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Choudhari NS, Khanna RC, Marmamula S, Mettla AL, Giridhar P, Banerjee S, Shekhar K, Chakrabarti S, Murthy GVS, Gilbert C, Rao GN. Incidence of primary open angle glaucoma in the Andhra Pradesh Eye Disease Study (APEDS). Eye (Lond) 2024; 38:2179-2186. [PMID: 37968514 PMCID: PMC11269674 DOI: 10.1038/s41433-023-02799-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 10/04/2023] [Accepted: 10/17/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND To report 15-year incidence rate of primary open angle glaucoma (POAG) in the Andhra Pradesh Eye Disease Study (APEDS). METHODS A population-based longitudinal study was carried out at three rural study sites. Phakic participants aged ≥40 years who participated at baseline (APEDS I) and the mean 15-year follow-up visit (APEDS III) were included. A comprehensive ophthalmic examination was performed on all participants. Mean intraocular pressure (IOP) was average of IOPs of right and left eyes. The definition of glaucoma was based on the International Society of Geographical and Epidemiological Ophthalmology (ISGEO) classification. The main outcome measure was incidence of POAG during the follow-up period in participants without glaucoma or suspicion of glaucoma at baseline. RESULTS Data from the available and eligible participants from the original cohort (1241/2790; 44.4%) were analysed. The mean age (standard deviation) of participants at baseline was 50.2 (8.1) years; 580 (46.7%) were men. Thirty-six participants developed POAG [bilateral in 17 (47.2%)] over 15 years. The incidence rate of POAG per 100-person years (95% confidence interval) was 2.83 (2.6, 3.08). Compared to baseline, the reduction in mean IOP [median (range) mm Hg] was -0.75 (-7.5, 9) in participants with incident POAG and -2.5 (-14.5, 14.5) in those without. The inter-visit difference in mean IOP was a significant risk factor on logistic regression analysis. CONCLUSION We report the long-term incidence of POAG in rural India. A longitudinal change in IOP, specifically a less pronounced reduction in IOP with increasing age, was a novel risk factor.
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Affiliation(s)
- Nikhil S Choudhari
- VST Glaucoma Centre, Dr. Kallam Anji Reddy Campus, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Kismatpur Road, Himayathsagar, Telangana State, India
| | - Rohit C Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Kismatpur Road, Himayathsagar, Telangana State, India.
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India.
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia.
- School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.
| | - Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Kismatpur Road, Himayathsagar, Telangana State, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India
- Department of Biotechnology/ Wellcome Trust India Alliance, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
| | - Asha Latha Mettla
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Kismatpur Road, Himayathsagar, Telangana State, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India
| | - Pyda Giridhar
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Kismatpur Road, Himayathsagar, Telangana State, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India
| | - Seema Banerjee
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Kismatpur Road, Himayathsagar, Telangana State, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India
| | - Konegari Shekhar
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Kismatpur Road, Himayathsagar, Telangana State, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India
| | - Subhabrata Chakrabarti
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India
| | - Gudlavalleti V S Murthy
- Indian Institute of Public Health, Madhapur, Hyderabad, India
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Clare Gilbert
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Gullapalli N Rao
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Kismatpur Road, Himayathsagar, Telangana State, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India
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Wang K, Lin X, Sheng S, Chen D, Liu X, Yao K. Association between glaucoma and stroke: A bidirectional mendelian randomization study. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2024; 4:147-155. [PMID: 39022764 PMCID: PMC11253272 DOI: 10.1016/j.aopr.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/25/2024] [Accepted: 04/15/2024] [Indexed: 07/20/2024]
Abstract
Purpose Observational studies have reported positive associations between glaucoma and stroke; however, controversial results exist. Importantly, the nature of the relationship remains unknown since previous studies were not designed to test causality. Therefore, we aimed to investigate the possible causal relationships between glaucoma and stroke. Methods Our two-sample Mendelian randomization (MR) encompassed multi-ethnic large-scale genome-wide association studies with more than 20000 cases and 260000 controls for glaucoma, and more than 80000 cases and 630000 controls for stroke. Individual effect estimates for each SNP were combined using the inverse-variance weighted (IVW) method. To avoid potential pleiotropic effects, we adjusted the main results by excluding genetic variants associated with metabolic factors. The weighted median and MR-Egger methods were also used for the sensitivity analysis. Results Our MR analysis revealed that glaucoma and its subtypes, including primary open-angle glaucoma and primary angle-closure glaucoma, exhibited no causal role in relation to any stroke (AS), any ischemic stroke (AIS), large-artery atherosclerotic stroke (LAS), small-vessel stroke (SVS), or cardioembolic stroke (CES) across MR analyses (all P > 0.05). The null associations remained robust even after adjusting for metabolic-related traits and were consistent in both the European and Asian populations. Furthermore, reverse MR analyses also did not indicate any significant causal effects of AS, AIS, LAS, or CES on glaucoma risk. Conclusions Evidence from our series of causal inference approaches using large-scale population-based MR analyses did not support causal effects between glaucoma and stroke. These findings suggest that the relationship of glaucoma management and stroke risk prevention should be carefully evaluated in future studies. In turn, stroke diagnosis should not be simply applied to glaucoma risk prediction.
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Affiliation(s)
- Kai Wang
- Eye Center of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xueqi Lin
- Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Institute of Infectious Disease and Biosecurity, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Siting Sheng
- Eye Center of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Dan Chen
- Eye Center of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xin Liu
- Eye Center of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ke Yao
- Eye Center of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Akiyama M, Tamiya G, Fujiwara K, Shiga Y, Yokoyama Y, Hashimoto K, Sato M, Sato K, Narita A, Hashimoto S, Ueda E, Furuta Y, Hata J, Miyake M, Ikeda HO, Suda K, Numa S, Mori Y, Morino K, Murakami Y, Shimokawa S, Nakamura S, Yawata N, Fujisawa K, Yamana S, Mori K, Ikeda Y, Miyata K, Mori K, Ogino K, Koyanagi Y, Kamatani Y, Ninomiya T, Sonoda KH, Nakazawa T. Genetic Risk Stratification of Primary Open-Angle Glaucoma in Japanese Individuals. Ophthalmology 2024:S0161-6420(24)00362-2. [PMID: 39023470 DOI: 10.1016/j.ophtha.2024.05.026] [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: 12/24/2023] [Revised: 05/26/2024] [Accepted: 05/28/2024] [Indexed: 07/20/2024] Open
Abstract
PURPOSE To assess the impact of genetic risk estimation for primary open-angle glaucoma (POAG) in Japanese individuals. DESIGN Cross-sectional analysis. PARTICIPANTS Genetic risk scores (GRSs) were constructed based on a genome-wide association study (GWAS) of POAG in Japanese people. A total of 3625 Japanese individuals, including 1191 patients and 2434 controls (Japanese Tohoku), were used for the model selection. We also evaluated the discriminative accuracy of constructed GRSs in a dataset comprising 1034 patients and 1147 controls (the Japan Glaucoma Society Omics Group [JGS-OG] and the Genomic Research Committee of the Japanese Ophthalmological Society [GRC-JOS]) and 1900 participants from a population-based study (Hisayama Study). METHODS We evaluated 2 types of GRSs: polygenic risk scores using the pruning and thresholding procedure and a GRS using variants associated with POAG in the GWAS of the International Glaucoma Genetics Consortium (IGGC). We selected the model with the highest areas under the receiver operating characteristic curve (AUC). In the population-based study, we evaluated the correlations between GRS and ocular measurements. MAIN OUTCOME MEASURE Proportion of patients with POAG after stratification according to the GRS. RESULTS We found that a GRS using 98 variants, which showed genome-wide significance in the IGGC, showed the best discriminative accuracy (AUC, 0.65). In the Japanese Tohoku, the proportion of patients with POAG in the top 10% individuals was significantly higher than that in the lowest 10% (odds ratio [OR], 6.15; 95% confidence interval [CI], 4.35-8.71). In the JGS-OG and GRC-JOS, we confirmed similar impact of POAG GRS (AUC, 0.64; OR [top vs. bottom decile], 5.81; 95% CI, 3.79-9.01). In the population-based study, POAG prevalence was significantly higher in the top 20% individuals of the GRS compared with the bottom 20% (9.2% vs. 5.0%). However, the discriminative accuracy was low (AUC, 0.56). The POAG GRS was correlated positively with intraocular pressure (r = 0.08: P = 4.0 × 10-4) and vertical cup-to-disc ratio (r = 0.11; P = 4.0 × 10-6). CONCLUSIONS The GRS showed moderate discriminative accuracy for POAG in the Japanese population. However, risk stratification in the general population showed relatively weak discriminative performance. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Masato Akiyama
- Department of Ocular Pathology and Imaging Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Gen Tamiya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Kohta Fujiwara
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yukihiro Shiga
- Department of Neuroscience, Université de Montréal, Montréal, Canada; Neuroscience Division, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Canada; Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yu Yokoyama
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kazuki Hashimoto
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masataka Sato
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kota Sato
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Akira Narita
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Sawako Hashimoto
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Emi Ueda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiko Furuta
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masahiro Miyake
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hanako O Ikeda
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kenji Suda
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shogo Numa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuki Mori
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazuya Morino
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yusuke Murakami
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Sakurako Shimokawa
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shun Nakamura
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nobuyo Yawata
- Department of Ocular Pathology and Imaging Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kimihiko Fujisawa
- Department of Ophthalmology, Japan Community Healthcare Organization Kyushu Hospital, Fukuoka, Japan
| | - Satoshi Yamana
- Department of Ophthalmology, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Kenichiro Mori
- Department of Ophthalmology, Aso Iizuka Hospital, Iizuka, Japan
| | - Yasuhiro Ikeda
- Department of Ophthalmology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | | | - Keisuke Mori
- Department of Ophthalmology, International University of Health and Welfare, Nasu-shiobara, Tochigi, Japan
| | - Ken Ogino
- Department of Ophthalmology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Yoshito Koyanagi
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoichiro Kamatani
- Laboratory of Complex Trait Genomics, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koh-Hei Sonoda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan; Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Sendai, Japan.
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Majithia S, Chong CCY, Chee ML, Yu M, Soh ZD, Thakur S, Lavanya R, Rim TH, Nusinovici S, Koh V, Sabanayagam C, Cheng CY, Tham YC. Associations between Chronic Kidney Disease and Thinning of Neuroretinal Layers in Multiethnic Asian and White Populations. OPHTHALMOLOGY SCIENCE 2024; 4:100353. [PMID: 37869020 PMCID: PMC10587624 DOI: 10.1016/j.xops.2023.100353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/22/2023] [Accepted: 06/14/2023] [Indexed: 10/24/2023]
Abstract
Purpose To evaluate the relationships between chronic kidney disease (CKD) with retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) thickness profiles of eyes in Asian and White populations. Design Cross-sectional analysis. Participants A total of 5066 Asian participants (1367 Malays, 1772 Indians, and 1927 Chinese) from the Singapore Epidemiology of Eye Diseases Study (SEED) were included, consisting of 9594 eyes for peripapillary RNFL analysis and 8661 eyes for GCIPL analysis. Additionally, 45 064 White participants (87 649 eyes) from the United Kingdom Biobank (UKBB) were included for both macular RNFL analysis and GCIPL analysis. Methods Nonglaucoma participants aged ≥ 40 years with complete data for estimated glomerular filtration rate (eGFR) were included from both SEED and UKBB. In SEED, peripapillary RNFL and GCIPL thickness were measured by Cirrus HD-OCT 4000. In UKBB, macular RNFL and GCIPL were measured by Topcon 3D-OCT 1000 Mark II. Chronic kidney disease was defined as eGFR < 60 ml/min/1.73 m2 in both data sets. To evaluate the associations between kidney function status with RNFL and GCIPL thickness profiles, multivariable linear regression with generalized estimating equation models were performed in SEED and UKBB data sets separately. Main Outcome Measures Average peripapillary and macular RNFL thickness and macular GCIPL thickness. Results In SEED, after adjusting for age, gender, ethnicity, systolic blood pressure, antihypertensive medication, diabetes, hyperlipidemia, body mass index, smoking status, and intraocular pressure, presence of CKD (β = -1.31; 95% confidence interval [CI], -2.37 to -0.26; P = 0.015) and reduced eGFR (per 10 ml/min/1.73 m2; β = -0.32; 95% CI, -0.50 to -0.13; P = 0.001) were associated with thinner average peripapillary RNFL. Presence of CKD (β = -1.63; 95% CI, -2.42 to -0.84) and reduced eGFR (per 10 ml/min/1.73 m2; β = -0.30; 95% CI, -0.44 to -0.16) were consistently associated with thinner GCIPL in SEED (all P < 0.001). In UKBB, after adjusting for the above-mentioned covariates (except ethnicity), reduced eGFR (per 10 ml/min/1.73 m2; β = -0.06; 95% CI, -0.10 to -0.01; P = 0.008) was associated with thinner macular RNFL and CKD (β = -0.62; 95% CI, -1.16 to -0.08; P = 0.024) was associated with thinner average GCIPL. Conclusion We consistently observed associations between CKD and thinning of RNFL and GCIPL across Asian and White populations' eyes. These findings further suggest that compromised kidney function is associated with RNFL and GCIPL thinning. Financial Disclosures The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Shivani Majithia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | | | - Miao Li Chee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Marco Yu
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Zhi Da Soh
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Sahil Thakur
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Raghavan Lavanya
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Tyler Hyungtaek Rim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Simon Nusinovici
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Victor Koh
- Centre for Innovation & Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Ophthalmology, National University Hospital, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
- Centre for Innovation & Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yih-Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
- Centre for Innovation & Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Majithia S, Quek DQY, Chee ML, Lim ZW, Nusinovici S, Soh ZD, Thakur S, Rim TH, Sabanayagam C, Cheng CY, Tham YC. Cardiovascular disease and thinning of retinal nerve fiber layer in a multi-ethnic Asian population: the Singapore epidemiology of eye diseases study. Front Med (Lausanne) 2023; 10:1235309. [PMID: 37928469 PMCID: PMC10620687 DOI: 10.3389/fmed.2023.1235309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/18/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction Our study aimed to examine the relationship between cardiovascular diseases (CVD) with peripapillary retinal fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thickness profiles in a large multi-ethnic Asian population study. Methods 6,024 Asian subjects were analyzed in this study. All participants underwent standardized examinations, including spectral domain OCT imaging (Cirrus HD-OCT; Carl Zeiss Meditec). In total, 9,188 eyes were included for peripapillary RNFL analysis (2,417 Malays; 3,240 Indians; 3,531 Chinese), and 9,270 eyes (2,449 Malays, 3,271 Indians, 3,550 Chinese) for GCIPL analysis. History of CVD was defined as a self-reported clinical history of stroke, myocardial infarction, or angina. Multivariable linear regression models with generalized estimating equations were performed, adjusting for age, gender, ethnicity, diabetes, hypertension, hyperlipidaemia, chronic kidney disease, body mass index, current smoking status, and intraocular pressure. Results We observed a significant association between CVD history and thinner average RNFL (β = -1.63; 95% CI, -2.70 to -0.56; p = 0.003). This association was consistent for superior (β = -1.79, 95% CI, -3.48 to -0.10; p = 0.038) and inferior RNFL quadrant (β = -2.14, 95% CI, -3.96 to -0.32; p = 0.021). Of the CVD types, myocardial infarction particularly showed significant association with average (β = -1.75, 95% CI, -3.08 to -0.42; p = 0.010), superior (β = -2.22, 95% CI, -4.36 to -0.09; p = 0.041) and inferior (β = -2.42, 95% CI, -4.64 to -0.20; p = 0.033) RNFL thinning. Among ethnic groups, the association between CVD and average RNFL was particularly prominent in Indian eyes (β = -1.92, 95% CI, -3.52 to -0.33; p = 0.018). CVD was not significantly associated with average GCIPL thickness, albeit a consistent negative direction of association was observed (β = -0.22, 95% CI, -1.15 to 0.71; p = 0.641). Discussion In this large multi-ethnic Asian population study, we observed significant association between CVD history and RNFL thinning. This finding further validates the impact of impaired systemic circulation on RNFL thickness.
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Affiliation(s)
- Shivani Majithia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Debra Q. Y. Quek
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Miao Li Chee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Zhi Wei Lim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Simon Nusinovici
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Zhi-Da Soh
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Sahil Thakur
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Tyler Hyungtaek Rim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Centre for Innovation and Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yih-Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Centre for Innovation and Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Vergroesen JE, Schuster AK, Stuart KV, Asefa NG, Cougnard-Grégoire A, Delcourt C, Schweitzer C, Barreto P, Coimbra R, Foster PJ, Luben RN, Pfeiffer N, Stingl JV, Kirsten T, Rauscher FG, Wirkner K, Jansonius NM, Arnould L, Creuzot-Garcher CP, Stricker BH, Keskini C, Topouzis F, Bertelsen G, Eggen AE, Bikbov MM, Jonas JB, Klaver CCW, Ramdas WD, Khawaja AP. Association of Systemic Medication Use with Glaucoma and Intraocular Pressure: The European Eye Epidemiology Consortium. Ophthalmology 2023; 130:893-906. [PMID: 37150298 DOI: 10.1016/j.ophtha.2023.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 04/17/2023] [Accepted: 05/01/2023] [Indexed: 05/09/2023] Open
Abstract
PURPOSE To investigate the association of commonly used systemic medications with glaucoma and intraocular pressure (IOP) in the European population. DESIGN Meta-analysis of 11 population-based cohort studies of the European Eye Epidemiology Consortium. PARTICIPANTS The glaucoma analyses included 143 240 participants and the IOP analyses included 47 177 participants. METHODS We examined associations of 4 categories of systemic medications-antihypertensive medications (β-blockers, diuretics, calcium channel blockers [CCBs], α-agonists, angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers), lipid-lowering medications, antidepressants, and antidiabetic medications-with glaucoma prevalence and IOP. Glaucoma ascertainment and IOP measurement method were according to individual study protocols. Results of multivariable regression analyses of each study were pooled using random effects meta-analyses. Associations with antidiabetic medications were examined in participants with diabetes only. MAIN OUTCOME MEASURES Glaucoma prevalence and IOP. RESULTS In the meta-analyses of our maximally adjusted multivariable models, use of CCBs was associated with a higher prevalence of glaucoma (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.08 to 1.39). This association was stronger for monotherapy of CCBs with direct cardiac effects (OR, 1.96; 95% CI, 1.23 to 3.12). No other antihypertensive medications, lipid-lowering medications, antidepressants, or antidiabetic medications were associated with glaucoma. Use of systemic β-blockers was associated with a lower IOP (β coefficient, -0.33 mmHg; 95% CI, -0.57 to -0.08 mmHg). Monotherapy of both selective systemic β-blockers (β coefficient, -0.45 mmHg; 95% CI -0.74 to -0.16 mmHg) and nonselective systemic β-blockers (β coefficient, -0.54 mmHg; 95% CI, -0.94 to -0.15 mmHg) was associated with lower IOP. A suggestive association was found between use of high-ceiling diuretics and lower IOP (β coefficient, -0.30 mmHg; 95% CI, -0.47 to -0.14 mmHg) but not when used as monotherapy. No other antihypertensive medications, lipid-lowering medications, antidepressants, or antidiabetic medications were associated with IOP. CONCLUSIONS We identified a potentially harmful association between use of CCBs and glaucoma prevalence. Additionally, we observed and quantified the association of lower IOP with systemic β-blocker use. Both findings potentially are important, given that patients with glaucoma frequently use systemic antihypertensive medications. Determining causality of the CCB association should be a research priority. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Joëlle E Vergroesen
- Department of Ophthalmology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Kelsey V Stuart
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom
| | - Nigus G Asefa
- Department of Ophthalmology, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Cécile Delcourt
- INSERM, BPH, U1219, Université de Bordeaux, Bordeaux, France
| | - Cédric Schweitzer
- INSERM, BPH, U1219, Université de Bordeaux, Bordeaux, France; Department of Ophthalmology, CHU de Bordeaux, Bordeaux, France
| | - Patrícia Barreto
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal; University of Coimbra, Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine (iCBR- FMUC), Coimbra, Portugal
| | - Rita Coimbra
- Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal; Department of Mathematics, University of Aveiro, Aveiro, Portugal
| | - Paul J Foster
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom
| | - Robert N Luben
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom; MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Julia V Stingl
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Toralf Kirsten
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany; Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany; Medical Informatics Center, Department of Medical Data Science, Leipzig University Medical Center, Leipzig, Germany
| | - Franziska G Rauscher
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany; Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
| | - Kerstin Wirkner
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany; Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
| | - Nomdo M Jansonius
- Department of Ophthalmology, University Medical Center Groningen, Groningen, The Netherlands
| | - Louis Arnould
- Department of Ophthalmology, University Hospital, Dijon, France
| | | | - Bruno H Stricker
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Christina Keskini
- First Department of Ophthalmology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Fotis Topouzis
- First Department of Ophthalmology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Geir Bertelsen
- Department of Community Medicine, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Anne E Eggen
- Department of Community Medicine, UiT, The Arctic University of Norway, Tromsø, Norway
| | | | - Jost B Jonas
- Ufa Eye Research Institute, Ufa, Russia; Institute of Molecular and Clinical Ophthalmology, University of Basel, Basel, Switzerland; Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Caroline C W Klaver
- Department of Ophthalmology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Institute of Molecular and Clinical Ophthalmology, University of Basel, Basel, Switzerland; Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Wishal D Ramdas
- Department of Ophthalmology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom; MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.
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7
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Ismail AMA, Saif HFAEA, Taha MM. Effect of alternate nostril breathing exercise on autonomic functions, ocular hypertension, and quality of life in elderly with systemic hypertension and high-tension primary open-angle glaucoma. Geriatr Nurs 2023; 52:91-97. [PMID: 37290219 DOI: 10.1016/j.gerinurse.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/19/2023] [Accepted: 05/19/2023] [Indexed: 06/10/2023]
Abstract
Investigating the response of ocular hypertension and quality of life to a 4-week alternate-nostril breathing exercise (ANBE) in older adults with systemic hypertension (SH) and high-tension form of primary open-angle glaucoma (HTF-POAG) was our aim. Sixty older adults with SH and HTF-POAG were randomly assigned to the ANBE group (n=30, received morning and evening 30 min sessions of daily ANBE) or the control (waitlist) group (n=30). Right-eye intraocular pressure (IOP), left-eye IOP, blood pressure, short-form-36 survey (SF36S), rates of respiration and radial-artery pulsation, hospital anxiety and depression scale (depression subscale abbreviated as HADS-D and anxiety subscale abbreviated as HADS-A), and glaucoma quality-of-life 15-item questionnaire (GQoL-15) were assessed. All measurements were improved in the ANBE group only. In conclusion, a 4-week ANBE could be an adjunctive modality to improve HADS-D, rates of respiration and radial-artery pulsation, HADS-A, blood pressure, IOP, GQol-15, and SF36S in older adults SH and HTF-POAG.
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Affiliation(s)
- Ali Mohamed Ali Ismail
- Lecturer, Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
| | | | - Mona Mohamed Taha
- Associate professor, Department of Rehabilitation, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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8
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Pezzino S, Sofia M, Greco LP, Litrico G, Filippello G, Sarvà I, La Greca G, Latteri S. Microbiome Dysbiosis: A Pathological Mechanism at the Intersection of Obesity and Glaucoma. Int J Mol Sci 2023; 24:ijms24021166. [PMID: 36674680 PMCID: PMC9862076 DOI: 10.3390/ijms24021166] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
The rate at which obesity is becoming an epidemic in many countries is alarming. Obese individuals have a high risk of developing elevated intraocular pressure and glaucoma. Additionally, glaucoma is a disease of epidemic proportions. It is characterized by neurodegeneration and neuroinflammation with optic neuropathy and the death of retinal ganglion cells (RGC). On the other hand, there is growing interest in microbiome dysbiosis, particularly in the gut, which has been widely acknowledged to play a prominent role in the etiology of metabolic illnesses such as obesity. Recently, studies have begun to highlight the fact that microbiome dysbiosis could play a critical role in the onset and progression of several neurodegenerative diseases, as well as in the development and progression of several ocular disorders. In obese individuals, gut microbiome dysbiosis can induce endotoxemia and systemic inflammation by causing intestinal barrier malfunction. As a result, bacteria and their metabolites could be delivered via the bloodstream or mesenteric lymphatic vessels to ocular regions at the level of the retina and optic nerve, causing tissue degeneration and neuroinflammation. Nowadays, there is preliminary evidence for the existence of brain and intraocular microbiomes. The altered microbiome of the gut could perturb the resident brain-ocular microbiome ecosystem which, in turn, could exacerbate the local inflammation. All these processes, finally, could lead to the death of RGC and neurodegeneration. The purpose of this literature review is to explore the recent evidence on the role of gut microbiome dysbiosis and related inflammation as common mechanisms underlying obesity and glaucoma.
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Affiliation(s)
- Salvatore Pezzino
- Department of Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Cannizzaro Hospital, University of Catania, 95126 Catania, Italy
| | - Maria Sofia
- Department of Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Cannizzaro Hospital, University of Catania, 95126 Catania, Italy
| | - Luigi Piero Greco
- Department of Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Cannizzaro Hospital, University of Catania, 95126 Catania, Italy
| | - Giorgia Litrico
- Department of Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Cannizzaro Hospital, University of Catania, 95126 Catania, Italy
| | - Giulia Filippello
- Complex Operative Unit of Ophtalmology, Cannizzaro Hospital, University of Catania, 95126 Catania, Italy
| | - Iacopo Sarvà
- Department of Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Cannizzaro Hospital, University of Catania, 95126 Catania, Italy
| | - Gaetano La Greca
- Department of Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Cannizzaro Hospital, University of Catania, 95126 Catania, Italy
| | - Saverio Latteri
- Department of Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Cannizzaro Hospital, University of Catania, 95126 Catania, Italy
- Correspondence: ; Tel.: +39-0957263584
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9
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Sperling S, Stokholm L, Thykjaer AS, Pedersen FN, Möller S, Laugesen CS, Andersen N, Andresen J, Bek T, la Cour M, Hajari J, Heegaard S, Højlund K, Kawasaki R, Kolko M, Schielke KC, Rubin KH, Vestergaard AH, Grauslund J. Bidirectional 5-year risks of diabetic retinopathy, glaucoma and/or ocular hypertension: Results from a national screening programme. Acta Ophthalmol 2022; 101:384-391. [PMID: 36514165 DOI: 10.1111/aos.15300] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 11/07/2022] [Accepted: 11/19/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE We aimed to investigate if diabetic retinopathy (DR), glaucoma and/or ocular hypertension (OHT) are prospectively linked, as previous studies have proposed cross-sectional associations, but longitudinal data from larger cohorts are lacking. METHODS We performed a bidirectional 5 years prospective, registry-based cohort study. We extracted data from national registers, including the Danish Registry of Diabetic Retinopathy, the Danish Civil Registration System, the Danish National Patient Register and the Danish National Prescription Registry. DR level was defined by the highest level of the two eyes. Glaucoma and/or OHT was defined by diagnostic codes (H40*) or at least three redeemed prescriptions of glaucoma medication (S01E*) within 1 year. We included 205 970 persons with diabetes and 1 003 170 age- and gender-matched non-diabetes controls. Exposures were level-specific DR (i) and glaucoma and/or OHT (ii), and outcomes were hazard ratios (HRs) for 5 years incident glaucoma and/or OHT (i) and DR (ii). RESULTS Persons with diabetes were more likely to develop glaucoma and/or OHT (multivariable adjusted HR 1.11, 95% CI 1.06-1.15), but this did not depend on the level of DR. In persons with diabetes, those with glaucoma and/or OHT were more likely to develop DR (multivariable adjusted HR 1.12, 95% CI 1.03-1.23) within 5 years. CONCLUSION In a national cohort, diabetes associated with a little higher risk of upcoming glaucoma and/or OHT, and, inversely, the presence of the latter predicted a higher risk of incident DR. Nevertheless, our data do not seem to justify including glaucoma evaluation in the national Danish DR-screening programme.
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Affiliation(s)
- Signe Sperling
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark
| | - Lonny Stokholm
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,OPEN - Open Patient data Explorative Network, Odense University Hospital & University of Southern Denmark, Odense, Denmark
| | - Anne Suhr Thykjaer
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Frederik Nørregaard Pedersen
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Sören Möller
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,OPEN - Open Patient data Explorative Network, Odense University Hospital & University of Southern Denmark, Odense, Denmark
| | | | - Nis Andersen
- Organization of Danish Practicing Ophthalmologists, Copenhagen, Denmark
| | - Jens Andresen
- Organization of Danish Practicing Ophthalmologists, Copenhagen, Denmark
| | - Toke Bek
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Morten la Cour
- Department of Ophthalmology, Rigshospitalet-Glostrup, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Javad Hajari
- Department of Ophthalmology, Rigshospitalet-Glostrup, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Steffen Heegaard
- Department of Ophthalmology, Rigshospitalet-Glostrup, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kurt Højlund
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
| | - Ryo Kawasaki
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Vision Informatics, University of Osaka, Osaka, Japan
| | - Miriam Kolko
- Department of Ophthalmology, Rigshospitalet-Glostrup, Copenhagen, Denmark.,Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | | | - Katrine Hass Rubin
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,OPEN - Open Patient data Explorative Network, Odense University Hospital & University of Southern Denmark, Odense, Denmark
| | - Anders Højslet Vestergaard
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jakob Grauslund
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
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10
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Impact of Systemic Comorbidities on Ocular Hypertension and Open-Angle Glaucoma, in a Population from Spain and Portugal. J Clin Med 2022; 11:jcm11195649. [PMID: 36233515 PMCID: PMC9570920 DOI: 10.3390/jcm11195649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/21/2022] [Accepted: 09/23/2022] [Indexed: 11/17/2022] Open
Abstract
Open-angle glaucoma (OAG), the most prevalent clinical type of glaucoma, is still the main cause of irreversible blindness worldwide. OAG is a neurodegenerative illness for which the most important risk factor is elevated intraocular pressure (IOP). Many questions remain unanswered about OAG, such as whether nutritional or toxic habits, other personal characteristics, and/or systemic diseases influence the course of glaucoma. As such, in this study, we performed a multicenter analytical, observational, case–control study of 412 participants of both sexes, aged 40–80 years, that were classified as having ocular hypertension (OHT) or OAG. Our primary endpoint was to investigate the relationship between specific lifestyle habits; anthropometric and endocrine–metabolic, cardiovascular, and respiratory events; and commonly used psychochemicals, with the presence of OHT or OAG in an ophthalmologic population from Spain and Portugal. Demographic, epidemiological, and ocular/systemic clinical data were recorded from all participants. Data were analyzed using the R Statistics v4.1.2 and RStudio v2021.09.1 programs. The mean age was 62 ± 15 years, with 67–80 years old comprising the largest subgroup sample of participants in both study groups. The central corneal thickness (ultrasound pachymetry)-adjusted IOP (Goldman tonometry) in each eye was 20.46 ± 2.35 and 20.1 ± 2.73 mmHg for the OHT individuals, and 15.8 ± 3.83 and 16.94 ± 3.86 mmHg for the OAG patients, with significant differences between groups (both p = 0.001). The highest prevalence of the surveyed characteristics in both groups was for overweight/obesity and daily coffee consumption, followed by psychochemical drug intake, migraine, and peripheral vasospasm. Our data show that overweight/obesity, migraine, asthma, and smoking are major risk factors for conversion from OHT to OAG in this Spanish and Portuguese population.
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11
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Mullany S, Marshall H, Diaz-Torres S, Berry EC, Schmidt JM, Thomson D, Qassim A, To MS, Dimasi D, Kuot A, Knight LS, Hollitt G, Kolovos A, Schulz A, Lake S, Mills RA, Agar A, Galanopoulos A, Landers J, Mitchell P, Healey PR, Graham SL, Hewitt AW, Souzeau E, Hassall MM, Klebe S, MacGregor S, Gharahkhani P, Casson RJ, Siggs OM, Craig JE. The APOE E4 Allele Is Associated with Faster Rates of Neuroretinal Thinning in a Prospective Cohort Study of Suspect and Early Glaucoma. OPHTHALMOLOGY SCIENCE 2022; 2:100159. [PMID: 36249683 PMCID: PMC9560531 DOI: 10.1016/j.xops.2022.100159] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/08/2022] [Accepted: 04/08/2022] [Indexed: 11/24/2022]
Abstract
Purpose Design Participants Methods Main Outcome Measures Results Conclusions
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12
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Glaucoma – risk factors and current challenges in the diagnosis of a leading cause of visual impairment. Maturitas 2022; 163:15-22. [DOI: 10.1016/j.maturitas.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/01/2022] [Accepted: 05/09/2022] [Indexed: 11/21/2022]
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13
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Martínez-Blanco AM, Cantor EJ, Valencia-Peña C. Prevalence and risk factors for primary angle-closure disease spectrum: The Colombian glaucoma study. Eur J Ophthalmol 2021; 32:11206721211060153. [PMID: 34796746 DOI: 10.1177/11206721211060153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To estimate the prevalence and risk factors associated with the primary angle-closure disease spectrum in participants of the Colombian Glaucoma Study. METHODS A cross-sectional study in subjects older than 50 years with a diagnosis of diabetes mellitus or/and systemic hypertension was conducted in Colombia to estimate glaucoma prevalence. This study included 1749 patients and classified them using gonioscopy into either open-angle or primary angle-closure disease spectrum groups. The patients in the primary angle-closure disease spectrum group were then subdivided into the following categories: primary angle-closure suspect, primary angle-closure, and primary angle-closure glaucoma. A logistic regression model was carried out to identify factors related to the primary angle-closure disease spectrum, including age, sex, height, and refraction. RESULTS The prevalence of primary angle-closure disease spectrum was 19.3% (338) (95% CI: 17.5-21.2). The prevalence of primary angle-closure suspect, primary angle-closure, and primary angle-closure glaucoma was 8.0% (140) (95% CI: 6.8-9.4), 10.1% (176) (95% CI: 8.7-11.6), and 1.2% (22) (95% CI: 0.8-1.9), respectively. In the multivariate analysis, advanced age (+80 years), female sex, and high hyperopia (p = 0.000, 0.021, and 0.001, respectively) were identified as independent factors related to the primary angle-closure disease spectrum. CONCLUSION A high prevalence of primary angle-closure disease spectrum was found in Colombian patients with a diagnosis of diabetes mellitus or/and systemic hypertension, especially primary angle-closure and primary angle-closure glaucoma. Age, female sex, and high hyperopia were identified as risk factors for the primary angle-closure disease spectrum.
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Affiliation(s)
- Alexander M Martínez-Blanco
- Ophthalmology Programme, 28006Universidad del Valle, Cali, Colombia
- VISOC, group Universidad del Valle, Cali, Colombia
- Department of Ophthalmology, Hospital Universitario del Valle, Cali, Colombia
- Department of Ophthalmology, Clinica Imbanaco Grupo Quirón Salud, Cali, Colombia
| | - Erika J Cantor
- Ophthalmology Programme, 28006Universidad del Valle, Cali, Colombia
| | - Claudia Valencia-Peña
- Ophthalmology Programme, 28006Universidad del Valle, Cali, Colombia
- VISOC, group Universidad del Valle, Cali, Colombia
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14
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Gillespie BW, Niziol LM, Ehrlich JR, Johnson CA, Caprioli J, VanVeldhuisen PC, Lichter PR, Musch DC. Demographic, Comorbid, and Clinical Variables Associated With Pointwise Visual Field Damage in Glaucoma: Data From the AGIS and CIGTS Clinical Trials. Transl Vis Sci Technol 2021; 10:28. [PMID: 34665232 PMCID: PMC8543401 DOI: 10.1167/tvst.10.12.28] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate differences across the visual field (VF) in the rate of glaucomatous progression, the likelihood of defect in four disease severity cross-sections, and comparisons of subgroups in each of between 12 demographic, comorbid, and clinical variables. Methods Two long-term glaucoma clinical trials used Humphrey Field Analyzer 24-2 VFs to calculate pointwise deviations from age-matched normal controls. Slopes of glaucomatous progression over time were calculated per participant using linear mixed models. Pointwise differences between subgroups in slopes and cross-sectional categories were tested, adjusting for multiple comparisons using false discovery rate (FDR) and Q values. Results Pointwise data were available for 1118 patients who had 15,073 VFs. On average, defects were seen at all VF points. Of the 12 variables, six had average pointwise slopes where Subgroup 1 had significantly faster progression than Subgroup 2 at all or many of the 52 VF points: participants who were older (≥65 vs. younger), 52/52; were male, 13/52; had diabetes, 29/52; had hypertension, 46/52; had a larger cup-to-disc ratio (≥0.7), 36/52; or had larger differences in absolute mean deviation (MD) between eyes (>3 dB), 52/52. Cross-sectional patterns at MD severity of -12 to -6.1 dB showed strong midline effects for gender and other patterns for hypertension, cup-to-disc ratio, absolute difference in MD between eyes, and disc notching. Conclusions The approach used provides new longitudinal and cross-sectional insights into variation across the VF associated with demographic, comorbid, and clinical variables. Translational Relevance This exploration and characterization of variable effects in the setting of pointwise VF testing may enable clinicians to anticipate patterns of VF loss based on demographic, comorbid, and clinical associations.
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Affiliation(s)
- Brenda W Gillespie
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Leslie M Niziol
- Department of Ophthalmology and Visual Sciences, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Joshua R Ehrlich
- Department of Ophthalmology and Visual Sciences, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Chris A Johnson
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA
| | - Joseph Caprioli
- Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Paul R Lichter
- Department of Ophthalmology and Visual Sciences, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - David C Musch
- Department of Ophthalmology and Visual Sciences, Medical School, University of Michigan, Ann Arbor, MI, USA.,Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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15
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Li Y, Mitchell W, Elze T, Zebardast N. Association Between Diabetes, Diabetic Retinopathy, and Glaucoma. Curr Diab Rep 2021; 21:38. [PMID: 34495413 DOI: 10.1007/s11892-021-01404-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 12/28/2022]
Abstract
PURPOSE OF REVIEW The strength of the relationship between diabetes, diabetic retinopathy (DR), and glaucoma remains controversial. We review evidence supporting and refuting this association and explore mechanistic pathological and treatment relationships linking these diseases. RECENT FINDINGS While studies have shown diabetes/DR may increase the risk for glaucoma, this remains inconsistently demonstrated. Diabetes/DR may contribute toward glaucomatous optic neuropathy indirectly (either by increasing intraocular pressure or vasculopathy) or through direct damage to the optic nerve. However, certain elements of diabetes may slow glaucoma progression, and diabetic treatment may concurrently be beneficial in glaucoma management. Diabetes plays a significant role in poor outcomes after glaucoma surgery. While the relationship between diabetes/DR and glaucoma remains controversial, multiple mechanistic links connecting pathophysiology and management of diabetes, DR, and glaucoma have been made. However, a deeper understanding of the causes of disease association is needed.
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Affiliation(s)
- Yangjiani Li
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, 510060, China
| | - William Mitchell
- Department of Ophthalmology, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA
- Department of Ophthalmology, Royal Victorian Eye and Ear, Melbourne, VIC, 3002, Australia
| | - Tobias Elze
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA
| | - Nazlee Zebardast
- Department of Ophthalmology, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA.
- Department of Ophthalmology, Harvard Medical School, Boston, MA, 02115, USA.
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16
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Is Obesity a Risk or Protective Factor for Open-Angle Glaucoma in Adults? A Two-Database, Asian, Matched-Cohort Study. J Clin Med 2021; 10:jcm10174021. [PMID: 34501469 PMCID: PMC8432455 DOI: 10.3390/jcm10174021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 08/28/2021] [Accepted: 09/02/2021] [Indexed: 11/17/2022] Open
Abstract
Obesity contributes to multiple systemic disorders; however, extensive discussion regarding obesity and open-angle glaucoma (OAG) remains limited, and conclusions in the existing literature diverge. This study aims to analyze the risk of OAG among obese adults in Taiwan. In this study, adults (aged ≥18 years) with a diagnostic code of obesity or morbid obesity registered in the Longitudinal Health Insurance Database (LHID) 2000 and LHID2005 from 1 January 2001 to 31 December 2010 were included. All adults were traced until the diagnosis of OAG, the occurrence of death, or 31 December 2013. Risk of OAG was significantly higher in obese adults than in non-obese adults after multivariable adjustment (adjusted hazard ratio (aHR): 1.43 (95% confidence interval (CI) 1.11-1.84)/aHR: 1.54 (95% CI 1.23-1.94) in the LHID2000/LHID2005). Both databases demonstrated that young obese adults (aged ≤40 years) had a remarkably increased risk of OAG compared with young non-obese adults (aHR 3.08 (95% CI 1.82-5.21)/aHR 3.81 (95% CI 2.26-6.42) in the LHID2000/LHID2005). This two-database matched-cohort study suggests that obese adults have an increased risk of OAG. In young adults, in particular, obesity could be a potential risk factor of OAG.
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17
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Eliseeva NV, Ponomarenko IV, Churnosov MI. [Analysis of the functional role of polymorphism in the CDKN2B-AS1 gene GWAS-significant for primary open-angle glaucoma (an in-silico study)]. Vestn Oftalmol 2021; 137:43-50. [PMID: 34410056 DOI: 10.17116/oftalma202113704143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Primary open-angle glaucoma (POAG) is the most common form of glaucoma in which genetic factors play a significant role. According to genome-wide studies (GWAS), the CDKN2B-AS1 gene is associated with POAG. PURPOSE To study in silico the functional significance of the CDKN2B-AS1 gene polymorphism GWAS-significant for primary open-angle glaucoma. MATERIAL AND METHODS The in-silico analysis was based on data from the GWAS catalog, five polymorphic loci of the CDKN2B-AS1 gene (rs1063192, rs7865618, rs2157719, rs944800, rs4977756) associated with POAG were selected. The study evaluated the regulatory potential, the relationship with the expression and alternative splicing of genes of the CDKN2B-AS1 gene polymorphism using modern databases for functional genomics - HaploReg and GTExportal. RESULTS An important functional significance of the polymorphic loci rs1063192, rs7865618, rs2157719, rs944800, rs4977756 of the CDKN2B-AS1 gene was revealed. These loci are located in the region of histones marking enhancers and in the region of hypersensitivity to DNAse-1, can be found in more than ten different organs and tissues, in the regions of regulatory DNA motifs to five transcription factors (AIRE, GATA, Tgif1, Pou2f2, and Zfp187), and are associated with expression of three genes (CDKN2B-AS1, CDKN2B, CDKN2A) and alternative splicing of transcripts of two genes (CDKN2B-AS1 and RP11-149I2.4) in cell cultures, organs and tissues with pathogenic significance for glaucoma development. CONCLUSION Polymorphism of the CDKN2B-AS1 gene (rs1063192, rs7865618, rs2157719, rs944800, rs4977756) has significant regulatory potential and is associated with the expression and alternative splicing of genes, which possibly underlies its association with primary open-angle glaucoma.
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Affiliation(s)
- N V Eliseeva
- Belgorod State National Research University, Belgorod, Russia
| | - I V Ponomarenko
- Belgorod State National Research University, Belgorod, Russia
| | - M I Churnosov
- Belgorod State National Research University, Belgorod, Russia
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18
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Perng WT, Hung YM, Lai WY, Chu KA, Wang YH, Wei JCC. Increased risk of glaucoma amongst new-onset gout patients aged 20-39 years: A nationwide population-based cohort study in Taiwan. Int J Clin Pract 2021; 75:e14169. [PMID: 33788372 DOI: 10.1111/ijcp.14169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 03/11/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To provide epidemiologic evidence of whether gout increases the risk of new-onset glaucoma. METHODS We conducted a 13-year nationwide, population-based, retrospective cohort study to examine the association between the history of gout and risk of glaucoma by using the Longitudinal Health Insurance Database (LHID) of Taiwan. The gout cohort included 52 943 patients with newly diagnosed gout who were recruited between 2000 and 2012. Each patient was propensity score matching with 1:1 person without gout from the LHID. To determine glaucoma occurrence, the study population was followed up until the end of 2013. Cumulative incidence, hazard ratios (HRs), and 95% confidence intervals (CIs) were calculated after adjusting for age, sex, comorbidities, and ever ophthalmic visit. A Cox proportional hazard model was used to analyse the association between gout and incidence of glaucoma amongst patients with different potential risks. RESULTS The adjusted HR for newly diagnosed glaucoma in the gout cohort was 1.00 (95% CI = 0.93-1.07, P = .931), compared with the non-gout cohort. Stratified subgroup analysis revealed that the HRs of glaucoma were 1.36 (95% CI = 1.09-1.70, P = .007), 0.99 (95% CI = 0.87-1.12, P = .871), and 0.95 (95% CI = 0.87-1.03, P = .235) in patients with gout aged 20-39, 40-54, and ≥55 years, respectively (P for interaction = .011). CONCLUSION This nationwide population-based cohort study revealed that gout patients in the age group 20-39 years had a higher risk of glaucoma than non-gout controls.
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Affiliation(s)
- Wuu-Tsun Perng
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Recreational Sport & Health Promotion, National Pingtung University of Science and Technology, Pintung, Taiwan
| | - Yao-Min Hung
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan
- College of Health and Nursing, Meiho University, Pingtung, Taiwan
| | - Wei-Yu Lai
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Kuo-An Chu
- Division of Chest Medicine, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
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19
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Hou H, Moghimi S, Baxter SL, Weinreb RN. Is Diabetes Mellitus a Blessing in Disguise for Primary Open-angle Glaucoma? J Glaucoma 2021; 30:1-4. [PMID: 33074964 PMCID: PMC7755751 DOI: 10.1097/ijg.0000000000001719] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/04/2020] [Indexed: 11/26/2022]
Abstract
Although numbers of studies have addressed this question, the relationship between diabetes mellitus and primary open-angle glaucoma is still unclear. This article discusses progress in understanding the complex relationship between these 2 entities and recent shifts in perspective that challenge the traditional dogma regarding diabetes mellitus and primary open-angle glaucoma. There are still many unanswered questions.
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Affiliation(s)
- Huiyuan Hou
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, United States
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, United States
| | - Sally L. Baxter
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, United States
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Robert N. Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, United States
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Abstract
How to cite this article: Dada T, Mahalingam K, Gupta V. Allostatic Load and Glaucoma: Are We Missing the Big Picture? J Curr Glaucoma Pract 2020;14(2):47–49.
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Affiliation(s)
- Tanuj Dada
- Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Karthikeyan Mahalingam
- Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Vivek Gupta
- Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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21
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Shin J, Kang MS, Park K, Lee JS. Association between metabolic risk factors and optic disc cupping identified by deep learning method. PLoS One 2020; 15:e0239071. [PMID: 32941514 PMCID: PMC7498045 DOI: 10.1371/journal.pone.0239071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 08/28/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE This study aims to investigate correlation between metabolic risk factors and optic disc cupping and the development of glaucoma. METHODS This study is a retrospective, cross-sectional study with over 20-year-old patients that underwent health screening examinations. Intraocular pressure (IOP), fundus photographs, Body Mass Index (BMI), waist circumference (WC), serum triglycerides, serum HDL cholesterol (HDL-C), serum LDL cholesterol (LDL-C), systolic blood pressure (BP), diastolic BP, and serum HbA1c were obtained to analyse correlation between metabolic risk factors and glaucoma. Eye with glaucomatous optic neuropathy(GON) was defined as having an optic disc with either vertical cup-to-disc ratio(VCDR) ≥ 0.7 or a VCDR difference ≥ 0.2 between the right and left eyes by measuring VCDR with deep learning approach. RESULTS The study comprised 15,585 subjects and 877 subjects were diagnosed as GON. In univariate analyses, age, BMI, systolic BP, diastolic BP, WC, triglyceride, LDL-C, HbA1c, and IOP were significantly and positively correlated with VCDR in the optic nerve head. In linear regression analysis as independent variables, stepwise multiple regression analyses revealed that age, BMI, systolic BP, HbA1c, and IOP showed positive correlation with VCDR. In multivariate logistic analyses of risk factors and GON, higher age (odds ratio [OR], 1.054; 95% confidence interval [CI], 1.046-1.063), male gender (OR, 0.730; 95% CI, 0.609-0.876), more obese (OR, 1.267; 95% CI, 1.065-1.507), and diabetes (OR, 1.575; 95% CI, 1.214-2.043) remained statistically significant correlation with GON. CONCLUSIONS Among the metabolic risk factors, obesity and diabetes as well as older age and male gender are risk factors of developing GON. The glaucoma screening examinations should be considered in the populations with these indicated risk factors.
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Affiliation(s)
- Jonghoon Shin
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, South Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Min Seung Kang
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, South Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Keunheung Park
- Department of Ophthalmology, Pusan National University College of Medicine, Busan, South Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jong Soo Lee
- Department of Ophthalmology, Pusan National University College of Medicine, Busan, South Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
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22
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Olszewska H, Kosny J, Jurowski P, Jegier A. Physical activity of patients with a primary open angle glaucoma. Int J Ophthalmol 2020; 13:1102-1108. [PMID: 32685399 PMCID: PMC7321953 DOI: 10.18240/ijo.2020.07.14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 08/22/2019] [Indexed: 11/23/2022] Open
Abstract
AIM To assess physical activity (PA) including its intensity in primary open angle glaucoma (POAG). METHODS PA was characterized by the use of questionnaires: Seven-Day Physical Activity Recall and Historical Leisure Activity Questionnaire. A questionnaire of 36 questions, developed by the authors, was used to assess the level of knowledge about glaucoma. RESULTS The study was conducted among 625 adults. The study group comprised 312 POAG patients aged over 40y, including 238 women (76%) and 74 men (24%). The control group consisted of 313 adults (>40 years old), including 202 (65%) women and 111 men (35%). The duration of current PA with an intensity of 4 metabolic equivalents (METs) was significantly shorter among people with POAG. PA in the past was significantly lower among people from the study group, regardless of gender. The level of glaucoma knowledge in patients with POAG was poor and significantly lower in men. CONCLUSION Regular PA is an important and underestimated factor predisposing to the progression of POAG. There is a necessity to undertake educational and preventive actions with a view to modify the health behavior of glaucoma patients.
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Affiliation(s)
- Halina Olszewska
- Department of Ophthalmology and Visual Rehabilitation, University Hospital WAM, Central Hospital in Lodz, Medical University of Lodz, Lodz 90-549, Poland
| | - Joanna Kosny
- Department of Ophthalmology and Visual Rehabilitation, University Hospital WAM, Central Hospital in Lodz, Medical University of Lodz, Lodz 90-549, Poland
| | - Piotr Jurowski
- Department of Ophthalmology and Visual Rehabilitation, University Hospital WAM, Central Hospital in Lodz, Medical University of Lodz, Lodz 90-549, Poland
| | - Anna Jegier
- Department of Sports Medicine, Medical University of Lodz, Lodz 90-549, Poland
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23
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Laiginhas R, Guimarães M, Cardoso P, Santos-Sousa H, Preto J, Nora M, Chibante J, Falcão-Reis F, Falcão M. Retinal Nerve Fiber Layer Thickness Decrease in Obesity as a Marker of Neurodegeneration. Obes Surg 2020; 29:2174-2179. [PMID: 30864103 DOI: 10.1007/s11695-019-03806-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Idiopathic intracranial hypertension (IIH) is a serious condition that is frequently associated with irreversibly vision loss, having a higher incidence among obese women. Our aims were to screen subclinical IIH in obese patients scheduled to bariatric surgery using peripapillary retinal nerve fiber layer (RNFL) thickness and to evaluate if the findings demand the possible need of a preoperative evaluation in this population. METHODS This study included 111 eyes from 36 obese patients (86% female, body mass index > 35 kg/m2) scheduled to bariatric surgery and 20 non-obese (body mass index < 25 kg/m2) age-matched controls. We measured sectorial and mean RNFL thickness in a 3.5-mm-diameter circular scan centered on the optic nerve head, using optical coherence tomography (Heidelberg Spectralis SD-OCT) in all participants. Multivariate linear regression was used for adjustments. RESULTS No patient had subclinical IIH corresponding to increased RNFL thickness. However, in obese individuals, global peripapillary RNFL was thinner than in controls (104 ± 6 μm versus 99 ± 12 μm, p = 0.005). Overall, RNFL thickness was superior in the control group for all sectors. The differences reached significance for the nasal, temporal, superior temporal, and inferior temporal sectors. These differences remained even after adjusting for possible confounders (hypertension, dyslipidemia, diabetes, age, sleep apnea syndrome, and sex). CONCLUSIONS Routine screening asymptomatic obese patients undergoing bariatric surgery for IIH using RNFL thickness was not clinically relevant in our study. However, we found that severe obesity is associated with neurodegeneration independently of the other components of the metabolic syndrome, what may justify future investigation on the need of monitoring these patients.
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Affiliation(s)
- Rita Laiginhas
- PDICSS, Faculty of Medicine of Porto University (FMUP), Porto, Portugal.,Department of Ophthalmology, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Marta Guimarães
- Unit for Multidisciplinary Research in Biomedicine (UMIB), Endocrine, Cardiovascular and Metabolic Research, University of Porto, Porto, Portugal.,Department of Anatomy, Institute of Biomedical Science Abel Salazar (ICBAS), University of Porto, Porto, Portugal.,Department of General Surgery, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal
| | - Pedro Cardoso
- Department of Ophthalmology, Centro Hospitalar de São João, Porto, Portugal
| | - Hugo Santos-Sousa
- Department of Surgery, Centro Hospitalar e Universitário de São João, Porto, Portugal.,Department of Surgery, Faculty of Medicine of Porto University (FMUP), Porto, Portugal
| | - John Preto
- Department of Surgery, Centro Hospitalar e Universitário de São João, Porto, Portugal
| | - Mário Nora
- Unit for Multidisciplinary Research in Biomedicine (UMIB), Endocrine, Cardiovascular and Metabolic Research, University of Porto, Porto, Portugal.,Department of General Surgery, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal
| | - João Chibante
- Department of Ophthalmology, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Fernando Falcão-Reis
- Department of Ophthalmology, Centro Hospitalar de São João, Porto, Portugal.,Department of Surgery and Physiology, Faculty of Medicine of Porto University (FMUP), Porto, Portugal
| | - Manuel Falcão
- Department of Ophthalmology, Centro Hospitalar de São João, Porto, Portugal. .,Department of Surgery and Physiology, Faculty of Medicine of Porto University (FMUP), Porto, Portugal.
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24
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Grzybowski A, Och M, Kanclerz P, Leffler C, De Moraes CG. Primary Open Angle Glaucoma and Vascular Risk Factors: A Review of Population Based Studies from 1990 to 2019. J Clin Med 2020; 9:E761. [PMID: 32168880 PMCID: PMC7141380 DOI: 10.3390/jcm9030761] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 02/18/2020] [Accepted: 02/28/2020] [Indexed: 12/17/2022] Open
Abstract
Glaucoma is one of the leading causes of blindness worldwide, and as the proportion of those over age 40 increases, so will the prevalence of glaucoma. The pathogenesis of primary open angle glaucoma (POAG) is unclear and multiple ocular risk factors have been proposed, including intraocular pressure, ocular perfusion pressure, ocular blood flow, myopia, central corneal thickness, and optic disc hemorrhages. The purpose of this review was to analyze the association between systemic vascular risk factors (including hypertension, diabetes, age, and migraine) and POAG, based on major epidemiological studies. Reports presenting the association between POAG and systemic vascular risk factors included a total of over 50,000 patients. Several epidemiological studies confirmed the importance of vascular risk factors, particularly hypertension and blood pressure dipping, in the pathogenesis and progression of glaucomatous optic neuropathy. We found that diabetes mellitus is associated with elevated intraocular pressure, but has no clear association with POAG. No significant correlation between migraine and POAG was found, however, the definition of migraine varied between studies.
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Affiliation(s)
- Andrzej Grzybowski
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, 61-285 Poznan, Poland
| | - Mariusz Och
- Department of Ophthalmology, The Voivodal Specialistic Hospital in Olsztyn, 10-561 Olsztyn, Poland;
| | - Piotr Kanclerz
- Department of Ophthalmology, Hygeia Clinic, 80-286 Gdańsk, Poland;
| | - Christopher Leffler
- Department of Ophthalmology, Virginia Commonwealth University, Richmond, Virginia, VA 23284, USA;
| | - Carlos Gustavo De Moraes
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Irving Medical Center, New York, NY 10032, USA;
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25
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Honda T, Nakagawa T, Watanabe Y, Hayashi T, Nakano T, Horie S, Tatemichi M. Association between Information and Communication Technology use and Ocular Axial Length Elongation among Middle-Aged Male Workers. Sci Rep 2019; 9:17489. [PMID: 31767931 PMCID: PMC6877562 DOI: 10.1038/s41598-019-53423-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 10/31/2019] [Indexed: 11/16/2022] Open
Abstract
The use of Information and Communication Technology devices (ICT) has spread globally; therefore, increasing exposure to these display devices is an important health issue in the workplace. The association between ocular axial length (AL) elongation and ICT use was investigated among 7334 middle-aged Japanese male workers. Detailed ICT use information was obtained using a self-administered questionnaire. The high AL group was defined as the group with AL above the 75th percentile for each 5-year age interval. Logistic analysis showed that the odds ratio (OR) for the high AL group of >8 hours/day, adjusted for potent confounding factors, was significantly elevated relative to <1 hour/day. Notably, there was a strong association in the older groups (OR = 6.60, 95% CI = 3.92–11.12), based on work-related uses: word processing, sending e-mails, preparation of presentation materials, and browsing websites. In addition, among workers with extended ICT use for these work-related purposes, a significant lateral difference was observed in AL. However, these associations were not observed for private use, such as playing games. The results of our prospective cross-sectional study show that increased time spent on work-related ICT uses was associated with AL elongation, particularly in older workers.
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Affiliation(s)
- Toru Honda
- Hitachi Health Care Center, Ibaraki, Japan.,Department of Health Policy and Management, University of Occupational and Environmental Health, Kitakyushu, Japan
| | | | | | | | - Tadashi Nakano
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Seichi Horie
- Department of Health Policy and Management, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Masayuki Tatemichi
- Department of Preventive Medicine, Tokai University, School of Medicine, Kanagawa, Japan.
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26
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Nwanaji-Enwerem JC, Wang W, Nwanaji-Enwerem O, Vokonas P, Baccarelli A, Weisskopf M, Herndon LW, Wiggs JL, Park SK, Schwartz J. Association of Long-term Ambient Black Carbon Exposure and Oxidative Stress Allelic Variants With Intraocular Pressure in Older Men. JAMA Ophthalmol 2019; 137:129-137. [PMID: 30419128 DOI: 10.1001/jamaophthalmol.2018.5313] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Importance Elevated intraocular pressure is a major risk factor for glaucoma, a leading cause of irreversible blindness worldwide. Environmental air pollution has been suggested as a potential contributor to elevated intraocular pressure; however, no studies have demonstrated such an association to date. Objective To investigate the association of long-term ambient black carbon exposure with intraocular pressure in community-dwelling older adults. Design, Setting, and Participants This population-based analysis, conducted from October 18, 2017, through March 22, 2018, used data from the all-male, New England-based Normative Aging Study of the US Department of Veterans Affairs. The analysis included 419 older men with a total of 911 follow-up study visits between January 1, 2000, and December 30, 2011. Intraocular pressure was measured by Goldmann applanation tonometry during the study visits. Validated spatiotemporal models were used to generate 1-year black carbon exposure levels at the addresses of the participants. Main Outcomes and Measures An independently developed genetic score approach was used to calculate allelic risk scores for 3 pathways associated with black carbon toxicity: endothelial function, oxidative stress, and metal processing. The associations among black carbon exposure, allelic risk scores, and intraocular pressure were explored using linear mixed-effects models. Results All 419 participants were men with a mean (SD) age of 75.3 (6.9) years. The mean (SD) 1-year black carbon exposure was 0.51 (0.18) μg/m3, and the mean (SD) intraocular pressure for the left eye was 14.1 (2.8) mm Hg and for the right eye was 14.1 (3.0) mm Hg. Of the 911 visits, 520 (57.1%) had a high endothelial function allelic risk score, 644 (70.7%) had a high metal-processing allelic risk score, and 623 (68.4%) had a high oxidative stress allelic risk score. In fully adjusted linear mixed-effects models, the association of black carbon with intraocular pressure was greater in individuals with a high oxidative stress allelic score (β = 0.36; 95% CI, 0.003-0.73) compared with individuals with a low score (β = -0.35; 95% CI, -0.86 to 0.15). Conclusions and Relevance Ambient black carbon exposure may be a risk factor for increased intraocular pressure in individuals susceptible to other biological oxidative stressors. If additional studies confirm these results, monitoring ambient black carbon exposure and physiological oxidative stress may prevent the development and progression of intraocular pressure-related disease.
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Affiliation(s)
- Jamaji C Nwanaji-Enwerem
- Department of Environmental Health, Harvard T. H. Chan School of Public Health and MD-PhD Program, Harvard Medical School, Boston, Massachusetts
| | - Weiye Wang
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | | | - Pantel Vokonas
- VA Normative Aging Study, Veterans Affairs Boston Healthcare System, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Andrea Baccarelli
- Department of Environmental Health Sciences, Columbia Mailman School of Public Health, New York, New York
| | - Marc Weisskopf
- Department of Environmental Health and Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Leon W Herndon
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Janey L Wiggs
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston
| | - Sung Kyun Park
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor.,Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor
| | - Joel Schwartz
- Department of Environmental Health and Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
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Laville V, Kang JH, Cousins CC, Iglesias AI, Nagy R, Cooke Bailey JN, Igo RP, Song YE, Chasman DI, Christen WG, Kraft P, Rosner BA, Hu F, Wilson JF, Gharahkhani P, Hewitt AW, Mackey DA, Hysi PG, Hammond CJ, vanDuijn CM, Haines JL, Vitart V, Fingert JH, Hauser MA, Aschard H, Wiggs JL, Khawaja AP, MacGregor S, Pasquale LR. Genetic Correlations Between Diabetes and Glaucoma: An Analysis of Continuous and Dichotomous Phenotypes. Am J Ophthalmol 2019; 206:245-255. [PMID: 31121135 PMCID: PMC6864262 DOI: 10.1016/j.ajo.2019.05.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 05/03/2019] [Accepted: 05/09/2019] [Indexed: 01/05/2023]
Abstract
PURPOSE A genetic correlation is the proportion of phenotypic variance between traits that is shared on a genetic basis. Here we explore genetic correlations between diabetes- and glaucoma-related traits. DESIGN Cross-sectional study. METHODS We assembled genome-wide association study summary statistics from European-derived participants regarding diabetes-related traits like fasting blood sugar (FBS) and type 2 diabetes (T2D) and glaucoma-related traits (intraocular pressure [IOP], central corneal thickness [CCT], corneal hysteresis [CH], corneal resistance factor [CRF], cup-to-disc ratio [CDR], and primary open-angle glaucoma [POAG]). We included data from the National Eye Institute Glaucoma Human Genetics Collaboration Heritable Overall Operational Database, the UK Biobank, and the International Glaucoma Genetics Consortium. We calculated genetic correlation (rg) between traits using linkage disequilibrium score regression. We also calculated genetic correlations between IOP, CCT, and select diabetes-related traits based on individual level phenotype data in 2 Northern European population-based samples using pedigree information and Sequential Oligogenic Linkage Analysis Routines. RESULTS Overall, there was little rg between diabetes- and glaucoma-related traits. Specifically, we found a nonsignificant negative correlation between T2D and POAG (rg = -0.14; P = .16). Using Sequential Oligogenic Linkage Analysis Routines, the genetic correlations between measured IOP, CCT, FBS, fasting insulin, and hemoglobin A1c were null. In contrast, genetic correlations between IOP and POAG (rg ≥ 0.45; P ≤ 3.0 × 10-4) and between CDR and POAG were high (rg = 0.57; P = 2.8 × 10-10). However, genetic correlations between corneal properties (CCT, CRF, and CH) and POAG were low (rg range -0.18 to 0.11) and nonsignificant (P ≥ .07). CONCLUSION These analyses suggest that there is limited genetic correlation between diabetes- and glaucoma-related traits.
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Affiliation(s)
- Vincent Laville
- Department of Computational Biology, Institut Pasteur, Paris, France
| | - Jae H Kang
- Channing Division of Network Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Clara C Cousins
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Adriana I Iglesias
- Departments of Ophthalmology and Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Réka Nagy
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Jessica N Cooke Bailey
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA; Institute for Computational Biology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Robert P Igo
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Yeunjoo E Song
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA; Institute for Computational Biology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Daniel I Chasman
- Division of Preventive Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - William G Christen
- Division of Preventive Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Peter Kraft
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard Medical School, Boston, Massachusetts, USA; Department of Biostatistics, Harvard T. H. Chan School of Public Health, Harvard Medical School, Boston, Massachusetts, USA
| | - Bernard A Rosner
- Channing Division of Network Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Biostatistics, Harvard T. H. Chan School of Public Health, Harvard Medical School, Boston, Massachusetts, USA
| | - Frank Hu
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard Medical School, Boston, Massachusetts, USA; Department of Nutrition, Harvard T. H. Chan School of Public Health, Harvard Medical School, Boston, Massachusetts, USA
| | - James F Wilson
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom; Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Puya Gharahkhani
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Alex W Hewitt
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia; School of Medicine, Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - David A Mackey
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia
| | - Pirro G Hysi
- Department of Twin Research and Genetic Epidemiology, King's College London, United Kingdom
| | - Christopher J Hammond
- Department of Twin Research and Genetic Epidemiology, King's College London, United Kingdom
| | - Cornelia M vanDuijn
- Departments of Ophthalmology and Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands; Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Jonathan L Haines
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA; Institute for Computational Biology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Veronique Vitart
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - John H Fingert
- Department of Ophthalmology and Visual Science, University of Iowa, Iowa City, Iowa, USA
| | - Michael A Hauser
- Departments of Ophthalmology and Medicine, Duke University, Durham, North Carolina, USA
| | - Hugues Aschard
- Department of Computational Biology, Institut Pasteur, Paris, France; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard Medical School, Boston, Massachusetts, USA
| | - Janey L Wiggs
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Anthony P Khawaja
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Stuart MacGregor
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Louis R Pasquale
- Channing Division of Network Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
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Bertaud S, Aragno V, Baudouin C, Labbé A. [Primary open-angle glaucoma]. Rev Med Interne 2018; 40:445-452. [PMID: 30594326 DOI: 10.1016/j.revmed.2018.12.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 11/26/2018] [Accepted: 12/04/2018] [Indexed: 11/18/2022]
Abstract
Primary open-angle glaucoma is a progressive chronic optic neuropathy, typically bilateral, that occurs after the age of 40 years. It is the second leading cause of irreversible blindness in the world. Primary open-angle glaucoma corresponds to a progressive loss of retinal ganglion cell characterized by an excavation of the optic disc associated with typical visual field defects. Elevated intraocular pressure is the main risk factor of primary open-angle glaucoma. Diagnosis and monitoring of primary open-angle glaucoma arebased on both analysis of structural alteration, by clinical examination of optic disc completed by imaging tests (Ocular Coherence Tomography), and functional alterations, by visual field tests. The only effective treatment to slow primary open-angle glaucoma progression is the reduction of the intraocular pressure with anti-glaucomatous eye drops, laser or surgical treatments.
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Affiliation(s)
- S Bertaud
- Service d'ophtalmologie, hôpital Ambroise-Paré, AP-HP, 9, avenue Charles-De-Gaulle, 92100 Boulogne-Billancourt, France.
| | - V Aragno
- Service d'ophtalmologie, hôpital Ambroise-Paré, AP-HP, 9, avenue Charles-De-Gaulle, 92100 Boulogne-Billancourt, France; Service d'ophtalmologie 3, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; CNRS, UMR 7210, Inserm, U968, 75012 Paris, UMR S 968, Sorbonne Universités, institut de la Vision, 75012 Paris, France
| | - C Baudouin
- Service d'ophtalmologie, hôpital Ambroise-Paré, AP-HP, 9, avenue Charles-De-Gaulle, 92100 Boulogne-Billancourt, France; Université de Versailles Saint-Quentin-en-Yvelines, 78000 Saint-Quentin-en-Yvelines, France; Service d'ophtalmologie 3, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; CNRS, UMR 7210, Inserm, U968, 75012 Paris, UMR S 968, Sorbonne Universités, institut de la Vision, 75012 Paris, France
| | - A Labbé
- Service d'ophtalmologie, hôpital Ambroise-Paré, AP-HP, 9, avenue Charles-De-Gaulle, 92100 Boulogne-Billancourt, France; Université de Versailles Saint-Quentin-en-Yvelines, 78000 Saint-Quentin-en-Yvelines, France; Service d'ophtalmologie 3, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; CNRS, UMR 7210, Inserm, U968, 75012 Paris, UMR S 968, Sorbonne Universités, institut de la Vision, 75012 Paris, France
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30
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Hou H, Shoji T, Zangwill LM, Moghimi S, Saunders LJ, Hasenstab K, Ghahari E, Manalastas PIC, Akagi T, Christopher M, Penteado RC, Weinreb RN. Progression of Primary Open-Angle Glaucoma in Diabetic and Nondiabetic Patients. Am J Ophthalmol 2018; 189:1-9. [PMID: 29447914 DOI: 10.1016/j.ajo.2018.02.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/31/2018] [Accepted: 02/03/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the rates of visual field (VF) loss and retinal nerve fiber layer (RNFL) thinning in primary open-angle glaucoma (POAG) patients with or without type 2 diabetes mellitus (DM). DESIGN Cohort study. METHODS A total of 197 eyes (55 eyes of 32 POAG patients with DM in POAG/DM group and 142 eyes of 111 age-matched POAG patients without DM in POAG/DM- group) were included from the Diagnostic Innovations in Glaucoma Study (DIGS). Type 2 DM participants were defined by self-report of DM history and use of antidiabetic medication. The rates of VF loss and RNFL loss were compared in POAG eyes with and without DM using univariate and multivariable mixed-effects models. RESULTS The median (interquartile range) follow-up was 5.7 years (4.0, 6.4). The mean rate of global RNFL loss in the POAG/DM group was 2-fold slower than in the POAG/DM- group overall (-0.40 μm/year vs -0.83 μm/year, respectively P = .01). Although a slower rate of VF mean deviation and pattern standard deviation loss was found in the POAG/DM group compared to the POAG/DM- group, the difference was not statistically significant. CONCLUSIONS POAG patients with treated type 2 DM, who had no detectable diabetic retinopathy, had significantly slower rates of RNFL thinning compared to those without diagnosed DM.
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31
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Shiga Y, Akiyama M, Nishiguchi KM, Sato K, Shimozawa N, Takahashi A, Momozawa Y, Hirata M, Matsuda K, Yamaji T, Iwasaki M, Tsugane S, Oze I, Mikami H, Naito M, Wakai K, Yoshikawa M, Miyake M, Yamashiro K, Kashiwagi K, Iwata T, Mabuchi F, Takamoto M, Ozaki M, Kawase K, Aihara M, Araie M, Yamamoto T, Kiuchi Y, Nakamura M, Ikeda Y, Sonoda KH, Ishibashi T, Nitta K, Iwase A, Shirato S, Oka Y, Satoh M, Sasaki M, Fuse N, Suzuki Y, Cheng CY, Khor CC, Baskaran M, Perera S, Aung T, Vithana EN, Cooke Bailey JN, Kang JH, Pasquale LR, Haines JL, Wiggs JL, Burdon KP, Gharahkhani P, Hewitt AW, Mackey DA, MacGregor S, Craig JE, Allingham RR, Hauser M, Ashaye A, Budenz DL, Akafo S, Williams SEI, Kamatani Y, Nakazawa T, Kubo M. Genome-wide association study identifies seven novel susceptibility loci for primary open-angle glaucoma. Hum Mol Genet 2018; 27:1486-1496. [PMID: 29452408 PMCID: PMC6251544 DOI: 10.1093/hmg/ddy053] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 01/16/2018] [Accepted: 01/17/2018] [Indexed: 11/12/2022] Open
Abstract
Primary open-angle glaucoma (POAG) is the leading cause of irreversible blindness worldwide for which 15 disease-associated loci had been discovered. Among them, only 5 loci have been associated with POAG in Asians. We carried out a genome-wide association study and a replication study that included a total of 7378 POAG cases and 36 385 controls from a Japanese population. After combining the genome-wide association study and the two replication sets, we identified 11 POAG-associated loci, including 4 known (CDKN2B-AS1, ABCA1, SIX6 and AFAP1) and 7 novel loci (FNDC3B, ANKRD55-MAP3K1, LMX1B, LHPP, HMGA2, MEIS2 and LOXL1) at a genome-wide significance level (P < 5.0×10-8), bringing the total number of POAG-susceptibility loci to 22. The 7 novel variants were subsequently evaluated in a multiethnic population comprising non-Japanese East Asians (1008 cases, 591 controls), Europeans (5008 cases, 35 472 controls) and Africans (2341 cases, 2037 controls). The candidate genes located within the new loci were related to ocular development (LMX1B, HMGA2 and MAP3K1) and glaucoma-related phenotypes (FNDC3B, LMX1B and LOXL1). Pathway analysis suggested epidermal growth factor receptor signaling might be involved in POAG pathogenesis. Genetic correlation analysis revealed the relationships between POAG and systemic diseases, including type 2 diabetes and cardiovascular diseases. These results improve our understanding of the genetic factors that affect the risk of developing POAG and provide new insight into the genetic architecture of POAG in Asians.
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Affiliation(s)
- Yukihiro Shiga
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Masato Akiyama
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Koji M Nishiguchi
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
- Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Kota Sato
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
- Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Nobuhiro Shimozawa
- Tsukuba Primate Research Center, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki, Japan
| | - Atsushi Takahashi
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Omics Research Center, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yukihide Momozawa
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Makoto Hirata
- Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Koichi Matsuda
- Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
| | - Taiki Yamaji
- Division of Epidemiology, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Motoki Iwasaki
- Division of Epidemiology, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Shoichiro Tsugane
- Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Isao Oze
- Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Haruo Mikami
- Cancer Prevention Center, Chiba Cancer Center Research Institute, Chiba, Japan
| | - Mariko Naito
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Munemitsu Yoshikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masahiro Miyake
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kenji Yamashiro
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Ophthalmology, Otsu Red-Cross Hospital, Otsu, Japan
| | | | - Kenji Kashiwagi
- Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Takeshi Iwata
- Division of Molecular and Cellular Biology, National Institute of Sensory Organs, Tokyo Medical Center, National Hospital Organization, Tokyo, Japan
| | - Fumihiko Mabuchi
- Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | | | - Mineo Ozaki
- Ozaki Eye Hospital, Hyuga, Miyazaki, Japan
- Department of Ophthalmology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Kazuhide Kawase
- Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Makoto Aihara
- Department of Ophthalmology, University of Tokyo, Tokyo, Japan
| | - Makoto Araie
- Kanto Central Hospital of the Mutual Aid Association of Public School Teachers, Tokyo, Japan
| | - Tetsuya Yamamoto
- Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Sciences, Hiroshima University, Hiroshima, Japan
| | - Makoto Nakamura
- Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yasuhiro Ikeda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koh-Hei Sonoda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tatsuro Ishibashi
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Nitta
- Fukuiken Saiseikai Hospital, Fukui, Japan
| | | | | | | | - Mamoru Satoh
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Iwate, Japan
| | - Makoto Sasaki
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Iwate, Japan
| | - Nobuo Fuse
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Miyagi, Japan
| | - Yoichi Suzuki
- Department of Education and Training, Tohoku Medical Megabank Organization, Miyagi, Japan
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Mani Baskaran
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Shamira Perera
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Eranga N Vithana
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Jessica N Cooke Bailey
- Department of Population and Quantitative Health Sciences, Institute for Computational Biology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Jae H Kang
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Louis R Pasquale
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Jonathan L Haines
- Department of Population and Quantitative Health Sciences, Institute for Computational Biology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Janey L Wiggs
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Kathryn P Burdon
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
- Department of Ophthalmology, Flinders University, Adelaide, SA, Australia
| | - Puya Gharahkhani
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Alex W Hewitt
- Centre for Eye Research Australia, University of Melbourne, Melbourne, VIC, Australia
- Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - David A Mackey
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth, WA, Australia
| | - Stuart MacGregor
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders University, Adelaide, SA, Australia
| | | | | | - Adeyinka Ashaye
- Department of Ophthalmology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Donald L Budenz
- Department of Ophthalmology, University of North Carolina at Chapel Hill, USA
| | - Stephan Akafo
- University of Ghana School of Medicine and Dentistry, Ghana
| | - Susan E I Williams
- Division of Ophthalmology, Department of Neurosciences, University of the Witwatersrand, South Africa
| | - Yoichiro Kamatani
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
- Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan
- Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Michiaki Kubo
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
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Jung I, Kwon JW, Choi JA, Jee D. Association between Psychological Stress and Glaucoma: Korea National Health and Nutritional Examination Survey 2008–2012. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.8.745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Ilyung Jung
- Department of Ophthalmology and Visual Science, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Jin Woo Kwon
- Department of Ophthalmology and Visual Science, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Jin A Choi
- Department of Ophthalmology and Visual Science, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Donghyun Jee
- Department of Ophthalmology and Visual Science, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
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33
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Nakano T, Hayashi T, Nakagawa T, Honda T, Owada S, Endo H, Tatemichi M. Increased Incidence of Visual Field Abnormalities as Determined by Frequency Doubling Technology Perimetry in High Computer Users Among Japanese Workers: A Retrospective Cohort Study. J Epidemiol 2017; 28:214-219. [PMID: 29176274 PMCID: PMC5865013 DOI: 10.2188/jea.je20170004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background This retrospective cohort study primarily aimed to investigate the possible association of computer use with visual field abnormalities (VFA) among Japanese workers. Methods The study included 2,377 workers (mean age 45.7 [standard deviation, 8.3] years; 2,229 men and 148 women) who initially exhibited no VFA during frequency doubling technology perimetry (FDT) testing. Subjects then underwent annual follow-up FDT testing for 7 years, and VFA were determined using a FDT-test protocol (FDT-VFA). Subjects with FDT-VFA were examined by ophthalmologists. Baseline data about the mean duration of computer use during a 5-year period and refractive errors were obtained via self-administered questionnaire and evaluations for refractive errors (use of eyeglasses or contact lenses), respectively. Results A Cox proportional hazard analysis demonstrated that heavy computer users (>8 hr/day) had a significantly increased risk of FDT-VFA (hazard ratio [HR] 2.85; 95% confidence interval [CI], 1.26–6.48) relative to light users (<4 hr/day), and this association was strengthened among subjects with refractive errors (HR 4.48; 95% CI, 1.87–10.74). The computer usage history also significantly correlated with FDT-VFA among subject with refractive errors (P < 0.05), and 73.1% of subjects with FDT-VFA and refractive errors were diagnosed with glaucoma or ocular hypertension. Conclusions The incidence of FDT-VFA appears to be increased among Japanese workers who are heavy computer users, particularly if they have refractive errors. Further investigations of epidemiology and causality are warranted.
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Affiliation(s)
- Tadashi Nakano
- Department of Ophthalmology, The Jikei University School of Medicine
| | | | | | | | - Satoshi Owada
- Department of Preventive Medicine, Tokai University, School of Medicine
| | - Hitoshi Endo
- Department of Preventive Medicine, Tokai University, School of Medicine
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34
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Kim HA, Han K, Lee YA, Choi JA, Park YM. Differential Association of Metabolic Risk Factors with Open Angle Glaucoma according to Obesity in a Korean Population. Sci Rep 2016; 6:38283. [PMID: 28004731 PMCID: PMC5177911 DOI: 10.1038/srep38283] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 11/07/2016] [Indexed: 12/24/2022] Open
Abstract
The associations of the metabolic syndrome (MetS) with intraocular pressure and primary open angle glaucoma (OAG) have been reported. This study aimed to determine whether a difference in association exists between OAG and metabolic risk factors according to obesity status among Korean adults. A total of 8,816 participants (≥40 years) in the Korea National Health and Nutrition Examination Survey were classified into obese, body mass index (BMI) ≥ 25 kg/m2 and non-obese, BMI < 25 kg/m2. The prevalence of MetS was 40.1% in non-obese OAG and 66.0% in obese OAG. The prevalence of OAG increased with increasing number components for MetS in total population and in non-obese subjects (P < 0.001, respectively), while the prevalence of OAG was not associated with number of components for MetS in obese subjects (P = 0.14). In non-obese individuals, subjects with high triglycerides, high blood pressure (BP), and MetS were more likely to have OAG compared with those without high triglycerides, high BP, and MetS after adjusting for potential confounders. However, MetS or its components exhibited no significant association with glaucoma status in obese individuals. Our study provides understanding on the differences in association of OAG with MetS and its components according to obesity status.
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Affiliation(s)
- Hyun-Ah Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yun-Ah Lee
- Department of Family Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin A Choi
- Department of Ophthalmology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong-Moon Park
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
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