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Ferreira NS, Costa VP, Miranda JF, Cintra LO, Barbosa LS, Barbosa da Silva MG, Abreu NA, Abe RY. Psychological Stress and Intraocular Pressure in Glaucoma. A Randomized Controlled Trial. Ophthalmol Glaucoma 2024:S2589-4196(24)00131-5. [PMID: 39019157 DOI: 10.1016/j.ogla.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 06/09/2024] [Accepted: 07/08/2024] [Indexed: 07/19/2024]
Abstract
PURPOSE To evaluate the intraocular pressure (IOP) behavior after applying a standardized protocol to induce psychological stress in primary open-angle glaucoma (POAG) patients. DESIGN Randomized controlled trial. PARTICIPANTS A total of 39 POAG patients were included: 18 in the stress group and 21 in the control group. METHODS Patients were randomized to undergo the Trier Social Stress Test (TSST) or to be included in the control group. All participants were submitted to a modified diurnal tension curve (DTC) 1 to 4 weeks before randomization, with 3 IOP measurements performed between 8:00 AM and 2:00 PM. We evaluated the response to the TSST by measuring the levels of salivary cortisol, salivary amylase, IOP, mean arterial pressure and heart rate before, immediately after, and 40 minutes after the TSST. The State Trait Anxiety Inventory (STAI) was applied to evaluate the levels of anxiety at the same time intervals. MAIN OUTCOME MEASURES Changes in IOP (mmHg), salivary cortisol and amylase, heart rate, mean arterial pressure and STAI scores. RESULTS At baseline, there were no significant differences between the groups regarding age (P=0.661), gender (P=0.669), salivary cortisol (P=0.104) and mean DTC IOP for the right (P=0.439) and left (P=0.576) eyes. We observed a significant mean IOP increase of 3.8 mmHg (right eye, P<0.001) and 4.1mmHg (left eye, P<0.001) when we compared IOP measurements obtained during the DTC and immediately after TSST. Salivary cortisol (5.9 nmol/L, P=0.004), salivary amylase (323,388 UL, P=0.004), mean arterial pressure (10.1mmHg, P<0.001) and heart rate (12.9bpm, P<0.001) also increased significantly after the TSST. In addition, 61.1% (11 out of 18) of the patients in the TSST group showed an IOP increase greater than 4 mmHg following the test. The STAI-state score significantly increased after the TSST compared to baseline (P<0.001) and decreased from post-stress to the recovery period (P<0.001). CONCLUSIONS POAG patients present significant elevations of IOP, salivary cortisol and amylase, mean arterial pressure, heart rate and STAI scores after psychological stress induced by the TSST.
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Affiliation(s)
| | | | | | | | | | | | | | - Ricardo Y Abe
- Hospital Oftalmológico de Brasília, Brasília, Distrito Federal, Brazil; Department of Ophthalmology - University of Campinas, Campinas, Brazil.
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Terauchi R, Wada T, Fukai K, Tatemichi M, Sano K, Nishijima E, Ogawa S, Noro T, Ito K, Kato T, Kato K, Nakano T. Association Between Days of the Week and Intraocular Pressure: Japan Ningen Dock Study. J Glaucoma 2024; 33:262-269. [PMID: 37974321 DOI: 10.1097/ijg.0000000000002333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 10/25/2023] [Indexed: 11/19/2023]
Abstract
PRCIS The analysis of intraocular pressure (IOP) by day of the week using the mega database showed a periodic weekly pattern with the highest value on Monday. PURPOSE To evaluate IOP by the day of the week. PATIENTS AND METHODS Annual health checkup examinees between April 2014 and March 2015 were cross-sectionally evaluated. As a result, 655,818 participants [51.5±10.5 (range: 20-96) years, 40.1% women] from 103 medical centers were included. IOP was measured using a noncontact tonometer. The mean IOPs of each day of the week were compared using multiple comparison test and multiple linear regression analysis. Wednesday was set as the reference. Moreover, weekly IOP variations stratified by sex and age were also evaluated. RESULTS Mean IOPs from Monday to Sunday were 13.19±2.97, 13.06±2.92, 13.05±2.91, 13.05±2.92, 13.12±2.94, 13.10±2.96, and 13.16±2.78 mm Hg. IOP was significantly higher on Monday, Friday, and Saturday than those on Wednesday ( P <0.001, <0.001, 0.002). After adjusting for factors affecting IOP, the IOPs on Monday and Saturday were higher than those on Wednesday [β=0.097 (95% CI: 0.074-0.121), P <0.001; β=0.032 (95% CI: 0.005-0.059), P =0.019]. Men had significantly higher IOPs on Monday and Saturday than on Wednesday [β=0.142 (95% CI: 0.110-0.173), P <0.001; β=0.053 (95% CI: 0.017-0.089), P =0.004], whereas women did not have a significant trend. Participants aged below 65 years had higher IOPs on Monday ( P <0.001 in under 60 years; P =0.003 in 60-64 years), while those aged 65 years or older did not ( P =0.856). CONCLUSION IOP values may have a periodic weekly pattern. The high IOP on Monday was more pronounced in men aged less than 65 years.
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Affiliation(s)
| | - Takashi Wada
- Health Science, The Jikei University Graduate School of Medicine, Tokyo
| | - Kota Fukai
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara
| | - Masayuki Tatemichi
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara
| | | | | | | | | | - Kyoko Ito
- Centre for Preventive Medicine, The Jikei University School of Medicine
| | - Tomohiro Kato
- Centre for Preventive Medicine, The Jikei University School of Medicine
| | - Kiminori Kato
- Department of Prevention of Noncommunicable Diseases and promotion of Health Checkup, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Ramesh PV, Morya AK, Azad A, Pannerselvam P, Devadas AK, Gopalakrishnan ST, Ramesh SV, Aradhya AK. Navigating the intersection of psychiatry and ophthalmology: A comprehensive review of depression and anxiety management in glaucoma patients. World J Psychiatry 2024; 14:362-369. [PMID: 38617979 PMCID: PMC11008383 DOI: 10.5498/wjp.v14.i3.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/28/2024] [Accepted: 02/29/2024] [Indexed: 03/19/2024] Open
Abstract
Glaucoma, a prevalent and debilitating eye disease, has long been associated with vision impairment and blindness. However, recent research has shed light on the often-underestimated psychological dimensions of this condition. Anxiety and depression, two pervasive psychiatric comorbidities, have been increasingly recognized among glaucoma patients. This comprehensive review aims to explore the intricate relationship between psychiatry and ophthalmology, in the context of managing depression and anxiety in glaucoma patients. By meticulously examining peer-reviewed literature, we synthesize current knowledge on the prevalence, risk factors, and underlying mechanisms of anxiety and depression in glaucoma. The evidence reveals that glaucoma patients face an elevated risk of experiencing these mood disorders. Factors such as progressive vision loss, complex medication regimens, and the fear of further visual deterioration contribute to their vulnerability. Moreover, we delve into the bidirectional relationship between glaucoma and mood disorders, shedding light on the complex interplay between ocular and emotional health. Our review investigates the implications of anxiety and depression on glaucoma management, including their potential impact on treatment adherence, disease progression, and overall quality of life. We also explore the neurobiological pathways linking glaucoma and mood disorders, providing a foundation for future research and potential therapeutic interventions. In conclusion, recognizing the psychological burden carried by glaucoma patients is essential for holistic and patient-centered care. This review underscores the pressing need for integrated approaches that bring together ophthalmological and psychiatric expertise to optimize the well-being of individuals facing the challenges of glaucoma. By addressing anxiety and depression in glaucoma care, healthcare providers can enhance the overall quality of life for these patients, ultimately leading to improved outcomes and a brighter future for those affected by this condition. This review offers valuable insight for healthcare practitioners and researchers, providing a concise overview of key topics and research in the field of managing depression and anxiety in glaucoma patients.
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Affiliation(s)
- Prasanna Venkatesh Ramesh
- Department of Glaucoma and Research, Mahathma Eye Hospital Private Limited, Trichy 620017, Tamil Nadu, India
| | - Arvind Kumar Morya
- Department of Ophthalmology, All India Institute of Medical Sciences, Hyderabad 508126, Telangana, India
| | - Ashik Azad
- Department of Optometry and Visual Science, Mahathma Eye Hospital Private Limited, Trichy 620017, Tamil Nadu, India
| | - Pavithra Pannerselvam
- Junior Resident, Mahathma Eye Hospital Private Limited, Trichy 620017, Tamil Nadu, India
| | - Aji Kunnath Devadas
- Department of Optometry and Visual Science, Mahathma Eye Hospital Private Limited, Trichy 620017, Tamil Nadu, India
| | | | - Shruthy Vaishali Ramesh
- Department of Cataract and Refractive Surgery, Mahathma Eye Hospital Private Limited, Trichy 620017, Tamil Nadu, India
| | - Ajanya K Aradhya
- Department of Optometry and Visual Science, Mahathma Eye Hospital Private Limited, Trichy 620017, Tamil Nadu, India
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Zhang J, Chen X, Zhu Y, Wan S, Hu S, Yang Y. Investigating the Causal Relationship Between Sleep Behaviors and Primary Open-Angle Glaucoma: A Bidirectional Two-Sample Mendelian Randomization Study. Nat Sci Sleep 2024; 16:143-153. [PMID: 38374869 PMCID: PMC10876006 DOI: 10.2147/nss.s439274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/08/2024] [Indexed: 02/21/2024] Open
Abstract
Background Although previous studies of sleep-related behaviors in relation to primary open-angle glaucoma (POAG) have been noted, the causal relationship remains unclear. The purpose of our present study was to investigate the relationships of genetically predicted sleep traits with POAG using a two-sample bidirectional Mendelian randomization (MR) method. Methods Summary-level data collected from publicly available genome-wide association studies (GWAS) of European decent were applied for the bidirectional MR analysis. After quality control steps, independent single-nucleotide polymorphisms for eight sleep behaviors and POAG were selected as the genetic instruments. The inverse-variance weighted (IVW) approach was adopted as the primary method, which was complemented by a series of sensitivity analyses to assess the robustness of the results by estimating heterogeneity and pleiotropy. Multivariable MR (MVMR) was used to assess the direct effect of sleep traits on POAG, after adjusting for several confounding factors. Results Our investigation revealed a positive correlation between genetically predicted ease of getting up in the morning and sleep duration and POAG using the IVW method (odds ratio (OR)=1.78, 95% confidence interval (CI):1.29-2.46, P = 4.33× 10-4; OR = 1.66, 95% CI:1.18-2.34, P = 3.38×10-3, respectively). Other supplementary MR methods also confirmed similar results. Moreover, the MVMR results also revealed that the adverse effects of these two sleep traits on POAG persisted after adjusting for body mass index, smoking, drinking, and education (all P < 0.05). Conversely, the relationships between genetic liability of POAG and different sleep behaviors were not statistically significant in the reverse-direction MR estimate (all P > 0.05). Conclusion Our study demonstrated that genetic prediction of getting up easily in the morning or sleep duration were associated with a higher risk of POAG, but not vice versa, in a European population. Further validation and clinical interventions are required to offer potential strategies to prevent and manage POAG.
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Affiliation(s)
- Jun Zhang
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China
| | - Xiaoyan Chen
- Department of Obstetrics and Gynecology, Women and Children’s Hospital of Chongqing Medical University, Chongqing Health Center for Women and Children, Chongqing, People’s Republic of China
| | - Yan Zhu
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China
| | - Shanshan Wan
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China
| | - Shuqiong Hu
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei, People’s Republic of China
| | - Yanning Yang
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China
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McDermott CE, Salowe RJ, Di Rosa I, O’Brien JM. Stress, Allostatic Load, and Neuroinflammation: Implications for Racial and Socioeconomic Health Disparities in Glaucoma. Int J Mol Sci 2024; 25:1653. [PMID: 38338933 PMCID: PMC10855412 DOI: 10.3390/ijms25031653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 02/12/2024] Open
Abstract
Glaucoma is the leading cause of irreversible blindness, and its pathophysiology includes neuroinflammatory changes. The present therapies for glaucoma target pressure-lowering mechanisms with limited success, making neuroinflammation a target for future interventions. This review summarizes the neuroinflammatory pathways seen in glaucoma and their interplay with stress. Glucocorticoids have been shown to activate proinflammatory glial cells, contributing to the neuroinflammation in glaucoma. Glucocorticoids have also been shown to increase the IOP directly. Stress-associated autonomic dysfunction can affect the vascular homeostasis in the retina and create oxidative stress. Diabetes, hyperglycemic-mediated endothelial damage, and vascular inflammation also play important roles in the neuroinflammation in glaucoma and diabetic retinopathy. Psychosocial stress has been implicated in an increased IOP and glaucoma outcomes. People who experience maladaptive chronic stress suffer from a condition known as allostatic load, which describes pathologic neuroendocrine dysregulation. The effects of allostatic load and chronic stress have been studied in patients affected by a lower socioeconomic status (SES) and marginalized racial identities. A lower SES is associated with higher rates of glaucoma and also affects the access to care and screening. Additionally, people of African ancestry are disproportionately affected by glaucoma for reasons that are multifactorial. In conclusion, this review explores neuroinflammation in glaucoma, highlighting opportunities for future investigation.
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Affiliation(s)
- Colleen E. McDermott
- Department of Surgery, University of Utah, Salt Lake City, UT 84101, USA
- Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (R.J.S.); (I.D.R.)
| | - Rebecca J. Salowe
- Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (R.J.S.); (I.D.R.)
| | - Isabel Di Rosa
- Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (R.J.S.); (I.D.R.)
| | - Joan M. O’Brien
- Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (R.J.S.); (I.D.R.)
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Stuart KV, Pasquale LR, Kang JH, Foster PJ, Khawaja AP. Towards modifying the genetic predisposition for glaucoma: An overview of the contribution and interaction of genetic and environmental factors. Mol Aspects Med 2023; 93:101203. [PMID: 37423164 PMCID: PMC10885335 DOI: 10.1016/j.mam.2023.101203] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/26/2023] [Accepted: 07/05/2023] [Indexed: 07/11/2023]
Abstract
Glaucoma, the leading cause of irreversible blindness worldwide, is a complex human disease, with both genetic and environmental determinants. The availability of large-scale, population-based cohorts and biobanks, combining genotyping and detailed phenotyping, has greatly accelerated research into the aetiology of glaucoma in recent years. Hypothesis-free genome-wide association studies have furthered our understanding of the complex genetic architecture underpinning the disease, while epidemiological studies have provided advances in the identification and characterisation of environmental risk factors. It is increasingly recognised that the combined effects of genetic and environmental factors may confer a disease risk that reflects a departure from the simple additive effect of the two. These gene-environment interactions have been implicated in a host of complex human diseases, including glaucoma, and have several important diagnostic and therapeutic implications for future clinical practice. Importantly, the ability to modify the risk associated with a particular genetic makeup promises to lead to personalised recommendations for glaucoma prevention, as well as novel treatment approaches in years to come. Here we provide an overview of genetic and environmental risk factors for glaucoma, as well as reviewing the evidence and discussing the implications of gene-environment interactions for the disease.
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Affiliation(s)
- Kelsey V Stuart
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jae H Kang
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Paul J Foster
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
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7
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Qian C, Soh ZD, Thakur S, Yan W, Shao X, Zhong H, Wang K. Assessment of anxiety and depression in patients with Posner-Schlossman syndrome. BMC Ophthalmol 2023; 23:287. [PMID: 37353735 DOI: 10.1186/s12886-023-03047-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/15/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND To assess the anxiety and depression levels in patients with Posner-Schlossman syndrome (PSS) and to determine the potential risk factors. METHODS In this cross-sectional study, a total of 195 participants, including 93 PSS patients and 102 healthy controls were recruited. Sociodemographic and clinical information were collected for all participants. Hospital Anxiety and Depression scale (HADS) was administered to evaluate the anxiety and depression levels. Visual function (VF) and quality-of-life (QOL) questionnaires were administered to assess variables potentially associated with anxiety and depression. RESULTS Increased anxiety level was observed in 22 (23.7%) PSS patients as compared to 10 (9.8%) of controls (P = 0.009). While the frequency of depression between the two groups was not significantly different (P = 0.349). The mean anxiety and depression scores were 6.98 ± 4.20 and 6.44 ± 3.66 in PSS patients as compared to 6.67 ± 3.21 (P = 0.564) and 5.96 ± 2.93 (P = 0.311) in controls. Logistic regression analysis showed mental well-being was significantly associated with anxiety (odds ratio [OR] = 0.920, 95% confidence interval [CI] = 0.881-0.962, P < 0.001) and depression (OR = 0.959, CI = 0.926-0.994, P = 0.023) in PSS patients. CONCLUSION More patients with PSS may experience anxiety as compared to healthy controls. Mental well-being is an independent risk factor for anxiety and depression. It is important for ophthalmologists to be aware of these factors and should pay more attention on mental health when PSS is managed in clinic.
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Affiliation(s)
- Chaoxu Qian
- Shanghai Aier Eye Hospital, Shanghai Aier Eye Institute, Shanghai, China
| | - Zhi Da Soh
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sahil Thakur
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Wen Yan
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xian Shao
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Hua Zhong
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Kaidi Wang
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Rd, 200031, Shanghai, China.
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Mamtani N, Mamtani H, Thippeswamy H, George RJ, Chaturvedi SK. Comments on "A Prospective Observational Study on Changes in Intraocular Pressure and Iridocorneal Angle Following the Use of Escitalopram and Amitriptyline". Indian J Psychol Med 2023; 45:323-324. [PMID: 37152398 PMCID: PMC10159559 DOI: 10.1177/02537176231164741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/09/2023] Open
Affiliation(s)
- Nidhi Mamtani
- Dept. of Glaucoma, Vision Research
Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Harkishan Mamtani
- Dept. of Psychiatry, National Institute of
Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
- Harkishan Mamtani, Dept. of Psychiatry, National
Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka 560029,
India. E-mail:
| | - Harish Thippeswamy
- Dept. of Psychiatry, National Institute of
Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Ronnie Jacob George
- Dept. of Glaucoma, Vision Research
Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Santosh K. Chaturvedi
- Dept. of Psychiatry, National Institute of
Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Beach KM, Hung LF, Lou L, Ostrin LA. Diurnal Variation and Effects of Dilation and Sedation on Intraocular Pressure in Infant Rhesus Monkeys. Curr Eye Res 2023; 48:289-296. [PMID: 36357337 PMCID: PMC10006333 DOI: 10.1080/02713683.2022.2141782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 10/26/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE Intraocular pressure (IOP) is an important factor in numerous ocular conditions and research areas, including eye growth and myopia. In infant monkeys, IOP is typically measured under anesthesia. This study aimed to establish a method for awake IOP measurement in infant rhesus monkeys, determine diurnal variation, and assess the effects of dilation and sedation. METHODS Awake IOP (iCare TonoVet) was measured every 2 h from 7:30 am to 5:30 pm to assess potential diurnal variations in infant rhesus monkeys (age 3 weeks, n = 11). The following day, and every 2 weeks to age 15 weeks, IOP was measured under three conditions: (1) awake, (2) awake and dilated (tropicamide 0.5%), and (3) sedated (ketamine and acepromazine) and dilated. Intraclass correlation coefficient (ICC) was used to determine intersession repeatability, and repeated measures. ANOVA was used to determine effects of age and condition. RESULTS At age 3 weeks, mean (±SEM) awake IOP was 15.4 ± 0.6 and 15.2 ± 0.7 mmHg for right and left eyes, respectively (p=.59). The ICC between sessions was 0.63[-0.5 to 0.9], with a mean difference of 2.2 ± 0.3 mmHg. Diurnal IOP from 7:30 am to 5:30 pm showed no significant variation (p=.65). From 3 to 15 weeks of age, there was a significant effect of age (p=.01) and condition (p<.001). Across ages, IOP was 17.8 ± 0.7 mmHg while awake and undilated, 18.4 ± 0.2 mmHg awake and dilated, and 11.0 ± 0.3 mmHg after sedation and dilation. CONCLUSIONS Awake IOP measurement was feasible in young rhesus monkeys. No significant diurnal variations in IOP were observed between 7:30 am and 5:30 pm at age 3 weeks. In awake monkeys, IOP was slightly higher after mydriasis and considerably lower after sedation. Findings show that IOP under ketamine/acepromazine anesthesia is significantly different than awake IOP in young rhesus monkeys.
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Affiliation(s)
- Krista M Beach
- University of Houston College of Optometry, Houston, TX, United States
| | - Li-Fang Hung
- University of Houston College of Optometry, Houston, TX, United States
| | - Linjiang Lou
- University of Houston College of Optometry, Houston, TX, United States
| | - Lisa A Ostrin
- University of Houston College of Optometry, Houston, TX, United States
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Sun C, Yang H, Hu Y, Qu Y, Hu Y, Sun Y, Ying Z, Song H. Association of sleep behaviour and pattern with the risk of glaucoma: a prospective cohort study in the UK Biobank. BMJ Open 2022; 12:e063676. [PMID: 36319053 PMCID: PMC9644340 DOI: 10.1136/bmjopen-2022-063676] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Given the role of intraocular pressure in glaucoma, the patient's sleeping pattern might contribute to the development and progression of glaucoma. We performed a study to understand the association between sleep behaviours and glaucoma. DESIGN Our study was a prospective cohort study. SETTING This was a prospective cohort study in the UK Biobank. Self-reported data on five sleep behaviours were collected using a questionnaire at baseline. We identified four sleep patterns based on a cluster analysis of the sleep behaviours. PARTICIPANTS In the UK Biobank, 409 053 participants were recruited between 2006 and 2010 and followed for a diagnosis of glaucoma. We identified glaucoma as any hospital admission with a diagnosis of glaucoma, based on UK Biobank inpatient hospital data. Individuals who withdrew from the UK Biobank, or were diagnosed with glaucoma before recruitment, or had self-reported surgery or laser treatment for glaucoma, or had no information on sleep behaviors were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES We estimated hazard ratios (HRs) with 95% confidence intervals (CI) using Cox proportional hazards models to estimate the associations of different sleep behaviors, as well as identified sleep patterns, with the risk of glaucoma, adjusting for multiple confounders. RESULTS Compared with individuals who had a healthy sleep pattern, an excess risk of any glaucoma was observed among individuals with snoring and daytime sleepiness (HR 1.11, 95% CI 1.03 to 1.19) or insomnia and short/long sleep duration (HR 1.13, 95% CI 1.06 to 1.20), but not late chronotype sleep pattern (HR 0.98, 95% CI 0.93 to 1.03). CONCLUSION Snoring, daytime sleepiness, insomnia, and short/long duration, individually or jointly, were all associated with the risk of glaucoma. These findings underscore the need for sleep intervention for individuals at high risk of glaucoma as well as potential ophthalmologic screening among individuals with chronic sleep problems for glaucoma prevention.
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Affiliation(s)
- Cun Sun
- Beijing Huimin Hospital, Beijing, China
| | - Huazhen Yang
- West China Biomedical Big Data Center, West China Hospital,Sichuan University, Chengdu, Sichuan, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yihan Hu
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Yuanyuan Qu
- West China Biomedical Big Data Center, West China Hospital,Sichuan University, Chengdu, Sichuan, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yao Hu
- West China Biomedical Big Data Center, West China Hospital,Sichuan University, Chengdu, Sichuan, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yajing Sun
- West China Biomedical Big Data Center, West China Hospital,Sichuan University, Chengdu, Sichuan, China
| | - Zhiye Ying
- West China Biomedical Big Data Center, West China Hospital,Sichuan University, Chengdu, Sichuan, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Huan Song
- West China Biomedical Big Data Center, West China Hospital,Sichuan University, Chengdu, Sichuan, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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Dada T, Mondal S, Midha N, Mahalingam K, Sihota R, Gupta S, Angmo D, Yadav RK. Effect of Mindfulness-Based Stress Reduction on Intraocular Pressure in Patients With Ocular Hypertension: A Randomized Control Trial. Am J Ophthalmol 2022; 239:66-73. [PMID: 35122746 DOI: 10.1016/j.ajo.2022.01.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE To evaluate the effect of mindfulness-based stress reduction (MBSR) on intraocular pressure (IOP) in patients with ocular hypertension (OHT). DESIGN Parallel arm, single masked, randomized controlled trial. METHODS Sixty patients with ocular hypertension and IOP > 21 and < 30 mmHg were recruited at a tertiary eye care centre in India. Thirty patients (group 1) underwent six weeks of one hour daily MBSR sessions, while the other 30 patients (group 2) were waitlisted and kept on follow-up. The primary outcome was change in IOP (ΔIOP) after six weeks of MBSR. Secondary outcomes were effect on serum cortisol level, diurnal variation of IOP, vessel perfusion and vessel density on optical coherence tomography angiography (OCTA), and quality of life (QOL). RESULTS At six weeks, a significant decrease in IOP was noted in group 1 (23.05 ± 1.17 to 19.15 ± 1.45 mmHg; P = .001) compared with group 2 (22.55 ± 0.98 mmHg to 22.37 ± 1.07 mmHg; P = .107). The ΔIOP was significantly greater in group 1 (3.93 ± 1.47) than group 2 (0.17 ± 0.58; P = .001). The diurnal fluctuation of IOP decreased in group 1 (4.87 ± 1.13 mmHg to 2.73 ± 0.98 mmHg; P = .001) as compared with group 2 (4.50 ± 0.86 mmHg to 4.30 ± 0.83 mmHg; P = .227). Significant improvement in vessel perfusion, vessel density, and flux index was noted on OCTA in group 1 compared with group 2. Group 1 showed a significant decrease (P ≤ .001) in serum cortisol level and an improved QOL (P = .001). CONCLUSION Mindfulness-based stress reduction was associated with a significant decrease in IOP and serum cortisol, along with an improvement in optic nerve head perfusion and QOL. Mindfulness-based stress reduction can be considered as a potential treatment option in the management of OHT.
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Häkkinen M, Ekström C. Distribution of intraocular pressure in a Swedish population. Ups J Med Sci 2022; 127:8829. [PMID: 36337274 PMCID: PMC9607869 DOI: 10.48101/ujms.v127.8829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/28/2022] [Accepted: 09/06/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Increased intraocular pressure (IOP) and pseudoexfoliation (PEX) are major risk factors for open-angle glaucoma (OAG), an age-related neurodegenerative disease of significant importance for public health. There are few studies on the distribution of IOP in populations where PEX is a common finding. METHODS The distribution of IOP was studied in 733 subjects 65-74 years of age, examined in a population survey in the rural district of Tierp, Sweden, 1984-86. The difference between the right and left eye and the effect of which eye was measured first were examined. Odds ratios, adjusted for age and sex, according to Mantel-Haenszel (ORMH), were calculated to estimate predictors of increased IOP, defined as a pressure ≥20 mm Hg in either eye. The pressure was measured with Goldmann applanation tonometry. Automated perimetry was used to identify OAG. RESULTS The distribution of IOP was close to that of other European-derived populations. The pressure in the first measured eye was higher than in the second measured eye. Increased IOP was related to OAG and PEX, ORMH 8.97 (95% confidence interval [CI] 3.84-20.9) and 2.40 (95% CI 1.53-3.76), respectively. An IOP ≥20 mm Hg increased the risk of having been diagnosed with diabetes (ORMH 1.83; 95% CI 1.08-3.09). CONCLUSION In this study of subjects 65-74-years-old in Sweden, the distribution of IOP was close to that of other European-derived populations. Although the difference was small, the pressure in the first measured eye was higher than in the second eye. Increased IOP was strongly related to untreated OAG and PEX.
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Affiliation(s)
- Maria Häkkinen
- Department of Surgical Sciences, Ophthalmology, Uppsala University, Uppsala, Sweden
| | - Curt Ekström
- Department of Surgical Sciences, Ophthalmology, Uppsala University, Uppsala, Sweden
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Dada T, Lahri B, Mahalingam K, Shakrawal J, Kumar A, Sihota R, Yadav RK. Beneficial effect of mindfulness based stress reduction on optic disc perfusion in primary open angle glaucoma: A randomized controlled trial. J Tradit Complement Med 2021; 11:581-586. [PMID: 34765522 PMCID: PMC8572716 DOI: 10.1016/j.jtcme.2021.06.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/21/2021] [Accepted: 06/26/2021] [Indexed: 11/01/2022] Open
Abstract
Background and aim Glaucoma is one of the leading causes of visual impairment worldwide. Next to intraocular pressure (IOP), vascular factors play a major role in glaucoma. Mindfulness-based stress reduction (MBSR) has been shown to reduce the IOP, normalize the stress biomarkers, modulate gene expression, and also improve the quality of life. This study was aimed to assess the effect of MBSR in optic disc perfusion of patients with primary open angle glaucoma (POAG). Experimental procedure POAG patients with controlled IOP (<21 mmHg) were randomised in to intervention group (n = 30) and control group (n = 30). Both the groups continued their routine glaucoma medications while the intervention group practiced 45 min of MBSR every day in addition. IOP and optic disc perfusion using OCT-Angiography were recorded at baseline and at 6 weeks for both the groups. Results The mean age of the participants were 53.23 ± 8.4yr in intervention and 50.23 ± 7.3yr in the control group (p = 0.06). All the baseline parameters were comparable in both groups. After MBSR, in the intervention group there was a significant reduction of IOP (p=0.001), increase in circum-papillary vessel density in superior quadrant (15.8%-17.4%, p=0.02) and nasal quadrant (14.2%-16.5%, p=0.01), increase in circum papillary vascular perfusion, in superior quadrant (38.9%-41.1%, p<0.001), in temporal quadrant (42.2%-44.5%, p<0.001), in inferior quadrant (40.1%-43.8%, p<0.001), and in nasal quadrant (40.6%-42.8%, p<0.001). There was also a significant increase in Flux Index after 6weeks (0.38-0.40, p<0.001). Conclusion MBSR can reduce barotrauma and improve optic disc perfusion in POAG patients and serve as a useful adjunct to the standard medical therapy.
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Affiliation(s)
- Tanuj Dada
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Brajesh Lahri
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Karthikeyan Mahalingam
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Jyoti Shakrawal
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Atul Kumar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Ramanjit Sihota
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Raj Kumar Yadav
- Integral Health Clinic, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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Shokoohi-Rad S, Shoeibi N, Ghasemi Nour M, Bakhtiari E. Evaluation of the Effect of Religious Fasting on Retinal Vessel Density and Retinal Thickness Using Optical Coherence Tomography Angiography. Neuroophthalmology 2021; 46:147-153. [DOI: 10.1080/01658107.2021.1995442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Saeed Shokoohi-Rad
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nasser Shoeibi
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Ghasemi Nour
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Elham Bakhtiari
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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15
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Berchuck SI, Jammal AA, Mukherjee S, Somers TJ, Medeiros FA. Impact of anxiety and depression on progression to glaucoma among glaucoma suspects. Br J Ophthalmol 2021; 105:1244-1249. [PMID: 32862132 PMCID: PMC9924953 DOI: 10.1136/bjophthalmol-2020-316617] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/24/2020] [Accepted: 08/01/2020] [Indexed: 01/12/2023]
Abstract
AIMS To assess the impact of anxiety and depression in the risk of converting to glaucoma in a cohort of glaucoma suspects followed over time. METHODS The study included a retrospective cohort of subjects with diagnosis of glaucoma suspect at baseline, extracted from the Duke Glaucoma Registry. The presence of anxiety and depression was defined based on electronic health records billing codes, medical history and problem list. Univariable and multivariable Cox proportional hazards models were used to obtain HRs for the risk of converting to glaucoma over time. Multivariable models were adjusted for age, gender, race, intraocular pressure measurements over time and disease severity at baseline. RESULTS A total of 3259 glaucoma suspects followed for an average of 3.60 (2.05) years were included in our cohort, of which 911 (28%) were diagnosed with glaucoma during follow-up. Prevalence of anxiety and depression were 32% and 33%, respectively. Diagnoses of anxiety, or concomitant anxiety and depression were significantly associated with risk of converting to glaucoma over time, with adjusted HRs (95% CI) of 1.16 (1.01, 1.33) and 1.27 (1.07, 1.50), respectively. CONCLUSION A history of anxiety or both anxiety and depression in glaucoma suspects was associated with developing glaucoma during follow-up.
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Affiliation(s)
- Samuel I. Berchuck
- Department of Statistical Science and Forge, Duke University, Durham, North Carolina, USA,Duke Eye Center and Department of Ophthalmology, Duke University, Durham, North Carolina, USA
| | - Alessandro A. Jammal
- Duke Eye Center and Department of Ophthalmology, Duke University, Durham, North Carolina, USA
| | - Sayan Mukherjee
- Departments of Statistical Science, Mathematics, Computer Science, Biostatistics & Bioinformatics, Duke University, Durham, North Carolina, USA
| | - Tamara J. Somers
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Felipe A. Medeiros
- Duke Eye Center and Department of Ophthalmology, Duke University, Durham, North Carolina, USA
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16
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Influence of mental stress on intraocular pressure and visual field testing: is there a white coat syndrome in glaucoma? Graefes Arch Clin Exp Ophthalmol 2021; 260:209-214. [PMID: 34463840 DOI: 10.1007/s00417-021-05315-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/01/2021] [Accepted: 07/01/2021] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To investigate the effects of mental stress stimulus on intraocular pressure (IOP) measurement and visual field (VF) testing. METHODS Patients with open angle glaucoma underwent a baseline IOP measurement and VF testing. Afterwards, they completed a computerized mental stress test (Stroop test) which is a known standardized method to induce mental stress. After test completion, patients underwent a second IOP measurement and VF testing. RESULTS Seventy-two eyes of 36 patients were enrolled. Mean age was 67.0 ± 9.5 years (range 47-84 years). The mean baseline IOP was 15.0 mmHg, and after the Stroop mental stress test, IOP increased to 16.0 mm Hg (P < 0.001). There was a trend towards significant mean deviation decreased from -6.9 dB to -8.0 dB (P = 0.054, t-test) following the stress test. This difference became significant using the Wilcoxon nonparametric test (P = 0.008). Correlation was found between glaucoma severity and change in IOP (P = 0.02) and PSD (P < 0.01). CONCLUSIONS We found a small but statistically significant increase in IOP and a trend towards deterioration of visual field mean deviation, following a short mental stress test. Patients with more severe glaucoma showed more pronounced changes. Our results suggest that mental stress could affect IOP measurement in the clinic.
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Levin AM, Vezina D, Wirostko BM. Home-Based Intraocular Pressure Measurements: Tracing a Parallel with Out-of-Office Blood Pressure Measurement. Ophthalmol Glaucoma 2021; 4:235-237. [PMID: 34030825 DOI: 10.1016/j.ogla.2021.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/23/2021] [Accepted: 03/02/2021] [Indexed: 01/19/2023]
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Gillmann K, Weinreb RN, Mansouri K. The effect of daily life activities on intraocular pressure related variations in open-angle glaucoma. Sci Rep 2021; 11:6598. [PMID: 33758276 PMCID: PMC7988182 DOI: 10.1038/s41598-021-85980-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 02/26/2021] [Indexed: 12/13/2022] Open
Abstract
The recent advent of continuous intraocular pressure (IOP) telemetry has led to an increased awareness of the importance of IOP fluctuations, and theories have emerged that IOP variations could play as much a role in glaucoma progression as the mean level of IOP. The aim of the present study was to evaluate the direct effect of common daily activities on IOP-related profiles. Primary open-angle glaucoma and glaucoma suspect patients were prospectively enrolled from specialist clinics at the University of California San Diego (UCSD), USA. Patients were fitted with a SENSIMED Triggerfish (TF) contact lens sensor (CLS) and were instructed to return to their usual daily activities for 24 h. They were asked to record each specific activity or event in a diary. The protocol was repeated twice. The following events were recorded: "walking/cycling", "resistance training", "yoga/meditation", and "emotional stress". CLS measurements recorded 60-to-30 min prior to each event were used as a baseline reference, and all IOP-related fluctuations for 120 min after the start of each event were reported in relation to this reference. Forty relevant events from 22 CLS recordings in 14 patients were retrieved from the diaries. Walking/cycling (n = 10) caused a small but statistically significant elevation of the IOP-related profile during the activity (p = 0.018). Resistance training (n = 11) caused a persistent elevation of the IOP-related profile from the onset of the activity (p = 0.005) through 120 min after the activity was stopped (p = 0.007). Yoga/meditation (n = 4) caused a sustained drop in the IOP-related profiles through to 120 min, although this was not statistically significant (p > 0.380). Emotional stress (n = 13) was associated with a gradual elevation of the IOP-related profile from the start of the stressful stimulus. Both early and late variations were statistically significant (p = 0.038 and p = 0.021, respectively). The present study suggests that emotional stress and resistance training may be associated with persistent IOP-related profile elevation.
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Affiliation(s)
- Kevin Gillmann
- Glaucoma Research Center, Montchoisi Clinic, Swiss Visio, Lausanne, Switzerland.,Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA
| | - Kaweh Mansouri
- Glaucoma Research Center, Montchoisi Clinic, Swiss Visio, Lausanne, Switzerland. .,Department of Ophthalmology, University of Colorado School of Medicine, Denver, CO, USA.
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Shin DY, Jung KI, Park HYL, Park CK. The effect of anxiety and depression on progression of glaucoma. Sci Rep 2021; 11:1769. [PMID: 33469104 PMCID: PMC7815884 DOI: 10.1038/s41598-021-81512-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 01/07/2021] [Indexed: 02/08/2023] Open
Abstract
Glaucoma is considered a chronic disease that requires lifelong management. Chronic diseases are known to be highly associated with psychological disturbances such as depression and anxiety. There have also been many studies on association between anxiety or depression and glaucoma. The majority of these studies explained that the glaucoma diagnosis causes anxiety or depression. However, It is also necessary to evaluate whether the psychological disturbance itself affect glaucoma. Therefore, we investigated the association of anxiety and depression with glaucoma progression, and elucidate mechanisms underlying that. We included 251 eyes with open angle glaucoma who were followed up for at least 2 years in this retrospective case–control study. The Beck Anxiety Inventory (BAI) and Beck Depressive Inventory-II (BDI-II) were used to assess anxiety and depression in glaucoma patients. Patients were classified into groups (high-anxiety group; HA-G, low-anxiety group; LA-G, high-depression group; HD-G, low-depression group; LD-G) according to their score on the BAI or BDI-II (separately). In logistic regression analysis, disc hemorrhage, peak intraocular pressure (IOP) and RNFL thickness loss rate were significantly associated with high anxiety (p = 0.017, p = 0.046, p = 0.026). RNFL thinning rate and disc hemorrhage were significant factors associated with anxiety in multivariate models (p = 0.015, p = 0.019). Multivariate linear regression analysis showed a significant positive correlation between the rate of RNFL thickness loss and BAI score (B = 0.058; 95% confidential interval = 0.020–0.097; p = 0.003), and RNFL loss and IOP fluctuation (B = 0.092; 95% confidential interval = 0.030–0.154; p = 0.004). For the depression scale, visual field mean deviation and heart rate variability were significantly associated with high depression in multivariate logistic regression analysis (p = 0.003, p = 0.006). We suggest that anxiety increase the risk of glaucoma progression and they are also associated with IOP profile and disc hemorrhage.
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Affiliation(s)
- Da Young Shin
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Kyoung In Jung
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Hae Young Lopilly Park
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Chan Kee Park
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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