Haynes W L, Johnson A T, Alward W L
Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City 52242.
Ophthalmology. 1992 Jul;99(7):1096-103. doi: 10.1016/s0161-6420(92)31845-7.
Exercise-induced anterior chamber pigment dispersion with intraocular pressure (IOP) elevation has been reported in patients with the pigmentary dispersion syndrome. Marked pigment dispersion with or without elevation of IOP could predispose these patients to visual field loss. The authors designed this study to evaluate the effects of jogging exercise on anterior chamber pigment and IOP in a group of patients with the pigmentary dispersion syndrome or pigmentary glaucoma.
Fourteen subjects with the pigmentary dispersion syndrome, 10 subjects with pigmentary glaucoma, and 10 control subjects underwent a 45-minute protocol of jogging exercise. Anterior chamber pigment was graded and IOP was measured before and up to 3 hours after completion of the exercise protocol.
Eyes of experimental subjects were significantly more likely to develop exercise-induced pigment dispersion than were eyes of control subjects. In experimental subjects, eyes treated with pilocarpine at the time of the study were significantly less likely to develop exercise-induced pigment dispersion than eyes not treated with pilocarpine. In two experimental subjects, pre-exercise treatment with pilocarpine appeared to inhibit exercise-induced pigment dispersion.
The authors do not believe that all patients with the pigmentary dispersion syndrome or pigmentary glaucoma need to avoid exercise. However, for patients with these disorders who regularly engage in jogging or more strenuous or more jarring types of exercise, they suggest an evaluation before and after the type of exercise in question. If marked exercise-induced pigment dispersion occurs, pilocarpine therapy may be an alternative to avoidance of the exercise.
色素性分散综合征患者中曾有运动诱发前房色素分散伴眼压升高的报道。无论眼压是否升高,明显的色素分散都可能使这些患者面临视野丧失的风险。作者设计了本研究,以评估慢跑运动对一组色素性分散综合征或色素性青光眼患者前房色素和眼压的影响。
14名色素性分散综合征患者、10名色素性青光眼患者和10名对照受试者进行了45分钟的慢跑运动方案。在运动方案完成前及完成后长达3小时内,对前房色素进行分级并测量眼压。
与对照受试者的眼睛相比,实验受试者的眼睛更易发生运动诱发的色素分散。在实验受试者中,研究时使用毛果芸香碱治疗的眼睛比未使用毛果芸香碱治疗的眼睛发生运动诱发色素分散的可能性显著降低。在两名实验受试者中,运动前使用毛果芸香碱治疗似乎抑制了运动诱发的色素分散。
作者认为并非所有色素性分散综合征或色素性青光眼患者都需要避免运动。然而,对于经常进行慢跑或更剧烈或更震动性运动的这些疾病患者,他们建议在进行相关类型运动前后进行评估。如果发生明显的运动诱发色素分散,毛果芸香碱治疗可能是避免运动之外的另一种选择。