Intraocular pressure response to perceived stress in juvenile-onset open angle glaucoma

Abstract

Précis: High perceived stress from academic pressure is associated with intraocular pressure (IOP) elevation and reduced fluctuation in juvenile-onset open angle glaucoma patients. Personalized stress assessment and relief strategies may serve as an adjunct therapy in glaucoma. Objective: To evaluate the effect of higher perceived stress, resulting from academic pressure, on IOP in juvenile-onset open angle glaucoma (JOAG) patients compared with healthy individuals. Methods: The study included 48 university students aged 18–27 years, comprising 24 JOAG patients on antiglaucoma eyedrops and 24 healthy controls. In an examiner-blind pretest-posttest design, participants’ IOP was measured weekly using Goldmann tonometry during three follow-up visits at the beginning and end of the academic semester. Perceived Stress Scale (PSS) scores were also evaluated at these 2-time points to capture the contrast in perceived stress between periods of low and high academic pressure. Results: The baseline PSS score at the semester’s start was lower in both groups (14.1±1.9 in glaucoma vs. 13.5±2.4 in control) and significantly increased by the end of the semester (29.2±2.1 vs. 28.5±1.3; P<0.001), indicating increased perceived stress. Concurrently, IOP rose from 22.01±5.87 to 25.08±5.84 mm Hg in the glaucoma group and from 11.36±2.03 to 13.65±2.11 mm Hg in the control group. Factorial analysis revealed a significant interaction between stress and JOAG (F(1,94)=15.94, P=0.001), partial η2=0.08, with stress having a greater increase on IOP in the glaucoma group (+3.10 mm Hg) compared with the control group (+2.23 mm Hg) (t(94)=4.457, P<0.001). Conclusions: Higher perceived stress significantly increases IOP, especially in JOAG patients, suggesting personalized stress management as a potential adjunct therapy for patients.