Association between lateral decubitus sleeping position and asymmetric visual field loss and its progression in primary open-angle glaucoma patients

Abstract

Background: To investigate the association between lateral decubitus sleeping position (LDSP) and asymmetric visual field (VF) loss and progression in primary open-angle glaucoma (POAG) patients. Methods: This was a prospective, cohort study. Sixty-eight POAG (53 normal tension glaucoma, NTG) patients with asymmetric VF loss were included from the Wenzhou Glaucoma Screening Program (WGSP) and followed up. A questionnaire was used to determine the LDSP. Asymmetric VF loss was defined as at least 2-dB difference in mean deviation (MD) between the 2 eyes at baseline. According to these values, the better eye and worse eye were defined. The number of those preferring the worse eye LDSP versus the better eye LDSP was compared. The number of progressive eyes with LDSP and fellow eyes of LDSP were also compared. Results: Forty-five (66.2%) POAG and 34 (64.2%) NTG patients preferred the LDSP. Of these, 24 (53.3%, p=0.66) and 16 (47.1%, p=0.73) preferred the worse eye LDSP, respectively. Twenty-six eyes of the 45 POAG patients with both asymmetric VF loss and LDSP were judged as progression until the last follow-up (24.7 ± 9.5 months). Among which, there were 12 (46.2%) eyes with LDSP and 14 (53.8%) fellow eyes of LDSP (p=0.70). Conclusions: Approximately two thirds of the POAG/NTG patients preferred the LDSP. However, we could not draw the conclusion that lateral decubitus sleeping position is associated with asymmetric VF loss or glaucoma progression. Keywords: primary open-angle glaucoma; normal tension glaucoma; preferred sleeping position; asymmetric visual field defect