Doing more physical activity delays visual field loss in glaucoma
Greater physical activity, such as increased walking and more time spent doing moderate-to-vigorous or nonsedentary activity, may reduce visual field (VF) loss in a treated population of patients with glaucoma, a study has found. Moreover, adding 5,000 daily steps or 2.6 hours of nonsedentary physical activity decreases the average rate of VF by 10 percent.
In total, 141 patients (mean age, 64±5.8 years) were included. During physical activity assessment, eye mean deviation (MD) was –6.6 decibels (dB) and average steps per day were 5,613±3,158. The unadjusted average rate of VF loss, as measured by pointwise VF sensitivity, was 0.36 dB/year (95 percent CI, –0.37 to –0.35).
Multivariable models showed a slower VF loss for patients who increased their walking (0.007 db/year/1,000 daily steps; p<0.001), had more moderate-to-vigorous activity (0.003 db/year/10 more minutes of moderate-to-vigorous activity per day; p<0.001) and more nonsedentary activity (0.007 dB/year/30 more minutes of nonsedentary time per day; p=0.005).
Older age, nonwhite race, glaucoma surgery, cataract surgery and moderate baseline VF damage (–6 dB ≥ MD >–12 dB), in contrast with mild VF damage (MD >–6 dB), were associated with a faster rate of VF loss. There were similar associations between baseline accelerometer-measured physical activity and rates of VF loss over other time periods (eg, within 1, 3 and 5 years of physical assessment).
“Future prospective studies are needed to determine if physical activity can slow VF loss in glaucoma or if progressive VF loss results in activity restriction,” the investigators said. “If the former is confirmed, this would mark physical activity as a novel modifiable risk factor for preventing glaucoma damage.”
This longitudinal, observational study enrolled older adults with suspect or manifest glaucoma. Participants wore accelerometers for 1 weeks to define average steps per day, minutes of moderate-to-vigorous activity and minutes of nonsedentary activity. The investigators retrospectively analysed all available VF measurements before and after physical activity assessment to measure VF loss rates.