YACHNA AHUJA MA KHIN PYI SON MEHRDAD MALIHI DAVID O. HODGE ARTHUR J. SIT
Rochester, Minnesota CONFLICT OF INTEREST DISCLOSURES: SEE THE ORIGINAL article1 for any disclosures of the authors.
REFERENCES
1. Ahuja Y, Ma Khin Pyi S, Malihi M, Hodge DO, Sit AJ. Clinical results of ab interno trabeculotomy using the Trabectome for open-angle glaucoma: the Mayo Clinic series in Rochester, Minnesota. Am J Ophthalmol 2013;156(5):927–935.e922. 2. Minckler D, Mosaed S, Dustin L, Ms BF. Trabectome (trabeculectomy-internal approach): additional experience and extended follow-up. Trans Am Ophthalmol Soc 2008;106: 149–159. discussion 159–160. 3. Jea SY, Francis BA, Vakili G, Filippopoulos T, Rhee DJ. Ab interno trabeculectomy versus trabeculectomy for open-angle glaucoma. Ophthalmology 2012;119(1):36–42. 4. Gedde SJ, Schiffman JC, Feuer WJ, Herndon LW, Brandt JD, Budenz DL. Three-year follow-up of the Tube Versus Trabeculectomy Study. Am J Ophthalmol 2009;148(5):670–684. 5. Jea SY, Mosaed S, Vold SD, Rhee DJ. Effect of a failed trabectome on subsequent trabeculectomy. J Glaucoma 2012;21(2): 71–75.
Relationship Between Preferred Sleeping Position and Asymmetric Visual-Field Loss in Open-Angle Glaucoma Patients EDITOR: THE AUTHORS KIM AND ASSOCIATES1 HAVE FOUND THAT
among subjects who prefer the lateral decubitus position during sleep, the eye in the dependent lateral decubitus position had worse field loss in 66% (P ¼ 0.001) of patients with normal-tension glaucoma and in 71.9% (P ¼ 0.013) of patients with high-tension glaucoma. In previous articles they have indicated that asymmetric visual field loss in patients with glaucoma is due to intraocular pressure elevation asymmetry when in the lateral decubitus position.2 In response to this, I have certain comments to make. It is well established that factors including a rise in intraocular pressure, a decrease in ocular perfusion pressure and a decrease in ocular blood flow influence the manifestation of glaucoma. In a study by Khayi and associates3 no significant change in choroidal blood flow or vascular resistance was found during posture change in patients with obstructive sleep apnea (also a risk factor)4 if they did not have cardiovascular comorbidities.3 VOL. 157, NO. 6
Kida and associates5 have found that significant diurnal-tonocturnal decreases in blood flow occurred in the optic nerve head and macula in the older subjects but not in the younger subjects. In another study by Han and associates,6 intraocular pressure was shown to decrease with increasing age. Both age and cardiovascular disease influence ocular dynamics and are risk factors for the manifestation of glaucoma.3,4 But in the present article the authors have not commented on using age-matched controls and ruling out cardiovascular comorbidities that could have acted as confounding factors and could possibly have caused visual field loss that was attributable solely to the lateral decubitus position in the subjects studied by Kim and associates.1 I recommend the use of age-matched controls and the ruling out of other risk factors for glaucoma in study subjects so as to understand clearly the role of the lateral decubitus position in the manifestation of glaucoma. PUNITA KUMARI SODHI
New Delhi, India CONFLICT OF INTEREST DISCLOSURES: ALL AUTHORS have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
REFERENCES
1. Kim KN, Jeoung JW, Park KH, Kim DM, Ritch R. Relationship between preferred sleeping position and asymmetric visual-field loss in open-angle glaucoma patients. Am J Ophthalmol 2014;157(3):740–746. 2. Kim KN, Jeoung JW, Park KH, Lee DS, Kim DM. Effect of lateral decubitus position on intraocular pressure in glaucoma patients with asymmetric visual field loss. Ophthalmology 2013; 120(4):731–735. 3. Khayi H, Pepin JL, Geiser MH, et al. Choroidal blood flow regulation after posture change or isometric exercise in men with obstructive sleep apnea syndrome. Invest Ophthalmol Vis Sci 2011;52(13):9489–9496. 4. Actis AG, Dall’Orto L, Penna R, Brogliatti B, Rolle T. An internal medicine perspective review of risk factors for assessing and progression of primary open angle glaucoma. Minerva Med 2013;104(4):471–485. 5. Kida T, Liu JH, Weinreb RN. Effect of aging on nocturnal blood flow in the optic nerve head and macula in healthy human eyes. J Glaucoma 2008;17(5):366–371. 6. Han YS, Lee JW, Lee JS. Intraocular pressure and influencing systemic health parameters in a Korean population. Indian J Ophthalmol 2013;Sep 6 [Epub ahead of print].
REPLY IN A PREVIOUS ARTICLE,1 WE FOUND THAT ELEVATION
of asymmetric intraocular pressure (IOP) in the lateral decubitus position was associated with asymmetric visual field (VF) loss in patients with glaucoma.1 We also found that the
CORRESPONDENCE
1327
Rochester, Minnesota CONFLICT OF INTEREST DISCLOSURES: SEE THE ORIGINAL article1 for any disclosures of the authors.
REFERENCES
1. Ahuja Y, Ma Khin Pyi S, Malihi M, Hodge DO, Sit AJ. Clinical results of ab interno trabeculotomy using the Trabectome for open-angle glaucoma: the Mayo Clinic series in Rochester, Minnesota. Am J Ophthalmol 2013;156(5):927–935.e922. 2. Minckler D, Mosaed S, Dustin L, Ms BF. Trabectome (trabeculectomy-internal approach): additional experience and extended follow-up. Trans Am Ophthalmol Soc 2008;106: 149–159. discussion 159–160. 3. Jea SY, Francis BA, Vakili G, Filippopoulos T, Rhee DJ. Ab interno trabeculectomy versus trabeculectomy for open-angle glaucoma. Ophthalmology 2012;119(1):36–42. 4. Gedde SJ, Schiffman JC, Feuer WJ, Herndon LW, Brandt JD, Budenz DL. Three-year follow-up of the Tube Versus Trabeculectomy Study. Am J Ophthalmol 2009;148(5):670–684. 5. Jea SY, Mosaed S, Vold SD, Rhee DJ. Effect of a failed trabectome on subsequent trabeculectomy. J Glaucoma 2012;21(2): 71–75.
Relationship Between Preferred Sleeping Position and Asymmetric Visual-Field Loss in Open-Angle Glaucoma Patients EDITOR: THE AUTHORS KIM AND ASSOCIATES1 HAVE FOUND THAT
among subjects who prefer the lateral decubitus position during sleep, the eye in the dependent lateral decubitus position had worse field loss in 66% (P ¼ 0.001) of patients with normal-tension glaucoma and in 71.9% (P ¼ 0.013) of patients with high-tension glaucoma. In previous articles they have indicated that asymmetric visual field loss in patients with glaucoma is due to intraocular pressure elevation asymmetry when in the lateral decubitus position.2 In response to this, I have certain comments to make. It is well established that factors including a rise in intraocular pressure, a decrease in ocular perfusion pressure and a decrease in ocular blood flow influence the manifestation of glaucoma. In a study by Khayi and associates3 no significant change in choroidal blood flow or vascular resistance was found during posture change in patients with obstructive sleep apnea (also a risk factor)4 if they did not have cardiovascular comorbidities.3 VOL. 157, NO. 6
Kida and associates5 have found that significant diurnal-tonocturnal decreases in blood flow occurred in the optic nerve head and macula in the older subjects but not in the younger subjects. In another study by Han and associates,6 intraocular pressure was shown to decrease with increasing age. Both age and cardiovascular disease influence ocular dynamics and are risk factors for the manifestation of glaucoma.3,4 But in the present article the authors have not commented on using age-matched controls and ruling out cardiovascular comorbidities that could have acted as confounding factors and could possibly have caused visual field loss that was attributable solely to the lateral decubitus position in the subjects studied by Kim and associates.1 I recommend the use of age-matched controls and the ruling out of other risk factors for glaucoma in study subjects so as to understand clearly the role of the lateral decubitus position in the manifestation of glaucoma. PUNITA KUMARI SODHI
New Delhi, India CONFLICT OF INTEREST DISCLOSURES: ALL AUTHORS have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
REFERENCES
1. Kim KN, Jeoung JW, Park KH, Kim DM, Ritch R. Relationship between preferred sleeping position and asymmetric visual-field loss in open-angle glaucoma patients. Am J Ophthalmol 2014;157(3):740–746. 2. Kim KN, Jeoung JW, Park KH, Lee DS, Kim DM. Effect of lateral decubitus position on intraocular pressure in glaucoma patients with asymmetric visual field loss. Ophthalmology 2013; 120(4):731–735. 3. Khayi H, Pepin JL, Geiser MH, et al. Choroidal blood flow regulation after posture change or isometric exercise in men with obstructive sleep apnea syndrome. Invest Ophthalmol Vis Sci 2011;52(13):9489–9496. 4. Actis AG, Dall’Orto L, Penna R, Brogliatti B, Rolle T. An internal medicine perspective review of risk factors for assessing and progression of primary open angle glaucoma. Minerva Med 2013;104(4):471–485. 5. Kida T, Liu JH, Weinreb RN. Effect of aging on nocturnal blood flow in the optic nerve head and macula in healthy human eyes. J Glaucoma 2008;17(5):366–371. 6. Han YS, Lee JW, Lee JS. Intraocular pressure and influencing systemic health parameters in a Korean population. Indian J Ophthalmol 2013;Sep 6 [Epub ahead of print].
REPLY IN A PREVIOUS ARTICLE,1 WE FOUND THAT ELEVATION
of asymmetric intraocular pressure (IOP) in the lateral decubitus position was associated with asymmetric visual field (VF) loss in patients with glaucoma.1 We also found that the
CORRESPONDENCE
1327
