Relationship between preferred sleeping position and asymmetric visual field loss in open-angle glaucoma patients

Purpose To investigate the relationship between preferred sleeping position and asymmetric visual field (VF) loss in open-angle glaucoma (OAG) patients. Design Retrospective, cross-sectional study. Methods Six hundred and ninety-two (692) patients with bilateral normal-tension glaucoma (NTG) or high-tension glaucoma were consecutively enrolled. A questionnaire to determine the preferred sleeping position was administered to each patient. Asymmetric VF loss was defined as a difference in mean deviation between the 2 eyes of at least 2 dB. According to these values, the better eye and worse eye were defined. Among the patients with asymmetric VF loss, the numbers preferring the worse eye-dependent lateral decubitus position and the better eye-dependent lateral decubitus position were compared. Results Among the enrolled patients, 309 (60.6%) with NTG and 121 (66.5%) with high-tension glaucoma had asymmetric VF between the 2 eyes. Among the 309 NTG patients, 100 (32.4%) preferred the lateral decubitus position. Of these, 66 (66.0%) preferred the worse eye-dependent lateral decubitus position (P =.001). Among the 121 high-tension glaucoma patients, 32 (26.4%) preferred the lateral decubitus position, and of these, 23 (71.9%) preferred the worse eye-dependent lateral decubitus position (P =.013). Conclusion Our results suggest that the sleep position habitually preferred by glaucoma patients may be associated with greater VF loss.