Author(s): SCHUHMANN, V., KUETTEL, J., VAN EIJGEN, J., GUGLETA, K., HANSSEN, H., Institution: UNIVERSITY OF BASEL, Country: SWITZERLAND, Abstract-ID: 154

INTRODUCTION:
Glaucoma is a leading cause of irreversible blindness, with intraocular pressure (IOP) reduction currently representing the only established therapeutic target. Increasing evidence suggests that physical activity and exercise may serve as complementary strategies, potentially influencing the incidence, severity, progression, and quality of life in primary open-angle glaucoma (POAG). Therefore, this scoping review aims to systematically map the existing evidence on the role of physical activity and exercise in POAG across these key disease-related dimensions.
METHODS:
A systematic literature search was conducted in MEDLINE (via PubMed), Embase (via Elsevier), and SPORTDiscus (via EBSCOhost), including studies published up to 13 June 2024. Eligible studies examined the association or effects of physical activity and exercise on outcomes related to primary open-angle glaucoma, including ophthalmological markers, systemic parameters, and quality of life. All study designs were considered, encompassing randomized controlled trials, non-randomized interventions, and observational studies. Study characteristics, participant demographics, and primary outcomes were extracted and summarized using descriptive tables and narrative synthesis.
RESULTS:
Eighteen studies were included, comprising 14 observational studies and 4 randomized controlled trials. Physical activity, particularly aerobic exercise, was associated with acute reductions in intraocular pressure and improvements in ocular perfusion pressure. Higher levels of physical activity and exercise were further associated with lower glaucoma prevalence and incidence, as well as reduced disease progression. No eligible studies examined disease severity or quality of life outcomes. Across studies, key limitations included short follow-up durations, small sample sizes, incomplete outcome assessment, reliance on self-reported physical activity measures, and heterogeneous or suboptimal glaucoma definitions.
CONCLUSION:
The available evidence suggests that physical activity and exercise may be associated with reduced glaucoma progression, potentially through both intraocular pressure–dependent and intraocular pressure–independent mechanisms, including improvements in ocular perfusion pressure. However, the current evidence base remains limited and insufficient to support formal recommendations of physical activity or exercise as adjunctive treatment strategies in glaucoma care. Future research should prioritize adequately powered, long-term randomized controlled trials with standardized and comprehensive outcome measures, encompassing both intraocular pressure–related and non–intraocular pressure–related endpoints, as well as quality of life, to clarify the therapeutic potential of physical activity and exercise in glaucoma prevention and management.