Prevalence of glaucoma and visual field changes in professional wind versus non-wind instrument players in the Philadelphia Orchestra

Abstract

Purpose : To compare the prevalence of glaucoma and glaucoma suspects in professional wind versus non-wind instrument players in the Philadelphia Orchestra. A secondary objective was to evaluate visual field changes in participants with glaucoma and glaucoma suspects, and correlate results with cumulative practice time.

Methods : Philadelphia Orchestra members were categorized as wind or non-wind instrument players. All study participants underwent screening eye examinations including intraocular pressure (IOP) using iCare tonometer (iCare, Helsinki, Finland) and fundus photography with the Volk Pictor Digital Retina Camera (Optomed Oy Ltd., Oulu, Finland). Participants with optic discs suspicious for glaucoma and high IOP had further evaluation for confirmation, including standard automated perimetry (Octopus 300, Haag-Streit Inc, Bern, Switzerland) and a comprehensive eye examination by a glaucoma specialist. The main outcome measures were the presence or absence of a glaucomatous optic disc and visual field mean defect.

Results : Of the 51 musicians enrolled, there were 9 (9/21, 43%) wind instrument players and 6 (6/30, 20%) non-wind instrument players diagnosed as glaucoma suspect in at least one eye (P=0.44) (Figure 1). Twelve (12/15, 80%) musicians returned for a confirmation eye examination. Wind instrument players had significantly greater Octopus visual field mean defect scores (1.08±1.5 dB) compared to non-wind instrument players (-0.43±0.7 dB; P<0.001). There was a statistically significant association between cumulative hour playing wind instruments and visual field mean defect in the multivariable model (increase in VF MD by 0.07 dB for every 1000 hours increase in cumulative practicing hour, P<0.001) (Figure 2).

Conclusions : Among members of the Philadelphia Orchestra, the difference in prevalence of glaucoma-suspicious optic discs between wind and non-wind instrument players was not significant. Therefore, the clinical significance of the greater visual field mean defect found in wind instrument players, and the association between the degree of visual field mean defect and the cumulative practice time of playing wind instruments, need further investigation.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.