Yamada Yurina, Kiyota Naoki, Yoshida Mitsuhide, Omodaka Kazuko, Nakazawa Toru
Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Sendai, Japan.
Curr Eye Res. 2023 Nov;48(11):1006-1013. doi: 10.1080/02713683.2023.2234105. Epub 2023 Jul 19.
This retrospective cross-sectional study aimed to investigate the association between autonomic parameters measured using the Kiritsu-Meijin device and visual-field defects in patients with open-angle glaucoma.
A total of 79 eyes of 42 patients with open-angle glaucoma were enrolled in this study. Kiritsu-Meijin testing comprised three phases: sitting, standing, and sitting again (2 min, 2 min, and 1 min, respectively). Continuous electrocardiograms were recorded for five minutes. Autonomic parameters were extracted from the resulting data and analyzed, including activity, balance, reaction, switchover, and recovery; these are five representative parameters derived from Kiritsu-Meijin testing. Correlations between these parameters and mean deviation from Humphrey visual field testing were determined. Additionally, we used a linear mixed-effects model to observe sectoral differences in the relationship between total deviation and the Kiritsu-Meijin parameters. In this study, we focused on superior, central, and inferior total deviations.
Significant positive correlations were observed between activity, balance, and recovery and mean deviation values ( = 0.29-0.38, < .05). The value between activity and inferior total deviation was higher than that between activity and superior total deviation ( = 0.22, < .05). Balance did not show any sectoral differences ( > .05). Recovery was more strongly associated with central to inferior total deviation than superior total deviation ( = 0.17-0.25, < .05).
Our findings suggest that in patients with open-angle glaucoma, lower activity and recovery are associated with more severe central and/or inferior visual field defects in the superior quadrant. These results imply that measurements of autonomic function made with the Kiritsu-Meijin device may have clinical utility in the management of glaucoma.
本回顾性横断面研究旨在调查使用“Kiritsu-Meijin”设备测量的自主神经参数与开角型青光眼患者视野缺损之间的关联。
本研究纳入了42例开角型青光眼患者的79只眼睛。“Kiritsu-Meijin”测试包括三个阶段:坐姿、站姿和再次坐姿(分别为2分钟、2分钟和1分钟)。连续记录五分钟的心电图。从所得数据中提取并分析自主神经参数,包括活动、平衡、反应、转换和恢复;这些是从“Kiritsu-Meijin”测试中得出的五个代表性参数。确定这些参数与Humphrey视野测试的平均偏差之间的相关性。此外,我们使用线性混合效应模型来观察总偏差与“Kiritsu-Meijin”参数之间关系的扇形差异。在本研究中,我们关注上方、中央和下方的总偏差。
活动、平衡和恢复与平均偏差值之间存在显著正相关(=0.29 - 0.38,<0.05)。活动与下方总偏差之间的值高于活动与上方总偏差之间的值(=0.22,<0.05)。平衡未显示任何扇形差异(>0.05)。恢复与中央至下方总偏差的相关性比与上方总偏差的相关性更强(=0.17 - 0.25,<0.05)。
我们的研究结果表明,在开角型青光眼患者中,较低的活动和恢复与上方象限更严重的中央和/或下方视野缺损相关。这些结果意味着使用“Kiritsu-Meijin”设备进行的自主神经功能测量可能在青光眼管理中具有临床应用价值。