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PURPOSE: This retrospective cross-sectional study aimed to investigate the association between autonomic parameters measured using the Kiritsu-Meijin device and visual-field defects in patients with open-angle glaucoma. METHODS: A total of 79 eyes of 42 patients with open-angle glaucoma were enrolled in this study. Kiritsu-Meijin testing comprised three phases: sitting, standing, and sitting again (2 min, 2 min, and 1 min, respectively). Continuous electrocardiograms were recorded for five minutes. Autonomic parameters were extracted from the resulting data and analyzed, including activity, balance, reaction, switchover, and recovery; these are five representative parameters derived from Kiritsu-Meijin testing. Correlations between these parameters and mean deviation from Humphrey visual field testing were determined. Additionally, we used a linear mixed-effects model to observe sectoral differences in the relationship between total deviation and the Kiritsu-Meijin parameters. In this study, we focused on superior, central, and inferior total deviations. RESULTS: Significant positive correlations were observed between activity, balance, and recovery and mean deviation values ( = 0.29-0.38, < .05). The value between activity and inferior total deviation was higher than that between activity and superior total deviation ( = 0.22, < .05). Balance did not show any sectoral differences ( > .05). Recovery was more strongly associated with central to inferior total deviation than superior total deviation ( = 0.17-0.25, < .05). CONCLUSION: Our findings suggest that in patients with open-angle glaucoma, lower activity and recovery are associated with more severe central and/or inferior visual field defects in the superior quadrant. These results imply that measurements of autonomic function made with the Kiritsu-Meijin device may have clinical utility in the management of glaucoma.
Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan.
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