Abstract
Purpose :
Glaucoma is a leading cause of avoidable blindness globally. Early detection for treatment to reduce the intraocular ocular pressure (IOP) delays the progression of primary open-angle glaucoma (POAG), but that sometimes is not enough to preserve vision to outlast the lifespan of affected persons. The study investigated the modifiable and non-modifiable risk factors associated with POAG progression in patients from Ghana.
Methods :
Two hundred and fifty diagnosed POAG patients with at least two reliable baseline and two follow-up 24-2 Visual Field tests over a period of 10 to 60 months were recruited for the evaluation of glaucoma progression. Ocular hypotensive drugs were the only form of treatment for all the POAG patients and none had undergone laser or surgery for glaucoma treatment. Using the International Physical Activity Questionnaire (IPAQ), the metabolic equivalent of task (MET) which is an objective measure of energy expenditure was evaluated. Patient biodata and information relating to baseline IOP, glaucoma stage, antiglaucoma drug, and medical history were collected from the medical record. Statistical analysis to determine risk factors of POAG progression was performed using binary logistic regression.
Results :
The mean age (SD) of the glaucoma patients was 46.2 ±10.9 yr and comprised 136 males and 114 females. With a mean follow-up time of 2.1 ± 0.9 yr, glaucoma progression was found in 28 patients using Guided Progression Analysis. Of these, 20 (71.4%) were physically inactive (<300 MET-min/ week). Of these, 20 (71.4%) were physically inactive (<300 MET-min/ week). The patients with moderate physical activity (OR: 0.27, 95%CI:0.10-0.73, P=0.010) and high physical activity levels (OR: 0.08, 95%CI:0.01-0.66, P=0.019) were protected against glaucoma progression. The risk of progression was higher with advancing age and at early-stage POAG. Glaucoma progression, however, was independent of sex, baseline IOP, and antiglaucoma drug.
Conclusions :
The study outcome indicates that higher physical activity is protective against the progression of primary open-angle glaucoma. Thus, primary open-angle glaucoma patients on antiglaucoma drugs to control IOP may adopt a physically active lifestyle to help further delay glaucoma progression. Prospective clinical trials on physical exercise as a neuroprotective intervention in primary open-angle glaucoma management are warranted.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.