Zaher Omar, Kuchtaruk Adrian A, McGinnis Emma S, Paunic Milica, Malvankar-Mehta Monali S
Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON.
Temerty Faculty of Medicine, University of Toronto, Toronto, ON.
Can J Ophthalmol. 2024 Aug;59(4):e343-e349. doi: 10.1016/j.jcjo.2023.06.007. Epub 2023 Jun 24.
To conduct a systematic review focusing on the impact of various relaxation techniques on the intraocular pressure of patients with glaucoma.
A systematic literature search was performed through CINAHL, MEDLINE, EMBASE, ClinicalTrials.gov, ProQuest Dissertations and Theses Global, and conferences until July 2022. Covidence software (Veritas Health Innovation, Melbourne, Australia) was used to conduct the systematic review. The screening was done by 2 independent reviewers, and a risk-of-bias assessment was completed after data extraction. Stata Statistical Software, version 14 (StataCorp LLC, College Station, Texas) was used to conduct a meta-analysis.
Twelve articles (596 subjects) were included for qualitative analysis and 5 articles (332 subjects) for quantitative analysis. One hour of daily mindfulness meditation for 3 weeks resulted in the most significant reduction in intraocular pressure (IOP) at 31.8%. Meditation consistently caused long-term reductions in IOP (standardized mean difference = -2.02; range, -3.16 to -0.89). Autogenic relaxation exercises showed a trend toward reducing IOP acutely but a significant reduction in the long term. Ocular relaxation exercises combined with visual imagery of aqueous humour drainage showed both acute and long-term reductions in IOP. The effects of yoga on IOP could depend on the positions being practiced.
Various relaxation techniques, such as meditation, visual imagery, autogenic relaxation exercises, and ocular relaxation exercises, seem to cause significant reductions in IOP. Future randomized, controlled trials should be carried out to further explore the utility of these techniques for patients with glaucoma.
进行一项系统评价，重点关注各种放松技巧对青光眼患者眼压的影响。
通过CINAHL、MEDLINE、EMBASE、ClinicalTrials.gov、ProQuest Dissertations and Theses Global以及会议进行系统的文献检索，直至2022年7月。使用Covidence软件（澳大利亚墨尔本的Veritas Health Innovation公司）进行系统评价。筛选由2名独立评审员完成，数据提取后进行偏倚风险评估。使用Stata统计软件14版（美国德克萨斯州大学城的StataCorp LLC公司）进行荟萃分析。
纳入12篇文章（596名受试者）进行定性分析，5篇文章（332名受试者）进行定量分析。每天进行1小时正念冥想，持续3周，可使眼压降低幅度最大，达31.8%。冥想持续导致眼压长期降低（标准化均数差=-2.02；范围为-3.16至-0.89）。自生放松练习显示出短期内眼压降低的趋势，但长期来看有显著降低。眼部放松练习结合房水引流的视觉想象，可使眼压在短期和长期均降低。瑜伽对眼压的影响可能取决于所练习的姿势。
各种放松技巧，如冥想、视觉想象、自生放松练习和眼部放松练习，似乎能显著降低眼压。未来应开展随机对照试验，进一步探索这些技巧对青光眼患者的效用。
