Isserow Lauren J, Harris Danielle, Schanzer Nathan, Siesky Brent, Verticchio Vercellin Alice, Wood Keren, Segev Fani, Harris Alon
Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
Department of Psychology, Reichman University, University Street 8, Herzellia 4610101, Israel.
Medicina (Kaunas). 2025 Feb 27;61(3):418. doi: 10.3390/medicina61030418.
Glaucoma is a leading cause of irreversible blindness worldwide. Presently, elevated intraocular pressure (IOP) is the only approved modifiable risk factor. A consensus of the current literature suggests that both physiological and psychological stress may also impact the lifelong course of glaucoma. Specifically, stress is known to influence sympathetic nervous system activity. An increase in sympathetic nervous system activity may elevate a person's blood pressure (BP) and IOP, and both are strongly associated with glaucomatous disease. Anxiety and depression have more conflicting evidence in relation to glaucoma. Socioeconomic and environmental stress may worsen adherence to therapy and disease outcomes due to a lack of financial resources and related access to healthcare. Neighborhood quality and environmental conditions, particularly urban environments, have been associated with glaucoma risk factors, higher glaucoma prevalence, and delayed surgical interventions. Racial differences have also been identified, with Black patients being more stressed and likely to present with increased glaucoma severity and faster disease progression than White patients. Mindfulness, meditation, and other forms of psychological relaxation have been shown to reduce IOP and stress biomarkers and result in improved quality of life (QOL). Larger studies in more diverse populations are needed to clarify risk and identify the best therapeutic approaches to reduce stress as a method to improve clinical outcomes and QOL for glaucoma patients.
青光眼是全球不可逆性失明的主要原因。目前，眼压升高是唯一已获认可的可改变风险因素。当前文献的共识表明，生理和心理压力也可能影响青光眼的病程。具体而言，已知压力会影响交感神经系统活动。交感神经系统活动增加可能会升高人的血压和眼压，而这两者都与青光眼疾病密切相关。焦虑和抑郁与青光眼的关系有更多相互矛盾的证据。社会经济和环境压力可能会因缺乏资金及相关医疗服务而导致治疗依从性变差和疾病预后不良。社区质量和环境条件，尤其是城市环境，与青光眼风险因素、较高的青光眼患病率以及延迟的手术干预有关。种族差异也已被发现，黑人患者比白人患者压力更大，青光眼严重程度增加且疾病进展更快。正念、冥想和其他形式的心理放松已被证明可降低眼压和压力生物标志物，并改善生活质量。需要在更多样化的人群中开展更大规模的研究，以明确风险并确定最佳治疗方法，将减轻压力作为改善青光眼患者临床预后和生活质量的一种手段。
