Effects of Phenylcapsaicin on Intraocular and Ocular Perfusion Pressure During a 30-Min Cycling Task: A Placebo-Controlled, Triple-Blind, Balanced Crossover Study

The main objective of this placebo-controlled, triple-blind, balanced crossover study was to assess the acute effects of phenylcapsaicin (PC) intake (2.5 mg) on intraocular pressure (IOP), ocular perfusion pressure (OPP), and heart rate (HR) during a 30-min cycling task performed at 15% of the individual maximal power. Twenty-two healthy young adults performed the cycling task 45 min after ingesting PC or placebo. IOP was measured with a rebound tonometer before exercise, during cycling (every 6 min), and after 5 and 10 min of recovery. OPP was assessed before and after exercise. HR was monitored throughout the cycling task. We found an acute increase of IOP levels related to PC consumption while cycling (mean difference = 1.91 ± 2.24 mmHg; p = .007, ηp2=.30), whereas no differences were observed for OPP levels between the PC and placebo conditions (mean difference = 1.33 ± 8.70 mmHg; p = .608). Mean HR values were higher after PC in comparison with placebo intake (mean difference = 3.11 ± 15.87 bpm, p = .019, ηp2=.24), whereas maximum HR did not differ between both experimental conditions (p = .199). These findings suggest that PC intake before exercise should be avoided when reducing IOP levels is desired (e.g., glaucoma patients or those at risk). Future studies should determine the effects of different ergogenic aids on IOP and OPP levels with other exercise configurations and in the long term.

Low cardiorespiratory fitness is associated with elevated intraocular pressure among apparently healthy adults

PURPOSE

To evaluate the association of cardiorespiratory fitness with elevated intraocular pressure (IOP) in healthy adults.

METHODS

In this cross-sectional study, we evaluated 17,990 asymptomatic self-referred adults free of diabetes or cardiovascular disease who were screened in a preventive healthcare setting. All subjects underwent measurement of IOP and completed a maximal exercise stress test according to the Bruce protocol. Fitness was categorized into age and sex-specific quintiles according to the treadmill time and dichotomized to low (lowest quintile) and non-low fitness groups. Elevated IOP was defined as ≥ 21 mmHg.

RESULTS

Median age was 45 (IQR 39-52) years and 12,073 (67%) were men. There were 3,351 (19%) subjects in the low fitness group. Median IOP was 14 mmHg (IQR 12-16) with elevated IOP documented in 188 (1%) subjects. Univariate binary logistic regression model demonstrated that compared with non-low fitness group, subjects in the low fitness group were 2.2 times more likely to have elevated IOP (95% CI 1.598-2.95, p<0.001). Multivariate binary logistic regression with adjustment to known cardiovascular risk factors (age, sex, hypertension, smoking, overweight, regular physical activity, low HDL cholesterol, high triglycerides, and fasting glucose levels) successfully demonstrated that lower fitness was independently and significantly associated with a 90% increased likelihood of elevated IOP (95% CI 1.37-2.61, p<0.001). Subgroup analysis revealed that the association was more pronounced among women compared with men (OR 3.8 vs. 1.6, p for interaction = 0.069).

CONCLUSIONS

Low cardiorespiratory fitness is independently associated with increased IOP among apparently healthy adults.

The intraocular pressure lowering-effect of low-intensity aerobic exercise is greater in fitter individuals: a cluster analysis

This study aimed to determine the influence of physical fitness level and sex on intraocular pressure (IOP) during the low-intensity aerobic exercise. Forty-four participants (twenty-two men) cycled 30 minutes at low intensity (10% of the maximal power). Maximal power was determined by asking participants to perform maximal sprints of 6 seconds against 3-4 different resistances separated by 3 minutes of rest. The IOP was measured on 9 occasions (1) prior to the warm-up, (2) after the warm-up, (3-7) every 6 minutes during the low-intensity cycling task, and (8-9) 5 and 10 minutes after the cycling task. Low-intensity aerobic exercise had a lowering effect on IOP, being the beneficial effect more accentuated and prolonged in the High-fit group (IOP reduction compared to baseline lasted 30 minutes) than in the Low-fit group (IOP was only reduced at 6 minutes of exercise compared to baseline). Participants´ sex had no effect on the IOP behaviour at any time point (p = 0.453). These findings indicate that individuals who need to reduce IOP levels (i.e., glaucoma patients or those at risk) should increase or maintain a high fitness level to benefit more from the IOP lowering effect during low-intensity aerobic exercises.

Influence of the body positions adopted for resistance training on intraocular pressure: a comparison between the supine and seated positions

OBJECTIVES

A variety of factors are known to mediate on the intraocular pressure (IOP) response to resistance training. However, the influence of the body position adopted during resistance training on IOP remain unknown. The objective of this study was to determine the IOP response to the bench press exercise at three levels of intensity when performed in supine and seated positions.

METHODS

Twenty-three physically active healthy young adults (10 men and 13 women) performed 6 sets of 10 repetitions against the 10-RM (repetition maximum) load during the bench press exercise against three levels of intensity (high intensity: 10-RM load; medium intensity: 50% of the 10-RM load; and control: no external load) and while adopting two different body positions (supine and seated). A rebound tonometer was employed to measure IOP in baseline conditions (after 60 s in the corresponding body position), after each of the 10 repetitions, and after 10 s of recovery.

RESULTS

The body position adopted during the execution of the bench press exercise significantly affected the changes in IOP (p < 0.001, η_p² = 0.83), with the seated position providing lower increases in IOP levels compared to the supine position. There was an association between IOP and exercise intensity, with greater IOP values in the more physically demanding conditions (p < 0.001, η_p² = 0.80).

CONCLUSIONS

The use of seated positions, instead of supine positions, for the execution of resistance training should be prioritized for maintaining more stable IOP levels. This set of findings incorporates novel insights into the mediating factors on the IOP response to resistance training. In future studies, the inclusion of glaucoma patients would allow to assess the generalizability of these findings.

Effect of Aerobic Exercise at Different Intensities on Intraocular Pressure in Young Males

PRCIS

High intensity aerobic exercise significantly reduced intraocular pressure in healthy young male adults.

OBJECTIVE

This study sought to determine how aerobic exercise at various intensities affects intraocular pressure (IOP) in young adults.

DESIGN

A repeated measures design was adopted.

PARTICIPANTS

A group of 20 volunteers (mean age: 21.24±1.73 y) took part in this study.

METHODS

IOP was measured with a tonometer (iCare TA01i, Icare Finland, Finland). Subjects completed 4 cycle ergometer sessions. During the first session, power was increased by 60 W every 3 minutes until exhaustion, corresponding to peak power. For the 3 following tests, each lasting 25 minutes, subjects exercised at intensities of 50%, 70%, and 85% of peak power, respectively, and measurements were taken every 5 minutes.

MAIN OUTCOME MEASURES

IOP, as determined using a tonometer, was the primary measure.

RESULTS

There was a significant reduction ( P <0.05) in IOP of both eyes during the 25 minutes high-intensity (85%) exercise test. There were also significant interactions between exercise durations and intensities. During high-intensity exercise, IOP, blood pressure, blood lactate, and the rating of perceived exertion were significantly related ( P <0.01).

CONCLUSIONS

These data show a significant reduction in IOP at high-intensity aerobic exercise, which may have implications for the management of ocular health.

Effect of wearing different types of face masks during dynamic and isometric resistance training on intraocular pressure

CLINICAL RELEVANCE

The use of face masks has demonstrated to be an effective strategy to prevent transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Wearing face masks, mainly Filtering Face Piece 2 (FFP2) masks, during exercise practice has demonstrated to affect several physiological measures.

BACKGROUND

This study was aimed at assessing the intraocular pressure (IOP) behaviour during the execution of the dynamic and isometric biceps-curl exercise with a surgical and FFP2 face mask.

METHODS

Twenty two physically active young adults performed sets of 10 repetitions against the 10-RM (repetition maximum) load and 1-minute isometric effort against a load 15% lower than the 10-RM load with the FFP2 and surgical mask and without any mask. A total of six exercise sets (3 experimental conditions [FFP2, surgical and control] × 2 exercise modalities) were performed. A rebound tonometer was used to measure IOP before, during (10 measurements), and after (30-seconds of passive recovery) each training set.

RESULTS

At rest, there were not statistically significant IOP differences (p = 0.222). During dynamic exercise, there was a progressive IOP rise (p < 0.001), and a higher IOP response with the FFP2 than without the mask (corrected p-value = 0.003). For the isometric exercise, there was a greater IOP response as a function of accumulated effort (p < 0.001), which was dependent of the face mask used (FFP2> surgical>control; corrected p-values< 0.01).

CONCLUSIONS

The FFP2 masks cause a heightened IOP response during the execution of dynamic and isometric biceps-curl exercise, suggesting that, when possible, glaucoma patients should limit the use of FFP2 masks during resistance training.

Immediate and cumulative effects of upper-body isometric exercise on the cornea and anterior segment of the human eye

Objectives

The execution of isometric resistance training has demonstrated to cause changes in the ocular physiology. The morphology of the cornea and anterior chamber is of paramount importance in the prevention and management of several ocular diseases, and thus, understating the impact of performing isometric exercise on the eye physiology may allow a better management of these ocular conditions. We aimed to determine the short-term effects of 2-minutes upper-body isometric effort at two different intensities on corneal and anterior eye morphology.

Methods

Eighteen healthy young adults performed a 2-minutes isometric biceps-curl exercise against two loads relative to their maximum strength capacity (high-intensity and low-intensity) in a randomized manner. An Oculus Pentacam was used to measure the corneal morphology and anterior chamber parameters in both experimental conditions at baseline, during the isometric effort (after 30, 60, 90 and 120 seconds), and after 30 and 120 seconds of passive recovery.

Results

We found that isometric effort causes an increase in pupil size (P < 0.001), and a decrease in the iridocorneal angle (P = 0.005), anterior chamber volume (P < 0.001) and K-flat (P < 0.001) during isometric effort, with these effects being more accentuated in high-intensity condition (P < 0.005 in all cases).Performing 2-minutes upper-body isometric effort did not alter anterior chamber depth, central corneal thickness, corneal volume, and K-steep (P > 0.05 in all cases).

Conclusions

Our data exhibit that performing 2-minutes of upper-body isometric exercise modifies several parameters of the corneal morphology and anterior eye biometrics, with these changes being greater for the high-intensity exercise condition. The findings of this study may be of relevance for the prevention and management of corneal ectasias and glaucoma.

Therapeutic and preventive eff ect of physical exercises in primary open-angle glaucoma

The review assesses physical exercises as an additional non-pharmacological mean of combating the progression of primary open-angle glaucoma. The ophthalmic hypotensive effect is determined by the type of exercise, its duration and intensity. Moderate aerobic activity is preferred. Among dynamic exercises, jogging has the greatest hypotensive effect. Upper body isometric resistance training provides a more lasting decrease in ophthalmotonus. The decrease in intraocular pressure (IOP) in patients with glaucoma is several times more pronounced in comparison with healthy people and occurs regardless of the nature of the local drug antihypertensive therapy. After the termination of classes IOP returns to the previous level on average within a month. An increase in ocular perfusion pressure associated with physical activity dictates the appropriateness of physical exercise for patients with pseudo-normal pressure glaucoma. The combination of hypotensive, vascular, neuroprotective effects of physical activity with a high level of physical fi tness does not exclude a decrease in the risk of development and progression of primary open-angle glaucoma. The development of indications for the use of physical activity by patients with advanced glaucoma, including those who have undergone hypotensive surgery, remains relevant. The type, intensity, dosage and mode of performing the recommended physical exercises require an individual choice.

Intraocular pressure responses to walking with surgical and FFP2/N95 face masks in primary open-angle glaucoma patients

Purpose

The use of face mask is globally recommended as a preventive measure against COVID-19. However, the intraocular pressure (IOP) changes caused by face masks remain unknown. The objective of this study was to assess the impact of wearing surgical and FFP2/N95 face masks during a 400-m walking protocol on IOP in primary open-angle glaucoma (POAG) patients.

Methods

Thirteen subjects diagnosed of POAG (21 eyes) were enrolled in this study. IOP was measured at baseline, during the 400-m walking protocol and after 5 min of passive recovery while POAG patients wore a surgical mask, FFP2/N95 mask and no mask in randomized order. From the 21 POAG eyes, we analyzed the IOP changes caused by physical exercise with two face masks and without wearing any face mask.

Results

At rest (baseline and recovery measurements), the use of the different face masks did not affect IOP levels (mean differences ranging from 0.1 to 0.6 mmHg). During physical activity, wearing an FFP2/N95 mask caused a small (mean differences ranging from 1 to 2 mmHg), but statistically significant, IOP rise in comparison to both the surgical mask and control conditions (Cohen’s d = 0.63 and 0.83, respectively).

Conclusion

Face masks must be used to minimize the risk of SARS-CoV-2 transmission, and POAG patients can safely use FFP2/N95 and surgical masks at rest. However, due to the IOP rise observed while walking with the FFP2/N95 mask, when possible, POAG patients should prioritized the use of surgical masks during physical activity.

Effects of Wearing the Elevation Training Mask During Low-intensity Cycling Exercise on Intraocular Pressure

PRCIS

Low-intensity aerobic exercise is recommended to reduce intraocular pressure (IOP) levels. However, this effect depends on several factors. We found that using an elevation training mask (ETM) during low-intensity aerobic exercise causes an IOP rise.

PURPOSE

The aim was to assess the influence of wearing an ETM on IOP during low-intensity endurance training.

METHODS

Sixteen physically active young adults (age=23.9±2.9 y) cycled during 30 minutes at 10% of maximal power production with and without an ETM in 2 different days and randomized order. A rebound tonometer was used to measure IOP at baseline, after a warm-up of 5 minutes, during cycling (6, 12, 18, 24, and 30 min), and recovery (5 and 10 min) by rebound tonometry.

RESULTS

The use of an ETM significantly affects the IOP behaviour during exercise (P<0.001, ηp²=0.66). In the ETM condition, there was an IOP increment during exercise (P<0.001, ηp²=0.28) whereas an IOP-lowering effect was observed in the control condition (P<0.001, ηp²=0.41). Post hoc comparisons showed that there were greater IOP values during exercise in the ETM condition in comparison to the control condition (average IOP difference=3.7±2.2 mm Hg; corrected P<0.01, and the Cohen d's >1.10, in all cases).

CONCLUSION

Low-intensity endurance exercise causes an increment in IOP when it is performed wearing an ETM and a decrease in IOP when the air flow is not restricted (control condition). Therefore, the ETM should be discouraged during low-intensity endurance exercise for individuals who need to reduce IOP levels (eg, glaucoma patients or those at risk). However, the external validity of these results needs to be addressed in future studies with the inclusion of glaucoma patients.

Intraocular Pressure Responses to Four Different Isometric Exercises in Men and Women

SIGNIFICANCE

The performance of resistance exercise has evidenced to induce abrupt intraocular pressure (IOP) changes, which has been linked to the onset and progression of glaucoma. We found that four different isometric resistance exercises lead to an instantaneous and progressive IOP elevation, with these changes being independent of the type of exercise.

PURPOSE

The impact of physical exercise on IOP has demonstrated to be dependent on exercise type and intesity, as well as individuals' characteristics. In this study, we aimed to explore the influence of the load, exercise type, and participant's sex on the IOP behavior during a 2-minute isometric effort.

METHODS

Twenty-eight physically active collegiate students performed 2 minutes of isometric exercise in the military press, biceps curl, leg extension, and calf raise exercises against two different loads (high load and low load). Intraocular pressure was measured by rebound tonometry before, during (semicontinuos assessment [24 measurements]), and after 10 seconds of recovery in each of the eight (four exercises × two loads) conditions.

RESULTS

We found a statistically significant effect of load (P < .001, np = 0.906), with greater IOP values when performing the isometric exercises against heavier loads. There was a positive IOP rise during the execution of isometric exercise in the high-load condition, returning to baseline levels after 10 seconds of passive recovery. The exercise type and participant's sex did not reveal statistically significant differences (P = .33 and P = .56, respectively).

CONCLUSIONS

Our data evidenced an instanteneous and progressive IOP rise during the execution of isometric exercise leading to muscular failure, regardless of the exercise type and participant's sex. After exercise, IOP rapidly retuned to baseline levels (within 10 seconds). The inclusion of glaucoma patients in future studies is guarranteed.

Determinant Factors of Intraocular Pressure Responses to a Maximal Isometric Handgrip Test: Hand Dominance, Handgrip Strength and Sex

PURPOSE

To assess the mediating role of strength levels, hand dominance and participants´ sex on the intraocular pressure (IOP) behaviour during the execution of a maximal isometric handgrip test.

METHODS

One hundred and seventy-six sport science students (102 men and 74 women) performed a maximal isometric handgrip test with the dominant and non-dominant hands. A rebound tonometer was used to measure IOP before effort, during effort, and immediately after performing the handgrip test. Men and women were divided based on their handgrip strength in low- and high-strength groups using a median split analysis.

RESULTS

There was an acute IOP rise during effort, returning to baseline levels immediately after exercise cessation (P < .001, η_p ² = 0.79). A greater increase in IOP during the execution of the handgrip test was observed for the dominant-hand compared to the non-dominant hand (P = .004, d = 0.30) and for men compared to women (P = .001, d = 0.90). The main effect of strength level did not reach statistical significance (P = .266).

CONCLUSIONS

The IOP rise associated with a maximal isometric handgrip effort is affected by the participants´ sex (men > women) and hand dominance (dominant hand > non-dominant hand), but not on strength levels. These findings need to be corroborated in glaucoma patients.

Influence of the breathing pattern during resistance training on intraocular pressure

This study aimed to assess the effect of the breathing pattern during resistance training on intraocular pressure (IOP). Twenty physically active collegiate students (7 women and 13 men) performed sets of 10 repetitions against the 10-RM (repetition maximum) load during the back-squat and biceps-curl exercises following 3 different breathing patterns: (I) Valsalva: holding the breath during the entire repetition; (II) normal breathing: holding the breath and exhaling during the first and second phases of the repetition, respectively; and (III) modified breathing: inhaling and holding the breath during the first and second phases of the repetition, respectively. Rebound tonometry was used to measure IOP before exercise, after each of the 10 repetitions, and after 1 min of recovery. The breathing pattern significantly affected the changes in IOP values (p < 0.001, [Formula: see text] = 0.509) with the normal breathing pattern providing lower increases in IOP values compared to the Valsalva (p < 0.001, d = 1.47) and modified breathing (p < 0.001, d = 0.96). Higher IOP values were observed for the back-squat compared to the biceps-curl exercise (p = 0.003, [Formula: see text] = 0.384). A normal breathing pattern should be recommended to avoid abrupt increments in IOP during resistance training. These findings may be especially important for individuals at high risk for glaucoma onset or progression due to the necessity of maintaining stable IOP levels to avoid the progression of this disease. In future studies, the inclusion of glaucoma patients would allow to assess the generalizability of these findings.