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Type A Behavior Pattern: Is it a Risk Factor for Open-Angle Chronic Glaucoma?

Bubella, Raffaella Morreale MD, PhD; Bubella, Daniele Morreale MD, PhD; Cillino, Salvatore MD, PhD

doi: 10.1097/IJG.0b013e3182707421
Original Studies

Aim: To evaluate the presence of type A behavior in patients affected by open-angle glaucoma (OAG) and the possible role of psychophysiological stress as a risk factor for OAG.

Materials and Methods: Fifty patients, 30 women and 20 men, affected by OAG, underwent ophthalmological examination consisting of complete biomicroscopy, tonometry and daily tonometric curve, examination of the visual field by means of computerized perimeter “Octopus 1-2-3,” and its assessment with the Glaucoma Staging System 2, morphologic monitoring of the retinal nerve fiber layer with GDx VCC and psychological assessment (Hamilton Anxiety Rating Scale) to evaluate the presence of anxiety and its level; type A/B personality questionnaire (Jenkin Modified Activity Survey; Ercta-B test for the further evaluation of type A personality; STAY test; Brief-cope test; Life event.

Results: Sixty-four percent of the subjects, 17 women and 13 men, showed type A behavior, and in these patients both trait and state anxiety were much more evident (P=0.001). In the type A subjects, there was a much more significant visual field involvement (P=0.001); this involvement showed a negative correlation (P=0.024) with the Brief-cope scale.

Conclusions: The personality study is an extremely important part of the diagnostic work-up and treatment of OAG.

Section of Ophthalmology, Department of Experimental Biomedicine and Clinical Neuroscience (BioNeC), University of Palermo, Palermo, Italy

Disclosure: The authors declare no conflict of interest.

Reprints: Raffaella Morreale Bubella, MD, PhD, Viale della Vittoria n.217, Agrigento 92100, Italy (e-mail:

Received November 5, 2011

Accepted August 14, 2012

© 2014 by Lippincott Williams & Wilkins.