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运动对原发性开角型青光眼患者眼血流参数的影响。

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

机构信息

Glaucoma Division, Department of Ophthalmology and Visual Science, Federal University of São Paulo, São Paulo, Brazil,

Glaucoma Division, Ver Mais Oftalmologia, Vinhedo, Brazil,

出版信息

Ophthalmic Res. 2020;63(3):309-313. doi: 10.1159/000501694. Epub 2019 Sep 4.

Abstract

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 (R2 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.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

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