Avaliação da pressão de perfusão ocular no repouso e durante exercício físico resistido nos filhos de pacientes com glaucoma primário de ângulo aberto

Abstract

Heredity and low values of ocular perfusion pressure (OPP) are considered important risk factors for the development of primary open-angle glaucoma (POAG). Although physical exercise increases OPP, the behavior of this variable in individuals with a family history of POAG (FH+) is not yet known. This is an experimental, cross-sectional, controlled study aimed at evaluating the behavior of systolic (sOPP), diastolic (dOPP), and mean (mOPP) ocular perfusion pressure at rest and during physical exercise in young FH+ individuals and comparing them to individuals without a family history of POAG (FH-). Thirty-four volunteers were evaluated, with 17 FH+ and 17 FH- matched by age. The protocol consisted of 3 minutes of rest, 3 minutes of physical exercise of hand grip at 30% of maximum voluntary contraction (MVC) followed by 3 minutes of recovery. Systolic (SBP), diastolic (DBP), and mean (MBP) blood pressures were measured by Dixtal® and intraocular pressure (IOP) by Goldmann applanation tonometry during the phases of rest, physical exercise, and recovery. sOPP was calculated as the difference between SBP and IOP; dOPP was calculated as the difference between DBP and IOP; and mOPP was calculated as the difference between 2/3 MBP and IOP. As a result, the FH+ group showed significantly lower baseline values of sOPP, dOPP, and mOPP compared to the FH- group (sOPP: right eye: 96±9 mmHg vs. 110±9 mmHg, P<0.001; left eye: 97±9 mmHg vs. 110±9 mmHg, P<0.001. dOPP: right eye: 49±6 mmHg vs. 60±8 mmHg, P<0.001; left eye: 50±5 mmHg vs. 60±7 mmHg, P<0.001. mOPP: right eye: 38±4 mmHg vs. 47±5 mmHg, P<0.001; left eye: 39±3 mmHg vs. 46±5 mmHg, P<0.001, respectively), although baseline IOP did not show a significant difference between the groups (right eye=0.487; left eye: P=0.817). During physical exercise, both FH+ and FH- groups showed a significant increase in sOPP, dOPP, and mOPP in the right eye (120±14 mmHg vs. 128±17 mmHg, P<0.001; 67±9 mmHg vs. 75±12 mmHg, P<0.001; 51±7 mmHg vs. 57±9 mmHg, P<0.001, respectively) and in the left eye (120±14 mmHg vs. 128±16 mmHg, P<0.001; 67±9 mmHg vs. 75±11 mmHg, P<0.001; 51±7 mmHg vs. 57±8 mmHg, P<0.001, respectively). However, the FH+ group maintained significantly lower values of sOPP, dOPP, and mOPP compared to the FH- group in the right eye (P=0.012, P=0.001, P=0.002, respectively) and in the left eye (P=0.011, P=0.001, P=0.002, respectively) throughout the experimental protocol. The percentage increase in mOPP in the FH+ group was greater compared to the FH- group during physical exercise (right eye: 34.1 ± 15.9% vs. 22.1 ± 13.2%, respectively; P = 0.025; left eye: 33.2 ± 17.7% vs. 22.4 ± 13.7%, respectively, P = 0.056). In recovery, the values of sOPP, dOPP, and mOPP for both groups returned to baseline. Thus, it is concluded that at rest, sOPP, dOPP, and mOPP were significantly lower in the FH+ group. Additionally, sOPP, dOPP, and mOPP increased during physical exercise in both groups, but the FH+ group showed lower absolute values and a higher percentage response during the experimental protocol.