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Type A behavior a risk factor for open-angle glaucoma
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In a new Journal of Glaucoma study, researchers reported that a personality study is a vital part of diagnosing and treating open-angle glaucoma.
Raffaella Morreale Bubella, MD, PhD, and colleagues evaluated 20 men and 30 women with open-angle glaucoma (OAG). Glaucoma progression was measured by conducting a complete biomicroscopic examination, tonometry and daily tonometric curve measurement, visual field examination, and morphologic monitoring of retinal nerve fiber layers with scanning laser polarimetry with variable corneal compensation (GDx-VCC).
Personality behaviors and anxiety were measured using the Hamilton Anxiety Rating Scale, several personality questionnaires, the State-Trait Anxiety Inventory test, the Brief-cope test and a life event.
Sixty-four percent of the participants demonstrated type A behaviors, according to the researchers; those participants exhibited significantly higher trait and state anxiety levels (P = .001). Additionally, the researchers found more significant visual field involvement in type A participants, which was negatively correlated with the Brief-cope test.
“It is therefore absolutely indispensable to perform the necessary follow-up to evaluate the possible evolutionary differences in the glaucomatous damage within the two groups; this is the only way of identifying the real role played by stress in the pathogenesis and evolution of OAG,” the researchers concluded.
Disclosure: The authors have no relevant financial disclosures.
Perspective
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Blair Lonsberry, MS, OD, MEd, FAAO
Stress and personality traits may be important risk factors for the development and/or progression of a disease. The purpose of this study is to evaluate the presence of type A behavior in patients affected by open-angle glaucoma (OAG) and the possible role of psychophysiological stress as a risk factor for OAG.
The study involved 50 OAG patients who submitted to standard glaucoma testing as well as psychological assessment for anxiety/stress and personality type. The authors found that the prevalence of type A personality in their OAG subjects was extremely high (64%) and they suggest this may be an important consideration when diagnosing and managing patients. In addition, type A subjects had more perimetric damage, a lower mean retinal nerve fiber layer thickness and a higher nerve fiber indicator index compared with type B subjects.
Although these results are interesting, in clinical practice many patients miss appointments, fail to adhere to their medications and have a cavalier attitude about glaucoma – hardly the behaviors of type A patients. We aren’t psychologists, so perhaps we don’t understand enough about type A personality, but it is hard to imagine a personality assessment being utilized as a glaucoma risk factor without further evidence supporting this possible association.
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J Glaucoma. 2014; doi: 10.1097/IJG.0b013e3182707421.
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