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Torres-Arellano JM, Tornero-Jimenez A, Sánchez-Ríos A, Olvera-Montaño O, Muñoz-Villegas P. Evaluation of the Relationship Between Diabetic Macular Edema and Renal Function in a Latino Population. Ophthalmol Ther 2023; 12:2745-2755. [PMID: 37543959 PMCID: PMC10441930 DOI: 10.1007/s40123-023-00787-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 07/28/2023] [Indexed: 08/08/2023] Open
Abstract
INTRODUCTION Diabetic macular edema (DME) is one of the leading causes of vision impairment. The relationship between DME and estimated glomerular filtration rate (eGFR) has not been clearly evaluated in Hispanic or Latino populations. The objective of this study was to evaluate the eGFR in a Latino population with DME. METHODS A cross-sectional, observational, and descriptive study was carried out on the basis of a multicenter phase III clinical trial. RESULTS A total of 82 subjects diagnosed with DME (36 women and 46 men) were included in the study. The mean age was 61.93 ± 6.71 years. Mean values of the blood chemistry parameters glycated hemoglobin and eGFR were 7.20 ± 0.95% and 74.42 ± 26.82 mL/min/1.73 m2, respectively. The time elapsed since diagnosis of diabetes mellitus was 15.30 ± 7.35 years, while the duration of DME was 1.41 ± 1.75 years. Mean values for central macular thickness (CMT) and total macular volume (TMV) were 440.99 ± 132.22 µm and 11.97 ± 2.11 mm3, respectively. DME duration had a negative correlation with TMV (Rho - 0.26, p < 0.05) and a positive correlation with mean arterial pressure (Rho 0.26, p < 0.05). CMT was correlated with TMV (Rho 0.43, p < 0.0001) and visual acuity (Rho 0.26, p < 0.05). No significant correlations were observed between eGFR and CMT, TMV, or any demographic variable (p > 0.05). Chronic kidney disease (CKD) was associated with hypertension (OR 9.32, p = 0.035), elevated intraocular pressure (IOP) (OR 0.03, p = 0.011), and advanced age (OR 0.45, p = 0.011). CMT was significantly associated with TMV (β = 27.69, p < 0.0001). CONCLUSIONS We did not find a correlation between eGFR and DME. Our findings suggest that the presence of hypertension is associated with a decrease in the GFR < 60 mL/min/1.73 m2, and CKD may be associated with advanced age and elevated IOP which may increase the risk for the development of glaucoma. TRIAL REGISTRATION NCT05217680 (clinicaltrials.gov).
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Affiliation(s)
- José M Torres-Arellano
- Regional Medical Affairs Department, Laboratorios Sophia, S.A. de C.V., Paseo del Norte 5255, Guadalajara Technology Park, 45010, Zapopan, JAL, Mexico
| | - Andrea Tornero-Jimenez
- Regional Medical Affairs Department, Laboratorios Sophia, S.A. de C.V., Paseo del Norte 5255, Guadalajara Technology Park, 45010, Zapopan, JAL, Mexico
- Instituto de Investigación en Oftalmología y Ciencias Visuales, CUCS, University of Guadalajara, Sierra Mojada 950, 44340, Guadalajara, JAL, Mexico
| | - Alejandra Sánchez-Ríos
- Regional Medical Affairs Department, Laboratorios Sophia, S.A. de C.V., Paseo del Norte 5255, Guadalajara Technology Park, 45010, Zapopan, JAL, Mexico
| | - Oscar Olvera-Montaño
- Regional Medical Affairs Department, Laboratorios Sophia, S.A. de C.V., Paseo del Norte 5255, Guadalajara Technology Park, 45010, Zapopan, JAL, Mexico
| | - Patricia Muñoz-Villegas
- Regional Medical Affairs Department, Laboratorios Sophia, S.A. de C.V., Paseo del Norte 5255, Guadalajara Technology Park, 45010, Zapopan, JAL, Mexico.
- Centro de Investigación en Matemáticas (CIMAT), Unidad Aguascalientes, Aguascalientes, Mexico.
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Hsu E, Desai M. Glaucoma and Systemic Disease. Life (Basel) 2023; 13:life13041018. [PMID: 37109547 PMCID: PMC10143901 DOI: 10.3390/life13041018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/09/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
Glaucoma is the leading cause of irreversible blindness in the world. Due to its potential to cause permanent vision loss, it is important to understand how systemic conditions and their respective treatments can be associated with or increase the risk for developing glaucoma. In this review, we examined the literature for up-to-date discussions and provided commentary on glaucoma, its pathophysiology, and associated risk factors. We discuss systemic diseases and the impact, risk, and mechanism for developing glaucoma, including pharmacologically induced glaucoma; inflammatory and auto-immune conditions; infectious, dermatologic, cardiovascular, pulmonary, renal, urologic, neurologic, psychiatric and systemic malignancies: intraocular tumors; as well as pediatric, and genetic conditions. The goal of our discussion of systemic conditions including their commonality, mechanisms, treatments, and associations with developing glaucoma is to emphasize the importance of ocular examinations and follow-up with the multidisciplinary teams involved in the care of each patient to prevent unnecessary vision-loss.
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Affiliation(s)
- Eugene Hsu
- Department of Ophthalmology, Boston University School of Medicine, 85 East Concord Street, 8th Floor, Boston, MA 02118, USA
| | - Manishi Desai
- Department of Ophthalmology, Boston University School of Medicine, 85 East Concord Street, 8th Floor, Boston, MA 02118, USA
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Liu W, Guo R, Huang D, Ji J, Gansevoort RT, Snieder H, Jansonius NM. Co-occurrence of chronic kidney disease and glaucoma: Epidemiology and etiological mechanisms. Surv Ophthalmol 2023; 68:1-16. [PMID: 36088997 DOI: 10.1016/j.survophthal.2022.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 08/26/2022] [Accepted: 09/02/2022] [Indexed: 02/01/2023]
Abstract
As the histology, physiology, and pathophysiology of eyes and kidneys show substantial overlap, it has been suggested that eye and kidney diseases, such as glaucoma and chronic kidney disease (CKD), may be closely interlinked. We review the relationship between CKD and various subtypes of glaucoma, including primary open-angle glaucoma, primary angle- closure glaucoma, normal tension glaucoma, pseudoexfoliation syndrome, and several glaucoma endophenotypes. We also discuss the underlying pathogenic mechanisms and common risk factors for CKD and glaucoma, including atherosclerosis, the renin-angiotensin system, genes and genetic polymorphisms, vitamin D deficiency, and erythropoietin. The prevalence of glaucoma appears elevated in CKD patients, and vice versa, and the literature points to many intriguing associations; however, the associations are not always confirmed, and sometimes apparently opposite observations are reported. Glaucoma and CKD are complex diseases, and their mutual influence is only partially understood.
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Affiliation(s)
- Wei Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China; Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ruru Guo
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Dandan Huang
- Department of Ophthalmology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Jian Ji
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Ron T Gansevoort
- Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nomdo M Jansonius
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
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Kolli A, Sekimitsu S, Wang J, Segre A, Friedman D, Elze T, Pasquale LR, Wiggs J, Zebardast N. Background polygenic risk modulates the association between glaucoma and cardiopulmonary diseases and measures: an analysis from the UK Biobank. Br J Ophthalmol 2022:bjophthalmol-2021-320305. [PMID: 35361574 PMCID: PMC9522920 DOI: 10.1136/bjophthalmol-2021-320305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/13/2022] [Indexed: 12/27/2022]
Abstract
AIMS To assess whether associations of cardiopulmonary conditions and markers with glaucoma differ by background genetic risk for primary open angle glaucoma (POAG). METHODS We constructed a POAG polygenic risk score (PRS) using genome-wide association study summary statistics from a large cross-ancestry meta-analysis. History of glaucoma (including self-report and codes for POAG, 'other glaucoma' or unspecified glaucoma), history of common cardiopulmonary conditions and cardiopulmonary measures were assessed in the UK Biobank. Stratifying by PRS decile 1 (lowest risk) versus decile 10 (highest risk), separate multivariable models were estimated to assess the associations of cardiopulmonary diseases or factors with glaucoma, adjusting for age, sex, smoking and medication use. A Bonferroni correction was used to adjust p values for multiple comparisons. RESULTS Individuals in POAG PRS decile 1 (417 cases, 44 458 controls; mean age 56.8 years) and decile 10 (2135 cases, 42 413 controls; mean age 56.7 years) were included. Within decile 1, glaucoma cases had significantly higher glycated haemoglobin (38.5 vs 35.9 mmol/mol) and higher prevalence of diabetes (17.5% vs 6.5%), dyslipidaemia (31.2% vs 18.3%) and chronic kidney disease (CKD) (6.7% vs 2.0%) than controls (adjusted p<0.0013 for each). Within decile 10, glaucoma was associated with higher prevalence of dyslipidaemia (27.7% vs 17.3%, p=6.9E-05). The magnitude of association between glaucoma and diabetes, CKD and glycated haemoglobin differed between deciles 1 and 10 (contrast test p value for difference <0.05). CONCLUSION The relations between systemic conditions and glaucoma vary by underlying genetic predisposition to POAG, with larger associations among those who developed glaucoma despite low genetic risk.
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Affiliation(s)
- Ajay Kolli
- Ophthalmology and Visual Science, University of Michigan, Ann Arbor, Michigan, USA.,Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | | | - Jiali Wang
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Ayellet Segre
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.,Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts, USA.,Ocular Genomics Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - David Friedman
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Tobias Elze
- Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Janey Wiggs
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.,Ocular Genomics Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Nazlee Zebardast
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
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Posch‐Pertl L, Michelitsch M, Wagner G, Wildner B, Silbernagel G, Pregartner G, Wedrich A. Cholesterol and glaucoma: a systematic review and meta-analysis. Acta Ophthalmol 2022; 100:148-158. [PMID: 33506616 PMCID: PMC9292534 DOI: 10.1111/aos.14769] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 12/27/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE Intraocular pressure is the main risk factor for glaucoma; however, additional risk factors may also matter. This systematic review and meta-analysis were conducted to summarize the evidence regarding the association of cholesterol parameters (total cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) levels) and glaucoma. METHODS Four electronic databases were searched for all publications containing 'glaucoma' and one of various forms of 'cholesterol' or 'lipoprotein'. Two independent reviewers screened abstracts and potentially full texts of identified articles for eligibility. Risk of bias was assessed with the Newcastle-Ottawa Scale. A random-effects meta-analysis was used to investigate the differences in total cholesterol, LDL and HDL levels between patients with and without glaucoma. RESULTS Overall, 29 observational studies were included in the systematic review and 26 reported quantitative information to investigate differences in cholesterol parameters between patients with glaucoma (N = 7196) and patients without glaucoma (N = 350 441). Patients with glaucoma had significantly higher total cholesterol levels than patients without glaucoma (Mean Difference (MD) 7.9 mg/dl, 95% CI 3.3 to 12.5, p = 0.001) and lower mean HDL levels (MD -2.0 mg/dl, 95% CI: -3.1 to -0.9, p = 0.001). Patients with glaucoma had higher mean LDL levels than patients without glaucoma, albeit not statistically significant (MD 6.1 mg/dl, 95% CI: -4.3 to 16.4, p = 0.251). CONCLUSION This systematic review and meta-analysis of observational studies found an association of glaucoma and high total cholesterol and low HDL levels, respectively. Although this supports the hypothesis that lipid levels pose an additional risk for glaucoma development, heterogeneity was substantial and causality cannot be presumed from identified observational studies.
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Affiliation(s)
| | | | - Gernot Wagner
- Department for Evidence‐based Medicine and Evaluation Danube University Krems Krems Austria
| | | | - Günther Silbernagel
- Division of Angiology Department of Internal Medicine Medical University of Graz Graz Austria
- Division of Cardiology Campus Benjamin Franklin Charité Berlin Berlin Germany
| | - Gudrun Pregartner
- Institute for Medical Informatics, Statistics and Documentation Medical University of Graz Graz Austria
| | - Andreas Wedrich
- Department of Ophthalmology Medical University of Graz Graz Austria
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Leibovitzh H, Cohen E, levi A, Kramer M, Shochat T, Goldberg E, Krause I. Relationship between homocysteine and intraocular pressure in men and women: A population-based study. Medicine (Baltimore) 2016; 95:e4858. [PMID: 27661027 PMCID: PMC5044897 DOI: 10.1097/md.0000000000004858] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 08/17/2016] [Accepted: 08/19/2016] [Indexed: 12/12/2022] Open
Abstract
The relationship between homocysteine levels and glaucoma has been questioned in previous studies without conclusive results. In the current study, we assessed the relationship between homocysteine levels and intraocular pressure which is one of the main factors in the development of glaucoma in men and women.A retrospective cross-sectional analysis of a database from a screening center in Israel which assessed 11,850 subjects, within an age range 20 to 80 years. The relationship between homocysteine and intraocular pressure has been investigated by comparing intraocular pressure in subjects with elevated and normal homocysteine and by comparing homocysteine levels in subjects with elevated and normal intraocular pressure. In addition, we compared the levels of homocysteine in subjects with and without a confirmed diagnosis of glaucoma.The mean IOP (±SD) in subjects with normal homocysteine levels(≤15 μmol/L) was 13.2 ± 2.3 mm Hg and 13.4 ± 2.4 mm Hg in those with high homocysteine levels (>15 μmol/L) (P < 0.008, 95% confidence interval [CI] 0.3-0.09).Nonetheless, after multivariate adjustment for age, gender, vitamin B12, and folic acid statistical significance was no longer demonstrated (P = 0.37). Mean homocysteine levels (±SD) in subjects with normal intraocular pressure of ≤ 21 mm Hg was 11.7 ± 5.5 μmol/L and 12.09 ± 3.43 μmol/L in those with elevated intraocular pressure (P = 0.4, 95%CI 1.1-1.8). Mean homocysteine levels (±SD) in subjects with glaucoma were 11.2 ± 3.5 μmol/L compared to 11.7 ± 5.5 μmol/L in subjects without glaucoma and normal intraocular pressure ≤ 21 mm Hg (P = 0.4, 95% CI 1.2-2.1).The current study displays no clinical correlation between the homocysteine level and the intraocular pressure. Homocysteine may not be used as a predictive parameter to recognize those subjects prone to develop elevated intraocular pressure.
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Affiliation(s)
| | - Eytan Cohen
- Department of Medicine F-Recanati
- Clinical Pharmacology Unit
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | | | - Michal Kramer
- Department of Ophthalmology, Rabin Medical Center, Petah Tikva
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | | | - Elad Goldberg
- Department of Medicine F-Recanati
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | - Ilan Krause
- Department of Medicine F-Recanati
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
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Djordjevic Jocic J, Cukuranovic R, Jovanovic P, Djordjevic V, Mihajlovic M, Bogdanovic D, Cukuranovic-Kokoris J, Stefanovic V. Ocular fundus abnormalities in patients with Balkan endemic nephropathy and other chronic kidney diseases. Int Urol Nephrol 2015; 47:1693-701. [DOI: 10.1007/s11255-015-1078-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 08/01/2015] [Indexed: 01/01/2023]
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