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. 2024 Nov;262(11):3671-3680.
doi: 10.1007/s00417-024-06530-w. Epub 2024 Jun 10.

Treadmill-walking impairs visual function in early glaucoma and elderly controls

Rosalie Beyer #  1 , Khaldoon O Al-Nosairy #  1 , Constantin Freitag  2 , Francie H Stolle  1 , Martin Behrens  2   3 , Gokulraj T Prabhakaran  1 , Hagen Thieme  1 , Lutz Schega #  2 , Michael B Hoffmann #  4   5
Affiliations

Treadmill-walking impairs visual function in early glaucoma and elderly controls

Rosalie Beyer et al. Graefes Arch Clin Exp Ophthalmol. 2024 Nov.

Abstract

Aims: Impaired vision is an additional risk factor in elderly for falls. We investigated the hypothesis that treadmill (TM) walking affects visual function in both healthy elderly and those with early-moderate visual dysfunction due to glaucoma.

Methods: Thirty healthy controls (HC) aged 64-83 years and 18 glaucoma patients (GLA) aged 62-82 years participated in this cross-sectional study. The impact of TM-walking on visual function was assessed binocularly for (i) best-corrected visual acuity (BCVA) with and without crowding effect, (ii) contrast sensitivity (CS), and (iii) and visual field (mean deviation, VF-MD). Visual function was tested while participants were standing or during TM-walking for 2 speed conditions: (i) fast walking at their preferred speed and (ii) walking at a fixed speed of 3.5 km/h.

Results: GLA, most with early-moderate VF loss, performed equally well as HC. Independent of GROUP, an impact of SPEED on visual functions was statistically evident with large statistical effect size for (i) both types of BCVA with a mean loss of 0.02-0.05 logMAR (η2 = 0.41) and (ii) VF-MD with mean loss of 1 dB (η2 = 0.70), but not for CS.

Conclusions: Here, we introduce a paradigm for the assessment of visual function during walking. We provide proof-of-concept that our approach allows for the identification of walking induced visual function loss, i.e., a deterioration of BCVA and VF-sensitivity during TM-walking in both groups. It is therefore of promise for the investigation of the relation of vision impairment and mobility, ultimately the increased frequency of falls in advanced glaucoma.

Keywords: Contrast sensitivity; Glaucoma; Mobility; Visual acuity; Visual field.

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Conflict of interest statement

Declarations. Ethical approval: All procedures performed involving human participants were in accordance with the ethical standards of the (Ethics Committee of the Otto-von-Guericke University of Magdeburg, Germany (registration number: 32/18) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent: Written informed consents were obtained from all participants. Conflict of interest: All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Figures

Fig. 1
Fig. 1
Measurement setup. You can see the treadmill with the safety belt, as well as the mirror through which the test person sees the monitor (on the right wall, here displaying the optotype for crowded VA). The Ocusweep® is attached to the left wall by means of a swivel arm (here 'parked' at the wall, with the back of the device visible). A camera (right) records the measurement
Fig. 2
Fig. 2
Visual function tests for a HC and GLA for different speed conditions. During TM-walking (Sself & S3.5), BCVA, with (VAC) and without crowding (VAS), and VF-MD deteriorated in comparison to S0. VAS = visual acuity with a single optotype; VAC = visual acuity with crowding; CS = contrast sensitivity; VF-MD = visual field, mean deviation, S0 = static condition, SSelf = individual's tolerated fast TM-walking speed, S3.5 = 3.5 km/h
Fig. 3
Fig. 3
Impact of different TM-walking speeds on visual function tests. A BCVA. (i) & (ii) Effect of TM-walking speeds on BCVA (VAS – without crowding, VAC – with crowding); BCVA was worsened during TM-walking compared to standing. B Contrast sensitivity (CS). (i) Effect of TM-walking speed on CS; the CS did not change during TM-walking and the repetition effect reached only weak significance. (ii) Bland–Altman diagram of test–retest repeatability of the two repetitions for S0 demonstrates good reproducibility over both measurements. C Visual field (VF). (i) Effect of TM-walking on VF; reduced VF-sensitivities were evident during walking. BCVA = best corrected visual acuity, ICC = intraclass coefficient, further abbreviations: see Fig. 2
Fig. 4
Fig. 4
Visual loss associated with TM-walking.p-values not italicized: group difference. p-values in italics: difference from no loss, i.e., 0, for each group separately. Significant results are highlighted in bold. A VAS loss. B VAC loss. C CS loss. D VF-MD loss. Significant visual function loss was only evident for VAS, VAC in HC and VF and affected both groups similarly
See this image and copyright information in PMC

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