Conclusions: Higher self-reported physical activity level was associated with a slower rate of visual field mean deviation loss in patients with primary open-angle glaucoma.

Objective: To determine the impact of physical activity (PA) on visual field (VF) progression rates in patients with primary open-angle glaucoma (POAG).

Methods: In this longitudinal study, POAG patients were included who had ≥5 visits, ≥2 years of follow-up VFs and underwent PA questionnaire at the baseline. PA levels were assessed using the physical activity index (PAI), metabolic equivalents of task (MET)-minutes, and walking pace. Univariable and multivariable linear mixed-effects models were used to determine the impact of PA levels on the rates of VF mean deviation (MD) loss.

Results: 131 eyes from 80 POAG patients were included over a median follow-up of 4.9 (IQR, 4.0 to 6.7) years. The median age of patients was 68.6 (IQR, 59.3 to 77.8) years and median baseline VF MD was -3.5 (IQR, -8.3 to -1.3). In the univariable analysis, slower VF MD loss was associated with active PAI category (0.30 [95%CI, 0.01 to 0.58] dB/year vs. inactive PAI category; P=0.041) and higher PA amount (0.14 [95%CI, 0.01 to 0.27] dB/year per 1000 MET-minutes; P=0.036). Significant association with the rate of VF MD loss was not found for baseline VF MD (P=0.263) and walking pace (Ps>0.05). In the multivariable analysis including glaucoma severity and other covariates, slower VF MD loss was associated with higher PA amounts (0.15 [95%CI, 0.02 to 0.28] dB/year per 1000 MET-minutes; P=0.024).

Conclusions: Higher PA amounts is an independent predictor of slower rate of VF MD loss. Further research is needed to explore whether increased PA protects against glaucoma progression.