Physical activity may have neuroprotective effects on the retina
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Key takeaways:
- Moderate to vigorous activity and mean daily active calories were both positively correlated with the rate of macular GCIPL thinning.
- The correlation persisted in those with no history of ophthalmic disease.
Increased physical activity may be associated with slower rates of macular ganglion cell-inner plexiform layer thinning, according to a study published in Investigative Ophthalmology & Visual Science.
“This study investigated the association between physical activity with macular thickness in two cohorts,” Ella C. Berry, MChD, from Flinders Health and Medical Research Institute in Australia, and colleagues wrote. “We initially demonstrated a positive association between physical activity and rates of longitudinal macular GCIPL thinning in 735 eyes from the PROGRESSA study. We then further evaluated this finding at a populational level by associated physical activity with total macular thickness in the UK Biobank.”
In the first analysis, 465 participants from the Progression Risk of Glaucoma: Relevant SNPs with Significant Association (PROGRESSA) study were asked to wear a Fitbit Inspire 2 device to monitor physical activity for 7 days. Of 735 eyes that had sufficient imaging via spectral domain-OCT to calculate rate of macular ganglion cell-inner plexiform layer (GCIPL) thinning, the researchers found that moderate to vigorous activity and mean daily active calories were both positively correlated with the rate of macular GCIPL thinning.
Using data from the UK Biobank, researchers then analyzed 8,862 eyes from 6,152 participants and found that physical activity had a positive correlation with macular thickness, even in a subanalysis of 5,885 participants who had no history of ophthalmic disease.
“Further work utilizing interventional study designs is required to formally investigate the influence of exercise in ophthalmic diseases,” Berry and colleagues wrote.
Perspective
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This Australian study evaluated the effect of physical activity on macular thickness. Two patient cohorts were evaluated: a group of patients extracted from the PROGRESSA glaucoma study who had early primary open-angle glaucoma and a group of patients from the normative population aged 40 to 69 years.
After multiple exclusion criteria were applied, 735 eyes from the PROGRESSA study and 8,862 eyes from the normative population were evaluated. Participants wore a step-monitoring device for 7 contiguous days, then were stratified into quartiles of activity. The upper quartile averaged over 10,542 steps per day, while the bottom quartile averaged less than 6,925 steps per day. In both groups, retrospective OCT data that had been previously obtained was analyzed.
Patients in the upper quartile of activity lost ganglion cell-inner plexiform layer (GCIPL) thickness at a 0.22 μm per year slower rate than did patients in the lower quartile of activity. In the normative population, total macular thickness was found to be greater in the high activity group than in the low activity group.
So, what does this mean clinically? The high activity group of glaucoma patients would essentially lose one less μm of GCIPL thickness over 5 years compared with the low activity group. This very small difference would likely have limited clinical impact. Also, correlating steps taken over a single 7-day period with OCT data collected over many preceding years is certainly less than ideal. It is quite possible that the steps taken during 1 week in which the patients were aware that they were being tracked and evaluated may not be an accurate representation of activity levels over the preceding years.
In the end, we know that physical activity is very beneficial for overall health and well-being, but this study does not definitively show that it meaningfully preserves macular thickness.
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