Impact of Physical Activity Levels on Visual Field Progression in Individuals With Glaucoma.

Prcis: Higher self-reported physical activity level was associated with a slower rate of visual field mean deviation loss in patients with primary open angle glaucoma.

Purpose: To determine the impact of physical activity (PA) on visual field (VF) progression rates in patients with primary open angle glaucoma (POAG).

Methods: In this longitudinal study, POAG patients were included who had ≥5 visits, ≥2 years of follow-up VFs and underwent PA questionnaire at the baseline. PA levels were assessed using the physical activity index (PAI), metabolic equivalents of task (MET)-minutes, and walking pace. Univariable and multivariable linear mixed-effects models were used to determine the impact of PA levels on the rates of VF mean deviation (MD) loss.

Results: One hundred thirty-one eyes from 80 POAG patients were included over a median follow-up of 4.9 (IQR: 4.0-6.7) years. The median age of patients was 68.6 (IQR: 59.3-77.8) years and the median baseline VF MD was -3.5 (IQR: -8.3 to -1.3). In the univariable analysis, slower VF MD loss was associated with active PAI category (0.30 [95% CI: 0.01-0.58] dB/year vs. inactive PAI category; P =0.041) and higher PA amount (0.14 [95% CI: 0.01-0.27] dB/year per 1000 MET-minutes; P =0.036). Significant association with the rate of VF MD loss was not found for baseline VF MD ( P =0.263) and walking pace ( Ps >0.05). In the multivariable analysis including glaucoma severity and other covariates, slower VF MD loss was associated with higher PA amounts (0.15 [95% CI: 0.02-0.28] dB/year per 1000 MET-minutes; P =0.024).

Conclusions: Higher PA amounts are an independent predictor of a slower rate of VF MD loss. Further research is needed to explore whether increased PA protects against glaucoma progression.