June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
Sensory Integration Abilities for Balance in Glaucoma
Author Affiliations & Notes
  • Rakie Cham
    Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
    Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Mark S Redfern
    Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Caitlin O'Connell
    Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Ian P Conner
    Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Gadi Wollstein
    Ophthalmology, NYU Langone Health, New York, United States
  • Kevin C Chan
    Ophthalmology, NYU Langone Health, New York, United States
    Radiology, NYU Langone Health, New York, United States
  • Footnotes
    Commercial Relationships   Rakie Cham, None; Mark Redfern, None; Caitlin O'Connell, None; Ian Conner, None; Gadi Wollstein, None; Kevin Chan, None
  • Footnotes
    Support  1. NIH / NEI, “Effects of Visual Fields on Standing Balance” (NIH R03-AG043748); 2. BrightFocus Foundation National Glaucoma Research Program (G2016030); 3. NIH / NEI, “Novel Glaucoma Diagnostics for Structure and Function” (NIH R01-EY013178); 4. Unrestricted grant from Research to Prevent Blindness
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 917. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Rakie Cham, Mark S Redfern, Caitlin O'Connell, Ian P Conner, Gadi Wollstein, Kevin C Chan; Sensory Integration Abilities for Balance in Glaucoma. Invest. Ophthalmol. Vis. Sci. 2020;61(7):917.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : Falls risk increases with glaucoma. The inability to see obstacles such as steps or stairs is one mechanism of falls. Another potential mechanism is reduced postural control. The impact of glaucoma on the ability to centrally integrate sensory information relevant for balance has not been systematically investigated. The goal of this study is to assess the influence of glaucoma severity on sensory integration abilities for balance.

Methods : Eleven adults diagnosed with glaucoma were recruited. Glaucoma severity was determined using two measures: (1) a functional measure, specifically visual field mean deviation (MD) assessed by automated Humphrey perimetry and (2) a structural measure, specifically retinal nerve fiber layer (RNFL) thickness as measured by OCT. Standing balance was assessed using an adapted version of the Sensory Organization Test (SOT) that probes the ability to integrate visual, somatosensory and vestibular information for balance control (Nashner, 1997). The six SOT postural conditions were used, each lasting 3 min. Underfoot center of pressure was used to compute sway speed. Statistical analyses consisted of mixed linear models performed within each postural condition, with glaucoma severity as a fixed effect and subject as the random effect. The dependent measure was sway speed. Statistical significance was set at 0.05.

Results : A worse visual field deficit, as reflected by MD, in the better eye was associated with increased sway speed in the first four SOT conditions (p<0.05), i.e. conditions involving altered or absent visual OR somatosensory information. This effect was not found in conditions when the postural control system relies solely on the vestibular system to maintain balance (SOT Conditions 5-6, p>0.2). Visual field deficits in the worse eye and structural damage in either eye, as reflected by RNFL thickness, were not associated with sway speed under any of the postural conditions.

Conclusions : Balance is impacted by glaucoma under conditions where sensory integration is challenged. Interestingly, visual field severity and sway speed were associated even during the eyes closed condition. This may suggest a central sensory integration mechanism. Further research is warranted.

Reference.
Nashner, L. M. (1997). Computerized Dynamic Posturography. In G. P. Jacobson, et al. (Eds.), Handbook of balance function testing. San Diego, CA: Singular Publishing Group, Inc.

This is a 2020 ARVO Annual Meeting abstract.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×