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Editors Selection IGR 25-3
Progression / Prognostic Factors: Can staying active slow visual field loss in glaucoma?
Comment by Alison Chan & Poemen Chan on:
125101 Impact of Physical Activity Levels on Visual Field Progression in Individuals with Glaucoma, Seo JH; Nishida T; Moghimi S et al., Journal of Glaucoma, 2025; 0:
Physical activity (PA) has long been associated with various systemic health benefits, such as a reduced incidence of chronic diseases and improved cardiovascular and musculoskeletal health.1 Previous studies have also shown that PA can improve ocular perfusion pressure and increase brain-derived neurotrophic factor (BDNF) levels,2,3 suggesting a potential protective effect against age-related neurodegenerative diseases.4,5 While cross-sectional studies have hinted at a positive association between PA and glaucoma, longitudinal studies have remain limited.
This longitudinal study by Seo et al. investigated the relationship between self-reported PA levels and the rate of visual field (VF) progression in patients with primary open-angle glaucoma (POAG). The study included 131 eyes of 80 POAG patients with a median follow-up of 4.9 years. The researchers assessed PA using three measures: the General Practice Physical Activity Questionnaire (GPPAQ), a quantification of PA amounts via metabolic equivalent of task (MET)-minutes, (MET value of each activity multiplied by the time spent performing the activity), and self-reported walking pace.
The analysis revealed that an active PA index category and a higher PA amount were associated with a slower rate of VF mean deviation (MD) loss in univariable analysis. The multivariable analysis further confirmed this finding, showing that a higher amount of PA – defined as ≥0.15 dB/y per 1000 MET-minutes – was significantly associated with a slower rate of VF MD loss, even after adjusting for confounding factors such as age, gender, body mass index, and intraocular pressure (IOP).
The authors conclude that higher self-reported PA levels correlated with a slower rate of VF progression in POAG eyes, irrespective of the underlying disease severity. While the exact mechanisms by which increased PA levels deter glaucoma progression are still unknown, this study provides encouraging evidence that lifestyle modifications, such as regular physical activity, may be beneficial additional factor in glaucoma management.
References
- Dhuli K, Naureen Z, Medori MC, et al. Physical activity for health. PubMed. 2022;63(2 Suppl 3):E150-E159. doi:10.15167/2421-4248/jpmh2022.63.2s3.2756
- Yip JLY, Broadway DC, Luben R, et al. Physical activity and ocular perfusion pressure: the EPIC-Norfolk Eye Study. Investigative Ophthalmology & Visual Science. 2011;52(11):8186. doi:10.1167/iovs.11-8267 https://doi.org/10.1167/iovs.11-8267
- Vaynman S, Ying Z, Gomez‐Pinilla F. Hippocampal BDNF mediates the efficacy of exercise on synaptic plasticity and cognition. European Journal of Neuroscience. 2004;20(10):2580-2590. doi:10.1111/j.1460-9568.2004.03720 https://doi.org/10.1111/j.1460-9568.2004.03720.x
- Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. BDJ. 2012;213(7):359. doi:10.1038/sj.bdj.2012.909 https://doi.org/10.1038/sj.bdj.2012.909
- Spielman LJ, Little JP, Klegeris A. Physical activity and exercise attenuate neuroinflammation in neurological diseases. Brain Research Bulletin. 2016;125:19-29. doi:10.1016/j.brainresbull.2016.03.012 https://doi.org/10.1016/j.brainresbull.2016.03.012
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