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Psychological Stress and Intraocular Pressure in Glaucoma: A Randomized Controlled Trial.
Nathalie Sena Ferreira1, Vital Paulino Costa2, Juliana Frange Miranda1
1Hospital Oftalmológico de Brasília, Brasília, Distrito Federal, Brazil.
Ophthalmology. Glaucoma
|July 17, 2024
Summary
Psychological stress significantly elevates intraocular pressure (IOP) in primary open-angle glaucoma (POAG) patients. This study demonstrates a notable increase in IOP and stress biomarkers following a standardized stress test.
Area of Science:
- Ophthalmology
- Psychoneuroendocrinology
- Glaucoma Research
Background:
- Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness.
- The impact of psychological stress on intraocular pressure (IOP) in POAG patients is not fully understood.
- Understanding stress-induced physiological changes is crucial for comprehensive glaucoma management.
Purpose of the Study:
- To investigate the behavior of intraocular pressure (IOP) in primary open-angle glaucoma (POAG) patients subjected to a standardized psychological stress protocol.
- To quantify the physiological and anxiety responses to acute psychological stress in POAG patients.
Main Methods:
- A randomized controlled trial involving 39 POAG patients (18 stress group, 21 control group).
- The Trier Social Stress Test (TSST) was administered to the stress group to induce psychological stress.
- Measurements included intraocular pressure (IOP), salivary cortisol, salivary amylase, mean arterial pressure, heart rate, and anxiety scores (STAI) before, during, and after the TSST.
Main Results:
- Psychological stress induced by the TSST led to significant increases in IOP (3.8 mmHg right eye, 4.1 mmHg left eye).
- Biomarkers of stress, including salivary cortisol and amylase, mean arterial pressure, and heart rate, were significantly elevated post-TSST.
- A majority of patients (61.1%) in the stress group exhibited an IOP increase greater than 4 mmHg, and anxiety scores significantly rose after the TSST.
Conclusions:
- Patients with POAG experience significant elevations in IOP, stress hormones, cardiovascular parameters, and anxiety levels in response to acute psychological stress.
- These findings highlight the potential role of psychological stress as a contributing factor to IOP fluctuations in POAG.
- Further research is warranted to explore the long-term implications and management strategies for stress-induced IOP changes in glaucoma.
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