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Increased physical activity slows down visual field loss in glaucoma patients

15 Nov 2018

Spending more time walking and doing moderate-to-vigorous physical and nonsedentary activities appears to lead to slower rates of visual field (VF) loss in glaucoma patients, according to a study.

The study included 141 older adults (mean age 64.9 years) with suspect or manifest glaucoma. All participants wore accelerometers for 1 week to estimate average steps and minutes of moderate-to-vigorous activity (MVPA) and nonsedentary activity per day.

Pointwise changes in VF sensitivity, the main outcome, was assessed in relation to physical activity measures. Eye mean deviation (MD) at the time of physical activity assessment was –6.6 dB, and average steps per day was 5,613.

Based on pointwise VF sensitivity, the unadjusted average rate of VF loss was 0.36 dB/year (95 percent CI, –0.37 to –0.35). In multivariable models, VF loss was slower in patients with higher number of steps per day (1,000 daily steps: 0.007 dB/year; p<0.001) and increased MVPA (10 more minutes daily: 0.003 dB/year; p<0.001) and nonsedentary activity (30 more minutes per day: 0.007 dB/year; p=0.005).

Risk factors for accelerated VF loss included older age, non-Caucasian race, glaucoma surgery, cataract surgery and moderate baseline VF damage (–6 dB≥ MD >–12 dB). Similar associations between baseline accelerometer-measured physical activity and rates of VF loss were seen over other time periods (eg, within 1, 3 and 5 years of activity assessment).

The present data highlight the potential of physical activity for delaying VF loss in glaucoma, with an additional 5,000 daily steps or 2.6 hours of nonsedentary physical activity decreasing the average rate of VF loss by roughly 10 percent, researchers said.

More prospective studies are warranted to explore whether physical activity can slow VF loss in glaucoma and/or if progressive VF loss results in activity restriction, they added. If positively confirmed, this would mark physical activity as a novel modifiable risk factor for preventing glaucoma damage.

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