Black Alex A, Wood Joanne M, Lovie-Kitchin Jan E, Newman Beth M
School of Optometry and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
Optom Vis Sci. 2008 Jun;85(6):489-97. doi: 10.1097/OPX.0b013e31817882db.
To investigate the effect of visual impairment on postural sway among older adults with open-angle glaucoma.
This study included 54 community-dwelling participants with open-angle glaucoma, aged 65 and older. Binocular visual field loss was estimated from merged monocular Humphrey Field Analyzer visual field results and retinal nerve fiber layer (RNFL) thickness was obtained from the Stratus Optical Coherence Tomographer. Postural sway was measured under four conditions: eyes open and closed, on a firm, and a foam surface. Data were collected for additional vision measures (visual acuity and contrast sensitivity), physical performance measures (self-reported physical activity levels and 6-min walk test), and demographic measures (age, gender, body mass index, and medical history). Multivariate linear regressions, adjusting for confounding factors, were performed to determine the association between visual loss and postural sway.
Participants with greater binocular visual field loss or thinner RNFL thickness showed increased postural sway, both on firm and foam surfaces, independent of age, gender, body mass index, and physical performance levels. These visual loss measures were significant predictors of postural sway, explaining almost 20% of its variance on the foam surface. Furthermore, participants with greater inferior hemifield visual field loss showed increased postural sway on the foam surface. Increasing glaucomatous visual impairment was accompanied by a steady decrease of the visual contribution to postural control.
Among older adults with glaucoma, greater visual field loss or thinner RNFL thickness is associated with reduced postural stability. This postural instability may be a contributing factor in the increased risk of falls among older adults with glaucoma.
研究视力损害对开角型青光眼老年患者姿势摆动的影响。
本研究纳入了54名年龄在65岁及以上、居住在社区的开角型青光眼患者。双眼视野缺损通过合并的单眼Humphrey视野分析仪视野结果进行估计，视网膜神经纤维层（RNFL）厚度通过Stratus光学相干断层扫描仪获得。在四种条件下测量姿势摆动：睁眼和闭眼，在坚实表面和泡沫表面。收集了其他视力指标（视力和对比敏感度）、身体机能指标（自我报告的身体活动水平和6分钟步行试验）以及人口统计学指标（年龄、性别、体重指数和病史）的数据。进行多变量线性回归并对混杂因素进行校正，以确定视力丧失与姿势摆动之间的关联。
双眼视野缺损较大或RNFL厚度较薄的参与者，在坚实表面和泡沫表面上的姿势摆动均增加，且不受年龄、性别、体重指数和身体机能水平的影响。这些视力丧失指标是姿势摆动的重要预测因素，在泡沫表面上解释了其近20%的方差。此外，下半视野缺损较大的参与者在泡沫表面上的姿势摆动增加。青光眼性视力损害的加重伴随着视觉对姿势控制的贡献稳步下降。
在患有青光眼的老年人中，更大的视野缺损或更薄的RNFL厚度与姿势稳定性降低有关。这种姿势不稳定可能是青光眼老年患者跌倒风险增加的一个促成因素。
