The Association of Glaucomatous Visual Field Loss and Balance.

Autor:	de Luna RA; Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland, USA., Mihailovic A; Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland, USA., Nguyen AM; Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland, USA., Friedman DS; Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland, USA., Gitlin LN; Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland, USA., Ramulu PY; Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland, USA.
Jazyk:	angličtina
Zdroj:	Translational vision science & technology [Transl Vis Sci Technol] 2017 May 22; Vol. 6 (3), pp. 8. Date of Electronic Publication: 2017 May 22 (Print Publication: 2017).
DOI:	10.1167/tvst.6.3.8
Abstrakt:	Purpose: To relate balance measures to visual field (VF) damage from glaucoma. Methods: The OPAL kinematic system measured balance, as root mean square (RMS) sway, on 236 patients with suspect/diagnosed glaucoma. Balance was measured with feet shoulder width apart while standing on a firm/foam surface with eyes opened/closed (Instrumental Clinical Test of Sensory Integration and Balance [ICTSIB] conditions), and eyes open on a firm surface under feet together, semi-tandem, or tandem positions (standing balance conditions). Integrated VF (IVF) sensitivities were calculated by merging right and left eye 24-2 VF data. Results: Mean age was 71 years (range, 57-93) and mean IVF sensitivity was 27.1 dB (normal = 31 dB). Lower IVF sensitivity was associated with greater RMS sway during eyes-open foam-surface testing (β = 0.23 z-score units/5 dB IVF sensitivity decrement, P = 0.001), but not during other ICTSIB conditions. Lower IVF sensitivity also was associated with greater RMS sway during feet together standing balance testing (0.10 z-score units/5 dB IVF sensitivity decrement, P = 0.049), but not during other standing balance conditions. Visual dependence of balance was lower in patients with worse IVF sensitivity (β = -21%/5 dB IVF sensitivity decrement, P < 0.001). Neither superior nor inferior IVF sensitivity consistently predicted balance measures better than measures of overall VF sensitivity. Conclusions: Balance was worse in glaucoma patients with greater VF damage under foam surface testing (designed to inhibit proprioceptive contributions to balance) as well as feet-together firm-surface conditions when somatosensory inputs were available. Translational Relevance: Good balance is essential to avoid unnecessary falls and patients with VF loss from glaucoma may be at higher risk of falls because of poor balance.
Databáze:	MEDLINE
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