Department of Ophthalmology, Gachon University, Gil Hospital, Incheon, Korea.
Am J Ophthalmol. 2013 Feb;155(2):329-335.e2. doi: 10.1016/j.ajo.2012.08.003. Epub 2012 Oct 27.
To investigate the effect of change of body posture from the supine to the lateral decubitus position on intraocular pressure (IOP) in patients with open-angle glaucoma.
Prospective, observational case series.
Setting. Institutional. Participants. Forty-four eyes of 22 patients with newly diagnosed bilateral open-angle glaucoma. Observation procedures. IOP was measured using the Tono-Pen XL (Reichert Inc) in both eyes 10 minutes after assuming each position: sitting, supine, right lateral decubitus, supine, left lateral decubitus, and supine. By comparing the mean deviation (MD) of Humphrey visual field between both eyes of a patient, eyes were classified into either worse-MD eye or better-MD eye. Main outcome measures. Magnitude of IOP alterations by postural changes and intereye difference of IOP with each posture.
The mean ± SD IOP of the dependent eyes (eye on the lower side in the lateral decubitus position) increased after changing from the supine to the right lateral decubitus position (19.1 ± 2.6 mm Hg vs 21.0 ± 2.7 mm Hg; P = .019) or the left lateral decubitus position (18.6 ± 2.9 mm Hg vs 20.6 ± 3.1 mm Hg; P = .002). The mean IOP of the dependent eyes was significantly higher than that of the nondependent eyes in the lateral decubitus positions (right lateral decubitus, +1.2 mm Hg; left lateral decubitus, +1.6 mm Hg; both, P < .05). Compared with the better-MD eyes, the worse-MD eyes showed a tendency for greater IOP rise with positional change from the supine to lateral decubitus position (2.3 ± 2.2 mm Hg vs 1.5 ± 2.1 mm Hg; P = .065).
The postural change from the supine to lateral decubitus position may increase the IOP of the dependent eyes in patients with open-angle glaucoma.
探讨从仰卧位变为侧卧位时，对开角型青光眼患者眼内压（IOP）的影响。
前瞻性、观察性病例系列。
机构设置。参与者：22 例新诊断为双侧开角型青光眼患者的 44 只眼。观察程序：使用 Tono-Pen XL（Reichert Inc）在每种体位 10 分钟后测量双眼的 IOP：坐位、仰卧位、右侧卧位、仰卧位、左侧卧位和仰卧位。通过比较患者双眼的 Humphrey 视野平均偏差（MD），将眼睛分为较差 MD 眼或较好 MD 眼。主要观察指标：体位变化引起的 IOP 变化幅度和每种体位的双眼 IOP 差异。
仰卧位改为右侧卧位（19.1 ± 2.6mmHg 比 21.0 ± 2.7mmHg；P =.019）或左侧卧位（18.6 ± 2.9mmHg 比 20.6 ± 3.1mmHg；P =.002）后，依赖眼（侧卧位时下方眼）的平均 IOP ± SD 增加。在侧卧位时，依赖眼的平均 IOP 明显高于非依赖眼（右侧卧位，+1.2mmHg；左侧卧位，+1.6mmHg；均 P<.05）。与较好 MD 眼相比，较差 MD 眼在从仰卧位变为侧卧位时，IOP 升高的趋势更大（2.3 ± 2.2mmHg 比 1.5 ± 2.1mmHg；P =.065）。
从仰卧位变为侧卧位的姿势改变可能会增加开角型青光眼患者依赖眼的 IOP。
