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Effects of Different Body Postures on the Intraocular Pressure in Patients with Primary Angle-Closure Disease

Park, Ji-Hye MD, PhD1; Yoo, Chungkwon MD, PhD1*; Yang, Kyung-Sook PhD2; Kim, Yong Yeon MD, PhD1

Optometry and Vision Science: July 2019 - Volume 96 - Issue 7 - p 477–483
doi: 10.1097/OPX.0000000000001399

SIGNIFICANCE Eyes with primary angle-closure disease showed higher intraocular pressure (IOP) in the recumbent postures including supine and lateral decubitus (LD) positions compared with the sitting position.

PURPOSE The purpose of this study was to investigate the effects of different body postures on the IOP in eyes with primary angle-closure suspect (PACS), primary angle closure (PAC), or primary angle-closure glaucoma (PACG).

METHODS This is a comparative case series of 31 patients with bilateral PAC disease, such as PACS, PAC, and PACG. The IOP was measured using Tonopen AVIA in sitting, supine, and right or left LD positions. Patients were instructed to rest their heads on the pillows in supine and LD positions. The eye on the lower side in the LD position was called dependent eye. The main outcome was the difference in IOP among different body postures.

RESULTS Among the 62 eyes (31 patients), PACG, PAC, and PACS were noted in 44, 12, and 6 eyes, respectively. The IOP was not significantly different between the two eyes in sitting and supine positions, whereas the IOP was significantly higher in the dependent eye than in the nondependent eye in LD positions. Compared with that measured in the supine position, IOP differences of the dependent eye were higher than those of the nondependent eye when measured in LD position (right LD vs. supine, P = .02; left LD vs. supine, P = .01). In addition, when the study patients were divided into three groups according to their diagnosis, no significant differences were observed in the IOPs and IOP differences among the three groups.

CONCLUSIONS Posture-induced IOP changes were comparable among eyes with PACS, PAC, and PACG.

1Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea

2Department of Biostatistics, Korea University College of Medicine, Seoul, Korea *

Submitted: October 24, 2018

Accepted: March 29, 2019

Funding/Support: None of the authors have reported funding/support.

Conflict of Interest Disclosure: None of the authors have reported a financial conflict of interest.

Author Contributions: Conceptualization: J-HP, CY, YYK; Data Curation: J-HP; Formal Analysis: J-HP, CY, K-SY; Investigation: J-HP; Methodology: J-HP, K-SY, YYK; Supervision: CY, K-SY, YYK; Writing – Original Draft: J-HP, CY; Writing – Review & Editing: J-HP, CY, K-SY, YYK.

© 2019 American Academy of Optometry