Seo Je Hyun, Nishida Takashi, Moghimi Sasan, Wu Jo-Hsuan, Fazio Massimo A, Girkin Christopher A, Liebmann Jeffrey M, Zangwill Linda M, Weinreb Robert N
Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, San Diego, La Jolla, CA.
Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, Korea.
J Glaucoma. 2025 Jul 1;34(7):499-506. doi: 10.1097/IJG.0000000000002576. Epub 2025 Apr 21.
Higher self-reported physical activity level was associated with a slower rate of visual field mean deviation loss in patients with primary open angle glaucoma.
To determine the impact of physical activity (PA) on visual field (VF) progression rates in patients with primary open angle glaucoma (POAG).
In this longitudinal study, POAG patients were included who had ≥5 visits, ≥2 years of follow-up VFs and underwent PA questionnaire at the baseline. PA levels were assessed using the physical activity index (PAI), metabolic equivalents of task (MET)-minutes, and walking pace. Univariable and multivariable linear mixed-effects models were used to determine the impact of PA levels on the rates of VF mean deviation (MD) loss.
One hundred thirty-one eyes from 80 POAG patients were included over a median follow-up of 4.9 (IQR: 4.0-6.7) years. The median age of patients was 68.6 (IQR: 59.3-77.8) years and the median baseline VF MD was -3.5 (IQR: -8.3 to -1.3). In the univariable analysis, slower VF MD loss was associated with active PAI category (0.30 [95% CI: 0.01-0.58] dB/year vs. inactive PAI category; P =0.041) and higher PA amount (0.14 [95% CI: 0.01-0.27] dB/year per 1000 MET-minutes; P =0.036). Significant association with the rate of VF MD loss was not found for baseline VF MD ( P =0.263) and walking pace ( Ps >0.05). In the multivariable analysis including glaucoma severity and other covariates, slower VF MD loss was associated with higher PA amounts (0.15 [95% CI: 0.02-0.28] dB/year per 1000 MET-minutes; P =0.024).
Higher PA amounts are an independent predictor of a slower rate of VF MD loss. Further research is needed to explore whether increased PA protects against glaucoma progression.
确定体力活动（PA）对原发性开角型青光眼（POAG）患者视野（VF）进展率的影响。
在这项纵向研究中，纳入了随访次数≥5次、随访VF≥2年且在基线时进行了PA问卷调查的POAG患者。使用体力活动指数（PAI）、代谢当量任务（MET）-分钟和步行速度评估PA水平。采用单变量和多变量线性混合效应模型来确定PA水平对VF平均偏差（MD）损失率的影响。
在中位随访4.9（四分位间距：4.0 - 6.7）年期间，纳入了80例POAG患者的131只眼睛。患者的中位年龄为68.6（四分位间距：59.3 - 77.8）岁，基线VF MD的中位数为 -3.5（四分位间距： -8.3至 -1.3）。在单变量分析中，VF MD损失较慢与活跃PAI类别相关（0.30 [95%可信区间：0.01 - 0.58] dB/年，与不活跃PAI类别相比；P = 0.041）以及PA量较高相关（每1000 MET - 分钟0.14 [95%可信区间：0.01 - 0.27] dB/年；P = 0.036）。未发现基线VF MD（P = 0.263）和步行速度（P > 0.05）与VF MD损失率有显著关联。在包括青光眼严重程度和其他协变量的多变量分析中，VF MD损失较慢与PA量较高相关（每1000 MET - 分钟0.15 [95%可信区间：0.02 - 0.28] dB/年；P = 0.024）。
较高的PA量是VF MD损失率较慢的独立预测因素。需要进一步研究以探讨增加PA是否能预防青光眼进展。
自我报告的较高体力活动水平与原发性开角型青光眼患者视野平均偏差损失率较慢相关。
