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

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

本项回顾性横断面研究旨在探究使用Kiritsu-Meijin设备测得的自主神经参数与开角型青光眼患者视野缺损之间的关联。本研究共纳入42名开角型青光眼患者的79只患眼。Kiritsu-Meijin测试包含三个阶段：依次为静息坐位、直立站位及再次静息坐位（分别持续2分钟、2分钟及1分钟），期间持续记录受试者心电图共5分钟。研究人员从采集得到的数据中提取并分析了多项自主神经参数，包括活动性（activity）、平衡性（balance）、反应性（reaction）、转换性（switchover）及恢复性（recovery）；上述五项均为Kiritsu-Meijin测试的代表性参数。本研究分析了上述参数与汉弗莱（Humphrey）视野测试所得平均偏差值之间的相关性。此外，本研究采用线性混合效应模型（linear mixed-effects model），探究总偏差值与Kiritsu-Meijin参数之间关联的区域差异，重点关注上方、中央及下方区域的总偏差值。结果显示，活动性、平衡性及恢复性与平均偏差值之间存在显著正相关（回归系数β=0.29~0.38，P<0.05）。活动性与下方区域总偏差值之间的回归系数β高于其与上方区域总偏差值的对应系数（β=0.22，P<0.05）。平衡性未表现出显著的区域差异（P>0.05）。恢复性与中央至下方区域总偏差值的关联强度高于其与上方区域总偏差值的关联（β=0.17~0.25，P<0.05）。本研究结果显示，在开角型青光眼患者中，较低的活动性与恢复性与上象限更严重的中央及/或下方视野缺损相关。上述结果提示，使用Kiritsu-Meijin设备测得的自主神经功能指标，或可在青光眼的临床管理中发挥应用价值。