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Abstract #61532 Published in IGR 17-1
Effect of Different Head Positions in Lateral Decubitus Posture on Intraocular Pressure in Treated Patients with Open Angle Glaucoma
Lee TE; Yoo C; Lin S; Kim YYAmerican Journal of Ophthalmology 2015; 160: 929-936.e4
See also comment(s) by Yvonne Buys •
PURPOSE: To investigate the effects of different head positions in the lateral decubitus posture on intraocular pressure (IOP) in medically treated patients with open angle glaucoma (OAG). DESIGN: Prospective observational study METHODS: Setting: Institutional PARTICIPANTS: Twenty patients with bilateral OAG who received only latanoprost as treatment. OBSERVATION PROCEDURES: IOP was measured using the ICare Pro tonometer in the sitting, supine, right and left lateral decubitus posture. In lateral decubitus posture, IOP measurements were taken with 3 different head positions (30°-higher, 30°-lower and parallel to the center of the thoracic vertebra) in a randomized sequence. MAIN OUTCOME MEASURES: Compared the IOPs between the dependent (lower-sided) and non-dependent eyes in the lateral decubitus postures with different head positions. We also analyzed the differences in IOPs between the better and worse eyes. RESULTS: IOP was higher in the dependent eyes than in the non-dependent eyes in lateral decubitus posture, regardless of the head position (all P < .05). Lower head position increased the IOP of dependent eyes, compared with the neutral or higher head position. However, the amounts of IOP elevation seen during the changes of body posture or head position were not significantly different between the better and worse eyes. CONCLUSIONS: Low head position elevates IOP of the dependent eyes of medically treated OAG patients compared with neutral head position in the lateral decubitus posture. Adjustment of the height of a pillow may help mitigate IOP elevations resulting from lying on the side with a low or no pillow in glaucoma patients.
Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea.
Full articleClassification:
6.1.3 Factors affecting IOP (Part of: 6 Clinical examination methods > 6.1 Intraocular pressure measurement; factors affecting IOP)