Glaucoma Division, Department of Ophthalmology and Visual Science, Federal University of São Paulo, São Paulo, Brazil,
Glaucoma Division, Ver Mais Oftalmologia, Vinhedo, Brazil,
Ophthalmic Res. 2020;63(3):309-313. doi: 10.1159/000501694. Epub 2019 Sep 4.
To evaluate exercise-induced changes in ocular blood flow (OBF) parameters in primary open-angle glaucoma (POAG) patients.
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.
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 (R2 0.14; p < 0.05). No significant associations were found for OPP (p ≥ 0.19).
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.
评估原发性开角型青光眼(POAG)患者运动诱导的眼血流(OBF)参数变化。
进行了一项前瞻性观察研究,纳入了接受药物治疗的 POAG 患者。纳入后,所有患者均以标准化方式进行 40 分钟的踏车运动。在运动前即刻、运动后 1 分钟和 30 分钟测量并比较以下参数:眼压(IOP;Goldman 压平眼压计)、平均动脉压(MAP)、眼脉冲幅度(OPA;通过动态轮廓眼压测量法评估)和眼灌注压(OPP;2/3MAP-IOP)。此外,我们还研究了运动后即刻与 OBF 参数变化相关的可能因素。
共纳入 30 只眼(30 例患者;平均年龄为 62.9±1.7 岁)。大多数患者为女性(53%),中位视野平均偏差指数为-3.5dB。运动后即刻 MAP(平均变化 21%)和 IOP(平均变化 17.3%)均显著升高(p<0.01),30 分钟后仍高于基线(p<0.01)。关于 OBF 参数,OPA(平均变化 58.8%)和 OPP(平均变化 21.7%)在运动后即刻均显著升高,并在运动后 30 分钟仍高于基线(p<0.01)。回归分析显示,只有年龄与 OPA 变化显著相关(R2 0.14;p<0.05)。OPP 无显著相关性(p≥0.19)。
有氧运动可导致 POAG 患者的 OBF 参数在短时间内显著增加。尽管眼压似乎略有升高,但同时 MAP 显著升高,导致 OBF 测量值更高。运动引起的短期变化及其对青光眼预后的可能影响值得进一步研究。