DOI: 10.1097/ijg.0000000000002734 ISSN: 1057-0829

Respiratory Muscle Training and Intraocular Pressure: A Prospective Study in Individuals With Normal and High-Normal Intraocular Pressure

Ata Baytaroğlu, Şerife Nur Çiftçi, Ali Yavuz Karahan
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Precis:

Expiratory resistance training with the AiroFit PRO device causes a dose-dependent, temporary increase in intraocular pressure (IOP) of about 3 mmHg, with individuals having high-normal IOP reaching values that approach clinically concerning thresholds at maximum resistance.

Purpose:

To examine the acute effects of graded expiratory resistance using the AiroFit PRO breathing trainer on intraocular pressure (IOP) in healthy individuals with normal and high-normal IOP and to evaluate the agreement between non-contact and applanation tonometry during respiratory strain.

Methods:

This prospective study included 60 healthy participants (120 eyes): 40 with normal IOP (Group 1) and 20 with high-normal IOP (Group 2). IOP was measured at baseline and during expiratory efforts at six progressively increasing resistance levels (10–200 cmH₂O/(L/s)) using both non-contact tonometry (NCT) and Goldmann applanation tonometry (GAT). Statistical analyses included the Friedman test for repeated measures, correlation analysis, and multiple linear regressions.

Results:

IOP demonstrated a significant progressive increase across all resistance levels (Friedman χ²(6)=442.86, P <0.001). The mean IOP increased from 16.57±4.22 mmHg at baseline to 19.58±4.20 mmHg at maximum resistance, representing a mean increase of 3.01 mmHg (18.2%). The magnitude of IOP change did not differ significantly between the normal and high-normal IOP groups (Cohen’s d=0.055). Baseline IOP was a strong predictor of the Level 6 IOP (R²=0.845). The NCT and GAT results showed excellent agreement (r=0.870–0.929) between the two methods.

Conclusions:

Respiratory training with the AiroFit device produces dose-dependent IOP increases. While the relative magnitude of IOP change is similar regardless of baseline IOP status, individuals with high-normal IOP reach absolute values approaching clinically concerning thresholds. These findings have implications for glaucoma risk counseling in users of respiratory-training devices.

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