Relationship between Sleeping Position and Asymmetric Visual Field loss in Glaucoma Patients by Quantitative Measurement of Body Position Using a Mobile Device

摘要

?Purpose?To investigate the relationship between sleeping body position continuously measured with a mobile device, and asymmetric visual-field (VF) loss in glaucoma patients.?Methods?The bilateral primary open-angle glaucoma (POAG) patients with asymmetric VF loss were enrolled. Asymmetric VF loss was defined as a difference in mean deviation between the two eyes of at least 2 dB, and the better eye and worse eye were defined. Home recordings of sleep body position were made over three consecutive nights. A mobile device with the application measuring body position was worn each night at bedtime. The sleep position was recorded in degrees every two seconds, with positive angles indicating right lateral decubitus position (LDP), and negative angles indicating left LDP, zero degrees in supine position. The overall sleep time in each position was measured. In the patients with asymmetric VF loss, the preferred type of sleep body position and the overall sleep time in each position was examined for a correlation with asymmetry of VF loss. At out-patient clinic, the intraocular pressure (IOP) was measured with the rebound tonometer in sitting, supine, right LDP, and left LDP. Position-weighted IOP were calculated by summing the IOP values in each position multiplied by the percentages of cumulative sleeping time of each position.?Results?26 POAG patients were included in the study. The preferred sleeping position was supine in 13 patients (50.0%) and lateral decubitus in 13 patients (50.0%). Among the patients preferred sleeping LDP, 7 patients (53.8%) preferred the worse eye-dependent LDP, 3 patients (23.1%) preferred the better eye-dependent LDP, and 3 patients (23.1%) slept in symmetric LDP (Table, Figure). The IOPs of the worse and better eyes in their dependent LDP were 20.2 ± 3.9 mmHg and 18.6 ± 2.8 mmHg, respectively (P=0.019). The position-weighted IOP of the worse eyes were higher than that of the better eyes (17.4 ± 2.8 mmHg vs. 16.1 ± 2.3 mmHg; P=0.002).?Conclusions?The quantitative measurement of sleep body position with a mobile device may be helpful investigating the association between sleep position and visual field loss. ?View OriginalDownload SlideView OriginalDownload Slide?View OriginalDownload SlideView OriginalDownload Slide?.