Reduced visual field may lead to activity decline
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Increased visual field damage may lead to decreased levels of physical activity in patients with glaucoma, according to findings published in Ophthalmology.
E. Jian-Yu, MD, MPH, of the department of epidemiology at Johns Hopkins Bloomberg School of Public Health, and colleagues sought patterns of objectively measured physical activity by level of visual field (VF) damage in patients with glaucoma. They included activity fragmentation and diurnal patterns of activity in the measurements.
The researchers evaluated data from a prospective cohort study of older adults diagnosed with glaucoma or suspected glaucoma.
Degree of VF damage was defined by average VF sensitivity within the integrated VF (IVF), Jian-Yu and colleagues wrote. Investigators equipped participants with hip accelerometers for 1 week to measure minute-by-minute activity for 7 consecutive days.
The main outcome was activity fragmentation and amount of activity over the course of the day between 5 a.m. and 11 p.m., the researchers wrote.
Jian-Yu and colleagues found that each 5-unit decibel decrement in IVF sensitivity was associated with 16.3 fewer active minutes per day and 2% greater activity fragmentation (P < .05 for both), but not with the number of active bouts per day.
Lower IVF sensitivity was associated with fewer steps in 3-hour increment groups ranging from 11 a.m. to 2 p.m. and 2 p.m. to 5 p.m. (106.6 fewer steps vs. 93.1; P < .05 for all), the researchers wrote. The 5 p.m. to 8 p.m. period recorded 89.2 fewer steps.
“Given the associations between more fragmented activity and physiological decline, our findings suggest possible physical health consequences in some glaucoma patients, ie, those with more fragmented activity due to severe VF damage,” the researchers wrote.
Perspective
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Mark Eltis, OD, FAAO
One of the most important concepts to keep in mind as a health care professional is the interconnectivity of various aspects of wellness. Glaucoma progression does not just affect the eyes but represents a weakening of one of the pillars of health. As one falls, others can come tumbling down like dominos with devastating consequences for the patient. A decrease in visual function can limit mobility, lead to morbidity and increase mortality risk.
Jian-Yu and colleagues confirm that VF damage is associated with lower physical activity in glaucoma patients. Worse VF damage was associated with more fragmented daily activity (active moments were shorter), resulting in lower accumulation of exercise.
This study highlights the opportunity for multispecialty optometry clinics where vision rehabilitation experts can work in concert with a glaucoma management team. Additionally, while the results are not conclusive, it is reasonable to suggest that the more we mitigate visual field damage the more we can improve overall health and increase longevity. Successful glaucoma treatment likely does more than prevent blindness, it also improves our patient’s quality of life.
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