The Relationship Between Kiritsu-Meijin-Derived Autonomic Function Parameters and Visual-Field Defects in Eyes with Open-Angle Glaucoma

Abstract

Purpose

This retrospective cross-sectional study aimed to investigate the association between autonomic parameters measured using the Kiritsu-Meijin device and visual-field defects in patients with open-angle glaucoma.

Methods

A total of 79 eyes of 42 patients with open-angle glaucoma were enrolled in this study. Kiritsu-Meijin testing comprised three phases: sitting, standing, and sitting again (2 min, 2 min, and 1 min, respectively). Continuous electrocardiograms were recorded for five minutes. Autonomic parameters were extracted from the resulting data and analyzed, including activity, balance, reaction, switchover, and recovery; these are five representative parameters derived from Kiritsu-Meijin testing. Correlations between these parameters and mean deviation from Humphrey visual field testing were determined. Additionally, we used a linear mixed-effects model to observe sectoral differences in the relationship between total deviation and the Kiritsu-Meijin parameters. In this study, we focused on superior, central, and inferior total deviations.

Results

Significant positive correlations were observed between activity, balance, and recovery and mean deviation values (β = 0.29–0.38, p < .05). The β value between activity and inferior total deviation was higher than that between activity and superior total deviation (β = 0.22, p < .05). Balance did not show any sectoral differences (p > .05). Recovery was more strongly associated with central to inferior total deviation than superior total deviation (β = 0.17–0.25, p < .05).

Conclusion

Our findings suggest that in patients with open-angle glaucoma, lower activity and recovery are associated with more severe central and/or inferior visual field defects in the superior quadrant. These results imply that measurements of autonomic function made with the Kiritsu-Meijin device may have clinical utility in the management of glaucoma.

Keywords:

• Autonomic nervous system
• sympathetic nerve
• parasympathetic nerve
• open-angle glaucoma
• Kiritsu-Meijin

Acknowledgements

We thank Tim Hilts for reviewing the English in this manuscript. We thank Hiromi Ohki for the technical support. We would like to express our sincere gratitude to Chieko Fujii for her valuable comments and insights into our paper.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The principal investigator, Yurina Yamada, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. The data that support the findings of this study are available from the corresponding author, Toru Nakazawa, and the principal investigator, Yurina Yamada, upon reasonable request.

Additional information

Funding

This paper was supported in part by JST grants from COI-NEXT (JPMJPF2201).