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Relationship Between Preferred Sleeping Position and Asymmetric Visual Field Loss in Open-Angle Glaucoma Patients

  • Kyoung Nam Kim
    Affiliations
    Department of Ophthalmology, Chungnam National University Hospital, Daejeon, South Korea
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  • Jin Wook Jeoung
    Affiliations
    Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea
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  • Ki Ho Park
    Correspondence
    Inquiries to Ki Ho Park, Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, South Korea
    Affiliations
    Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea

    Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
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  • Dong Myung Kim
    Affiliations
    Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea

    Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
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  • Robert Ritch
    Affiliations
    Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York

    Department of Ophthalmology, New York Medical College, Valhalla, New York
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Published:December 16, 2013DOI:https://doi.org/10.1016/j.ajo.2013.12.016

      Purpose

      To investigate the relationship between preferred sleeping position and asymmetric visual field (VF) loss in open-angle glaucoma (OAG) patients.

      Design

      Retrospective, cross-sectional study.

      Methods

      Six hundred and ninety-two (692) patients with bilateral normal-tension glaucoma (NTG) or high-tension glaucoma were consecutively enrolled. A questionnaire to determine the preferred sleeping position was administered to each patient. Asymmetric VF loss was defined as a difference in mean deviation between the 2 eyes of at least 2 dB. According to these values, the better eye and worse eye were defined. Among the patients with asymmetric VF loss, the numbers preferring the worse eye–dependent lateral decubitus position and the better eye–dependent lateral decubitus position were compared.

      Results

      Among the enrolled patients, 309 (60.6%) with NTG and 121 (66.5%) with high-tension glaucoma had asymmetric VF between the 2 eyes. Among the 309 NTG patients, 100 (32.4%) preferred the lateral decubitus position. Of these, 66 (66.0%) preferred the worse eye–dependent lateral decubitus position (P = .001). Among the 121 high-tension glaucoma patients, 32 (26.4%) preferred the lateral decubitus position, and of these, 23 (71.9%) preferred the worse eye–dependent lateral decubitus position (P = .013).

      Conclusion

      Our results suggest that the sleep position habitually preferred by glaucoma patients may be associated with greater VF loss.
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      References

      1. The effectiveness of intraocular pressure reduction in the treatment of normal-tension glaucoma. Collaborative Normal-Tension Glaucoma Study Group.
        Am J Ophthalmol. 1998; 126: 498-505
        • Prata T.S.
        • De Moraes C.G.
        • Kanadani F.N.
        • Ritch R.
        • Paranhos Jr., A.
        Posture-induced intraocular pressure changes: considerations regarding body position in glaucoma patients.
        Surv Ophthalmol. 2010; 55: 445-453
        • Liu J.H.
        • Zhang X.
        • Kripke D.F.
        • Weinreb R.N.
        Twenty-four-hour intraocular pressure pattern associated with early glaucomatous changes.
        Invest Ophthalmol Vis Sci. 2003; 44: 1586-1590
        • Kiuchi T.
        • Motoyama Y.
        • Oshika T.
        Postural response of intraocular pressure and visual field damage in patients with untreated normal-tension glaucoma.
        J Glaucoma. 2010; 19: 191-193
        • Tsukahara S.
        • Sasaki T.
        Postural change of IOP in normal persons and in patients with primary wide open-angle glaucoma and low-tension glaucoma.
        Br J Ophthalmol. 1984; 68: 389-392
        • Lee Y.R.
        • Kook M.S.
        • Joe S.G.
        • et al.
        Circadian (24-hour) pattern of intraocular pressure and visual field damage in eyes with normal-tension glaucoma.
        Invest Ophthalmol Vis Sci. 2012; 53: 881-887
        • Krieglstein G.
        • Langham M.E.
        Influence of body position on the intraocular pressure of normal and glaucomatous eyes.
        Ophthalmologica. 1975; 171: 132-145
        • Jain M.R.
        • Marmion V.J.
        Rapid pneumatic and Mackey-Marg applanation tonometry to evaluate the postural effect on intraocular pressure.
        Br J Ophthalmol. 1976; 60: 687-693
        • Malihi M.
        • Sit A.J.
        Effect of head and body position on intraocular pressure.
        Ophthalmology. 2012; 119: 987-991
        • Lee J.Y.
        • Yoo C.
        • Jung J.H.
        • Hwang Y.H.
        • Kim Y.Y.
        The effect of lateral decubitus position on intraocular pressure in healthy young subjects.
        Acta Ophthalmol. 2012; 90: e68-e72
        • Lee T.E.
        • Yoo C.
        • Kim Y.Y.
        Effects of different sleeping postures on intraocular pressure and ocular perfusion pressure in healthy young subjects.
        Ophthalmology. 2013; 120: 1565-1570
        • Wong M.H.
        • Lai A.H.
        • Singh M.
        • Chew P.T.
        Sleeping posture and intraocular pressure.
        Singapore Med J. 2013; 54: 146-148
        • Kim K.N.
        • Jeoung J.W.
        • Park K.H.
        • Lee D.S.
        • Kim D.M.
        Effect of lateral decubitus position on intraocular pressure in glaucoma patients with asymmetric visual field loss.
        Ophthalmology. 2013; 120: 731-735
        • Lee J.Y.
        • Yoo C.
        • Kim Y.Y.
        The effect of lateral decubitus position on intraocular pressure in patients with untreated open-angle glaucoma.
        Am J Ophthalmol. 2013; 155: 329-335
        • Liu J.H.
        • Bouligny R.P.
        • Kripke D.F.
        • Weinreb R.N.
        Nocturnal elevation of intraocular pressure is detectable in the sitting position.
        Invest Ophthalmol Vis Sci. 2003; 44: 4439-4442
        • Noël C.
        • Kabo A.M.
        • Romanet J.P.
        • Montmayeur A.
        • Buguet A.
        Twenty-four-hour time course of intraocular pressure in healthy and glaucomatous Africans: relation to sleep patterns.
        Ophthalmology. 2001; 108: 139-144
        • Liu J.H.
        • Kripke D.F.
        • Hoffman R.E.
        • et al.
        Elevation of human intraocular pressure at night under moderate illumination.
        Invest Ophthalmol Vis Sci. 1999; 40: 2439-2442
        • Liu J.H.
        • Kripke D.F.
        • Twa M.D.
        • et al.
        Twenty-four-hour pattern of intraocular pressure in the aging population.
        Invest Ophthalmol Vis Sci. 1999; 40: 2912-2917
        • Buys Y.M.
        • Alasbali T.
        • Jin Y.P.
        • et al.
        Effect of sleeping in a head-up position on intraocular pressure in patients with glaucoma.
        Ophthalmology. 2010; 117: 1348-1351
        • Kiuchi T.
        • Motoyama Y.
        • Oshika T.
        Relationship of progression of visual field damage to postural changes in intraocular pressure in patients with normal-tension glaucoma.
        Ophthalmology. 2006; 113: 2150-2155
        • Friberg T.R.
        • Sanborn G.
        • Weinreb R.N.
        Intraocular and episcleral venous pressure increase during inverted posture.
        Am J Ophthalmol. 1987; 103: 523-526
        • Sultan M.
        • Blondeau P.
        Episcleral venous pressure in younger and older subjects in the sitting and supine positions.
        J Glaucoma. 2003; 12: 370-373
        • Krieglstein G.K.
        • Waller W.K.
        • Leydhecker W.
        The vascular basis of the positional influence of the intraocular pressure.
        Albrecht Von Graefes Arch Klin Exp Ophthalmol. 1978; 206: 99-106
        • Longo A.
        • Geiser M.H.
        • Riva C.E.
        Posture changes and subfoveal choroidal blood flow.
        Invest Ophthalmol Vis Sci. 2004; 45: 546-551
        • De Koninck J.
        • Lorrain D.
        • Gagnon P.
        Sleep positions and position shifts in five age groups: an ontogenetic picture.
        Sleep. 1992; 15: 143-149
        • Levine R.A.
        • Demirel S.
        • Fan J.
        • et al.
        Asymmetries and visual field summaries as predictors of glaucoma in the ocular hypertension treatment study.
        Invest Ophthalmol Vis Sci. 2006; 47: 3896-3903
        • Greenfield D.S.
        • Liebmann J.M.
        • Ritch R.
        • et al.
        Visual field and intraocular pressure asymmetry in the low-pressure glaucoma treatment study.
        Ophthalmology. 2007; 114: 460-465

      Linked Article

      • Relationship Between Preferred Sleeping Position and Asymmetric Visual-Field Loss in Open-Angle Glaucoma Patients
        American Journal of OphthalmologyVol. 157Issue 6
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          The authors Kim and associates1 have found that among subjects who prefer the lateral decubitus position during sleep, the eye in the dependent lateral decubitus position had worse field loss in 66% (P = 0.001) of patients with normal-tension glaucoma and in 71.9% (P = 0.013) of patients with high-tension glaucoma. In previous articles they have indicated that asymmetric visual field loss in patients with glaucoma is due to intraocular pressure elevation asymmetry when in the lateral decubitus position.
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