Postural Change In Intraocular Pressure Analyzed by Waist Hip Ratio And Body Mass Index

Abstract

Purpose : While greater body mass index (BMI) is associated with increased intraocular pressure (IOP) in both the seated and supine positions, BMI has no significant effect on the magnitude of postural IOP changes (Geloneck, 2015). To our knowledge the relation of postural IOP change to waist-hip ratio (WHR) has not previously been reported. The purpose of this study is to investigate the influence of adiposity as measured by BMI and WHR on postural change in IOP in glaucomatous (G) and non-glaucomatous (NG) subjects.

Methods : Subjects were at least 40 yrs old. All G subjects were under treatment for open-angle glaucoma. Blood pressure, weight, height, waist and hip measurements were performed. Tonometry using a Tonopen was performed 5 minutes after assuming each body position. IOP was first measured in the seated position, and then in the supine, right lateral decubitus (RLD) and left lateral decubitus (LLD) positions in randomized order. We analyzed mean IOP change from seated to each of the 3 recumbent positions by BMI (low BMI: <=30 vs high BMI: >30) and WHR (above vs below median).

Results : 20 NG and 16 G subjects were recruited (Table). Among NG subjects, 9 were low BMI and 11 were high BMI. Among G subjects 7 were low BMI and 9 were high BMI. The median WHR was 0.920. There were no statistically significant differences between the low and high BMI NG groups nor between the high and low WHR NG groups in mean postural IOP change from seated to any of the recumbent positions (Figure). There was a non-significant trend of greater change in the low WHR and high BMI NG groups. A similar pattern of greater change in the low WHR and high BMI groups was found among G subjects.

Conclusions : High WHR and low BMI were associated with nonsignificant trends of greater mean postural IOP change compared with subjects having low WHR and high BMI in both normal and glaucomatous individuals. Larger studies are needed to determine whether these trends are able to achieve statistical significance.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

Table of subject characteristics

 

Change in IOP by glaucoma status and adiposity metric. *Change significant at p<0.05