%) and IOP (mean change, 17.3%) increased significantly immediately after the workout (p < 0.01), persisting higher than baseline following 30 min (p < 0.01%). Regarding OBF parameters, both OPA (mean change, 58.8%) and OPP (mean change, 21.7%) increased significantly immediately after the workout and persisted higher than baseline 30 min after the workout (p < 0.01). Regression analysis revealed that only age was significantly associated with OPA variation (R 2 0.14; p < 0.05). No significant associations were found for OPP (p ≥ 0.19). Conclusion: Aerobic exercise leads to a significant short-time increase in OBF parameters in patients with POAG. Even though IOP seems to present a modest elevation, it is accompanied by a significant increase in MAP, leading to higher OBF measurements. Exercise-induced short-term changes and its possible implications for glaucoma prognosis deserve further investigation.

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“…The results of population-based studies suggest that glaucoma is the leading cause of blindness globally, with an estimated 60 million people worldwide having visual impairment due to glaucoma 15 , 16 . Although its etiology is still not sufficiently understood, there are numerous risk factors, from genetic to environmental factors, such as family history, race, age, high IOP 13 , lifestyle, sleep quality, diet, exercise 17 , corticosteroid use 18 , and inflammation 19 , 20 .…”

Section: Introductionmentioning

confidence: 99%

Periodontitis and the subsequent risk of glaucoma: results from the real-world practice

Sun

Shen

Chen

et al. 2020

Sci Rep

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Periodontitis is a multifactorial inflammatory disease that can cause tooth loss and contribute to systemic inflammation. It is suggested that periodontitis may be associated with the development of glaucoma. Based on data from Taiwan’s National Health Insurance Research Database, a retrospective cohort study was conducted to investigate the risk of developing glaucoma in patients with periodontitis. The periodontitis cohort consisted of newly diagnosed adult patients (n = 194,090, minimum age = 20 years) between 2000 and 2012. The comparison group included age-, gender-, and diagnosis date-matched people without periodontitis (n = 194,090, minimum age = 20 years). Incident glaucoma was monitored until the end of 2013. Hazard ratios (HRs) with confidence intervals (CIs) were established based on the Cox proportional hazard models. The risk of developing glaucoma was higher in patients with periodontitis than those without periodontitis (31.2 vs. 23.3 patients per 10,000 person-years, with an adjusted HR of 1.26 [95% CI 1.21–1.32]). A high risk was evident even after stratifying by age (adjusted HRs = 1.34 [1.26–1.44] for ages 20–49, 1.24 [1.13–1.36] for ages ≥ 65, and 1.20 [1.12–1.29] for ages 50–64 years), sex (adjusted HRs = 1.33 [1.24–1.41] and 1.21 [1.14–1.28] for men and women, respectively), presence of comorbidity (adjusted HRs = 1.38 [1.29–1.47] and 1.18 [1.12–1.25] for without and with comorbidity, respectively), and corticosteroid use (adjusted HRs = 1.27 [1.21–1.33] and 1.21 [1.08–1.35] for without and with corticosteroid use, respectively). Specifically, patients with periodontitis exhibited a significantly high risk of primary open-angle glaucoma (adjusted HR = 1.31 [1.21–1.32]) but not for primary closed-angle glaucoma (adjusted HR = 1.05 [0.94–1.17]). People with periodontitis are at a greater risk of glaucoma than individuals without periodontitis. Ocular health should be emphasized for such patients, and the underlying mechanisms need further investigation.

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Modifiable factors in the management of glaucoma: a systematic review of current evidence

Cited by 47 publications

References 50 publications

Effect of a maximal treadmill test on intraocular pressure and ocular perfusion pressure: The mediating role of fitness level

Effect of a maximal treadmill test on intraocular pressure and ocular perfusion pressure: The mediating role of fitness level

Exercise-Induced Changes in Ocular Blood Flow Parameters in Primary Open-Angle Glaucoma Patients

Periodontitis and the subsequent risk of glaucoma: results from the real-world practice

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