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Aderounmu AB, Ademola-Popoola DS, Olatunji FO, Yusuf IA. Twenty-Four-Hour Intraocular Pressure Pattern In Glaucoma Suspects in an African Population. J Glaucoma 2023; 32:1058-1063. [PMID: 37851967 DOI: 10.1097/ijg.0000000000002313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 09/18/2023] [Indexed: 10/20/2023]
Abstract
PRCIS Twenty-four-hour intraocular pressure measurement (Phasing) among glaucoma suspects showed higher intraocular pressure (IOP), greater fluctuation, and more varying peak times occurring mostly outside clinic hours, between 12 midnight and 8 am in 68.9% of them. PURPOSE To characterise 24-hour variation in IOP, in glaucoma suspects and normal individuals in an African population. MATERIALS AND METHODS A cross-sectional analytical study was carried out between March and October 2019 at the University of Ilorin Teaching Hospital. A total of 204 study participants, comprising 102 primary open angle glaucoma (POAG) suspects and 102 age and sex-matched controls with healthy eyes were recruited. Participants had a comprehensive ophthalmic examination. Measurements of IOP were taken every 2 hours during a 24-hour period using an iCare tonometer. RESULTS The mean age was 43.64±14.02 SD and 43.02±13.55 SD ( P =1.000) for POAG suspects and controls, respectively. The mean peak IOP was significantly higher in POAG suspects (21.87± 4.65 mm Hg) compared with controls (17.17± 2.32 mm Hg) ( P <0.001). Whereas, the mean trough IOP reading was not significantly different between the 2 groups. In both groups of participants, the peak and trough IOP in the majority were recorded outside of clinic hours. The majority (68.9%) of POAG suspects had a peak IOP between midnight and 8 am, whereas the control group peaked mostly at 4 pm (16.7%) and 4 am (41.7%). Twenty-four-hour IOP variation was 6 mm Hg or less in 73.6% of control eyes, while in the POAG suspects, 83.3% of eyes had variation greater than 6 mm Hg. CONCLUSIONS Compared with age and sex-matched healthy controls, glaucoma suspects of African descent showed significantly higher mean IOP and IOP variation, with most peak IOP detected outside of clinic hours.
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Affiliation(s)
- Azeezat B Aderounmu
- Department of Ophthalmology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Dupe S Ademola-Popoola
- Department of Ophthalmology, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Fatai O Olatunji
- Department of Ophthalmology, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Ibrahim A Yusuf
- Department of Ophthalmology, Federal Medical Center, Abeokuta, Nigeria
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Uche NJ, Okoye O, Kizor-Akaraiwe N, Chuka-Okosa C, Uche EO. Determinants of participation in glaucoma genomic research in South East Nigeria: A cross-sectional analytical study. PLoS One 2023; 18:e0289643. [PMID: 37976286 PMCID: PMC10655997 DOI: 10.1371/journal.pone.0289643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 07/21/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Genomic research advances the understanding of human health and disease. It also drives both the discovery of salient genetic association(s) as well as targeted screening, diagnostic and therapeutic strategies. Human subject participation is crucial for the success of genomic research. METHODS This is a cross sectional analytical study conducted at two tertiary centers in Enugu Southeast Nigeria. Semi structured questionnaires were administered to eligible consenting participants. Data on their demographics, willingness to participate in genomic research and motivation for participation were obtained. Data was analyzed using Stata version 17 and summarized using median, frequencies and interquartile range(IQR). Associations between covariates were evaluated with Chi square test and multivariable logistic regression. RESULTS Among 228 glaucoma subjects who participated in our study,119(52.2%) were female and 109(47.8%) were male. The median age was 64 years(IQR = 50-76). Although 219 (96.0%) participants expressed willingness to participate in a glaucoma genetic study, only 27(11.9%) of them will be willing to participate if there will not be feedback of results to participants (χ2 = 18.59, P<0.001). No participant expressed willingness to submit ocular tissue samples. Majority (96.2%) of subjects will not participate if the intended research required submission of body samples after death. Desire to know more about glaucoma (63%) was the most common reason for participation. In a multivariable logistic model, subjects between 61-90 years (p = 0.004, OR = 7.2) were 7 times more likely to express willingness to participate in glaucoma genetic research after adjusting for other covariates when compared to subjects aged 41-60 years. Other covariates did not influence participants' willingness. CONCLUSION Glaucoma subjects are more likely to be willing to participate in genetic research, if they would receive feedback of results. Willingness to participate in genetic research is significantly associated with age. LIMITATIONS We did not evaluate the salient options for feedback of results to participants in our study.
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Affiliation(s)
- Nkechinyere J. Uche
- Department of Ophthalmology, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
| | - Onochie Okoye
- Department of Ophthalmology, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
| | | | - Chimdi Chuka-Okosa
- Department of Ophthalmology, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
| | - Enoch O. Uche
- Department of Surgery, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
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Lai ACK, Buchan JC, Chan JCH, Nolan W. Determinants of late presentation of glaucoma in Hong Kong. Eye (Lond) 2023; 37:1717-1724. [PMID: 36100709 PMCID: PMC10219946 DOI: 10.1038/s41433-022-02235-8] [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: 11/04/2021] [Revised: 07/29/2022] [Accepted: 09/01/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Glaucoma is the commonest cause of irreversible blindness worldwide. As it is typically asymptomatic until advanced, the risk of blindness from late presentation is higher than other eye diseases. This study aims to investigate the risk factors for late presentation of primary glaucoma patients. METHODS We undertook a hospital-based case-control study of a random sample of glaucoma patients from a hospital in Hong Kong. Structured questionnaires and existing information from the electronic patient record were used, and the odds of presenting late were analysed by logistic regression. RESULTS Of 210 recruited participants, 83 (39.5%) presented with advanced glaucoma unilaterally or bilaterally. The mean age of participants was 61.1 ± 11.9 years, with 110 males (52.4%). Univariate analysis revealed that male sex and primary angle-closure glaucoma (PACG) have 3.06 (CI95:1.71-5.48; P < 0.001) and 2.47 (CI95:1.11-5.49; P = 0.03) times higher odds of late presentation, respectively. Multivariate analysis revealed late presenters were 3.54 (CI95:1.35-9.35; P = 0.01) times more likely to have PACG than primary open-angle glaucoma (POAG). Patients with elevated baseline intraocular pressure (IOP) also had 1.06 times higher odds of presenting with advanced glaucoma (CI95:1.02-1.11; P = 0.002). Linear regression revealed that PACG patients present with 7.12 mmHg higher IOP than POAG patients (CI95:4.23-10.0; P < 0.001). CONCLUSION In conclusion, a high proportion of glaucoma patients present late in Hong Kong, with gender and type of glaucoma being significant determinants. Our study shows that PACG presents with higher IOP and, along with male gender, are more likely to have advanced disease than POAG.
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Affiliation(s)
- Anakin Chu Kwan Lai
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK.
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China.
| | - John C Buchan
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Jonathan Cheuk-Hung Chan
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Winifred Nolan
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
- NIHR Biomedical Research Centre, Moorfields and UCL Institute of Ophthalmology, London, UK
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Oluwaniyi AT, Olawoye O, Sarimiye TF, Ajayi BGK. Comparison of Ocular Biomery in Primary Open Angle Glaucoma and Non-glaucoma in South West Nigeria. JOURNAL OF THE WEST AFRICAN COLLEGE OF SURGEONS 2023; 13:37-44. [PMID: 37228875 PMCID: PMC10204919 DOI: 10.4103/jwas.jwas_264_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 12/05/2022] [Indexed: 05/27/2023]
Abstract
Background Glaucoma is a public health problem in Nigeria. The number of individuals affected by glaucoma in Nigeria is much higher than the individuals known to have the disease. Ocular parameters such as intraocular pressure, central cornea thickness, axial length and refractive error have all been documented as risk factors of glaucoma especially among Caucasians and African Americans, with little documentation in Africa where there's an alarming rate of blindness. Aim and Objectives To compare central cornea thickness (CCT), intraocular pressure (IOP), axial length (AL) and refractive state in participants with primary open angle glaucoma (POAG) and non-glaucoma in South-West Nigeria. Materials and Methods This hospital-based case-control study was carried out among 184 newly diagnosed POAG and non-glaucoma adult participants attending the outpatient clinic of Eleta eye institute. The CCT, IOP, AL and refractive state were measured in each participant. Test of significance between proportions in categorical variables were assessed using chi square test (χ2) in both groups. The means were compared using independent t-test while correlation between parameters were analyzed using Pearson correlation coefficient. Results The mean age of the POAG participants was 57.16 + 13.3 years and the mean age of the non-glaucoma participants was 54.15 + 13.4 years. The mean IOP in the POAG group was 30.2 + 8.9mmHg while non- glaucoma group was 14.2 + 2.6mmHg (P < 0.001), other ocular parameters were not significantly different in both groups. In the POAG group, decreased spherical equivalent refractive error (i.e increasing myopia) was significantly associated with increased axial length (r= -0.252, P = 0.01), but not significant in the non- glaucoma group. However, in the non-glaucoma group, central cornea thickness increased with increasing intraocular pressure (r= 0.305, P = 0.003), which was not significant in the glaucoma group. Conclusion Patients with POAG had much higher IOP and thus, IOP remains a significant risk factor in its development. There was a significant relationship between refractive state and axial length in the POAG group while a significant relationship was identified between central cornea thickness and intraocular pressure in the non- glaucoma group.
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Affiliation(s)
| | - Olusola Olawoye
- Department of Ophthalmology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | | | - B. G. K. Ajayi
- Eleta Eye Institute, Olomi Academy, Ibadan, Oyo State, Nigeria
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Olawoye OO, Fawole O, Ashaye AO, Chan VF, Azuara-Blanco A, Congdon N. Effectiveness of community outreach screening for glaucoma in improving equity and access to eye care in Nigeria. Br J Ophthalmol 2023; 107:30-36. [PMID: 34362773 DOI: 10.1136/bjophthalmol-2021-319355] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/23/2021] [Indexed: 11/04/2022]
Abstract
PURPOSE To determine the effectiveness of community outreach screening for glaucoma in improving equity and access to eye care in Nigeria. METHODOLOGY This was a prospective study in which two cohort of participants were recruited in Nigeria: 1 from 24 outreach screenings and another from consecutive patients presenting spontaneously to a tertiary eye clinic in Nigeria. Sociodemographic and clinical data were obtained from participants and compared. RESULTS Our sample consisted of 120 patients with glaucoma or suspected glaucoma (6.38% of 1881 screenees) recruited from the 24 outreach screenings, and another 123 patients with glaucoma who presented spontaneously at the eye clinic. Participants from the screenings were significantly older (p=0.012), less educated (p<0.001), had lower incomes (p<0.001), lower glaucoma knowledge scores and were less aware of their glaucoma (both p<0.001) and were more likely to be dependent on relations and children (p=0.002) compared with clinic participants. Of the 120 patients identified at the screenings and referred to the clinic for definitive care, 39 (32.5%) presented at the clinic within 3 months. Reasons for poor uptake of referral services were lack of a felt need and lack of money for transportation. Considering only patients who accepted referral, they were still less educated (p<0.001), poorer (p=0.001) and less knowledgeable about glaucoma (p=0.003) than spontaneous clinic presenters. CONCLUSION Outreach screening improved equity of access but its effects were somewhat reduced by poor uptake of referral care. Interventions such as free transportation and educational efforts may improve the uptake of referral services and maximise equity gains.
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Affiliation(s)
- Olusola Oluyinka Olawoye
- Department of Ophthalmology, University of Ibadan College of Medicine, Ibadan, Oyo, Nigeria .,Centre for Public Health School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Olufunmilayo Fawole
- Department of Epidemiology and Medical Biostatistics, University of Ibadan College of Medicine, Ibadan, Oyo, Nigeria
| | - Adeyinka O Ashaye
- Department of Ophthalmology, University of Ibadan College of Medicine, Ibadan, Oyo, Nigeria
| | - Ving Fai Chan
- Centre for Public Health School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Augusto Azuara-Blanco
- Centre for Public Health School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Nathan Congdon
- Centre for Public Health School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.,Preventive Ophthalmology, Zhongshan Ophthalmic Center, Guangdong, China.,Orbis International, New York, New York, USA
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Piyasena MP, Daka Q, Qureshi R, Li T, Takwoingi Y, Virgili G, Azuara-Blanco A. Prognostic factors for predicting progression of open angle glaucoma in adults. Hippokratia 2022. [PMCID: PMC9629823 DOI: 10.1002/14651858.cd015436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Qëndresë Daka
- University of Prishtina “Hasan Prishtina”; Prishtinë - Kosovo Other
| | - Riaz Qureshi
- Department of Ophthalmology; University of Colorado Anschutz Medical Campus; Denver Colorado USA
| | - Tianjing Li
- Department of Ophthalmology; University of Colorado Anschutz Medical Campus; Denver Colorado USA
| | - Yemisi Takwoingi
- Test Evaluation Research Group, Institute of Applied Health Research; University of Birmingham; Birmingham UK
| | - Gianni Virgili
- Centre for Public Health; Queen's University Belfast; Belfast - Northern Ireland UK
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Zhang L, Liu K, Nie F, Duan X. Research advance in optic disc tilt and rotation in high myopia and its implications for glaucoma and visual field defects. Eur J Ophthalmol 2021; 32:2505-2514. [PMID: 34859716 DOI: 10.1177/11206721211063716] [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
High myopia is of worldwide concern due to its high prevalence, and myopia is an independent risk factor for glaucoma. The purpose of this paper is to review the mechanism and clinical manifestations of optic disc tilt and rotation in high myopia and its relationship with glaucoma, to provide clues for monitoring fundus changes in high myopia and the early diagnosis of high myopia with glaucoma.
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Affiliation(s)
- Lurong Zhang
- Department of Ophthalmology, 70566The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ke Liu
- Department of Ophthalmology, 70566The Second Xiangya Hospital of Central South University, Changsha, China
| | - Fen Nie
- Department of Ophthalmology, 70566The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xuanchu Duan
- Department of Ophthalmology, 70566The Second Xiangya Hospital of Central South University, Changsha, China.,159368Central South University, Aier School of Ophthalmology, Aier Eye Hospital, Changsha, China
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Ezinne NE, Ojukwu CS, Ekemiri KK, Akano OF, Ekure E, Osuagwu UL. Prevalence and clinical profile of glaucoma patients in rural Nigeria-A hospital based study. PLoS One 2021; 16:e0260965. [PMID: 34855905 PMCID: PMC8639068 DOI: 10.1371/journal.pone.0260965] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/20/2021] [Indexed: 12/04/2022] Open
Abstract
Purpose To determine the prevalence and clinical presentation of participants with glaucoma attending a public eye care facility in Nigeria. Method Hospital based retrospective study of glaucoma participants aged 50 years and above seen over a 5-year period. Descriptive statistics summarized the demographic, clinical characteristics and treatment of the participants and determined the association of variables with gender and age. Prevalence of the glaucoma by type, and their 95% confidence intervals (CI) were also calculated. Result Of the 5482 case files that were reviewed, 995 (18.15%, 95% Cl 17.15–19.19%) had glaucoma particularly primary open angle glaucoma (11.55%, 95%CI 10.73–12.42%) and were mostly females (564, 56.7%) aged 69 ± 12 years (range, 50–103 years). In contrast to other glaucoma types, the prevalence of primary angle closure glaucoma (3.68, 95%CI 3.22–4.22) increased by 15% over 5 years. The mean intraocular pressure ranged from 15–50 mmHg but higher in females than males (27.8 ± 6.1mmHg versus 26.6 ± 6.0 mmHg, P <0.05) who had comparable VA (0.58 ± 0.4 Log MAR) and cup-disc ratios (P >0.05). On presentation, the glaucoma hemi field test (GHFT) was outside the normal limits in 45.5% and 54.5% of males and females, respectively. The type of visual field defect was associated with glaucoma type (P = 0.047). Arcuate scotoma was most common (35.5%) across glaucoma types, paracentral scotoma more common in Secondary glaucoma while Seidel scotoma was highest in NTG (19.3%). Beta-blocker was the mainstay of management (42.2%) but more likely to be prescribed to males while more females received carbonic anhydrase inhibitors. Conclusions The high prevalence of glaucoma in older people remains a public health problem in Nigeria. The fact that about half of the participants presented with visual field defect suggests there is a need for public health messages to emphasize on early glaucoma screening, detection and management.
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Affiliation(s)
- Ngozika E. Ezinne
- Department of Clinical Surgical Sciences, Optometry Unit, University of the West Indies, St Augustine Campus, Trinidad and Tobago
- Department of Optometry, Madonna University, Elele campus, Okija, Nigeria
| | - Chukwuebuka S. Ojukwu
- Department of Optometry, Madonna University, Elele campus, Okija, Nigeria
- Department of Public Health, Oxford Brookes University, Oxford, United Kingdom
| | - Kingsley K. Ekemiri
- Department of Clinical Surgical Sciences, Optometry Unit, University of the West Indies, St Augustine Campus, Trinidad and Tobago
| | - Obinna F. Akano
- I and Eye Optometry, Bronx, New York, New York, United States of America
| | - Edgar Ekure
- Department of Biomedicine, Salus University, Elkins Park, Pennsylvania, United States of America
| | - Uchechukwu Levi Osuagwu
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
- African Vision Research Institute, Discipline of Optometry, University of KwaZulu-Natal, Durban, South Africa
- * E-mail:
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Khan S, Kirubarajan A, Lee M, Pitha I, Buckey JC. The Correlation Between Body Weight and Intraocular Pressure. Aerosp Med Hum Perform 2021; 92:886-897. [PMID: 34819215 DOI: 10.3357/amhp.5769.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
INTRODUCTION: Preflight body weight is a strong predictor of visual changes in spaceflight. To understand the effect of body weight on the eye, we examined the effect of increased body mass index on intraocular pressure on Earth.METHODS: We conducted a systematic review to summarize the relationship between weight parameters (including body mass index (BMI) and obesity indices), and intraocular pressure (IOP). Study selection and data extraction were performed in duplicate using EMBASE, MEDLINE, and CENTRAL, from database inception to the second week of April 2020.RESULTS: A total of 66 individual studies were included for qualitative analysis from the 1364 studies eligible for title and abstract screening. A total of 39 studies were available for quantitative analysis. The average BMI was 25.9 (range, 20.148.8) and the average IOP was 14.9 mmHg (range, 11.627.8). The overall pooled RR between BMI and elevated intraocular pressure (IOP) was 1.06 (95 CI%, 1.041.07), meaning for each unit increase in BMI one is 6 more likely of having higher IOP than baseline. Two studies assessed the effects of bariatric surgery, and both showed significant decreases in IOP postoperatively.CONCLUSION: A higher BMI was associated with increased IOP in ground-based studies. IOP also decreased with weight loss. These data support the idea that alterations in body weight affect intraocular pressures. Further research is needed to understand the relationship between body weight, IOP, and microgravity-induced visual changes. This finding may also be useful clinically.Khan S, Kirubarajan A, Lee M, Pitha I, Buckey JC Jr. The correlation between body weight and intraocular pressure. Aerosp Med Hum Perform. 2021; 92(11):886-897.
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Nislawati R, Taufik Fadillah Zainal A, Ismail A, Waspodo N, Kasim F, Gunawan AMAK. Role of hypertension as a risk factor for open-angle glaucoma: a systematic review and meta-analysis. BMJ Open Ophthalmol 2021; 6:e000798. [PMID: 34632075 PMCID: PMC8479953 DOI: 10.1136/bmjophth-2021-000798] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/05/2021] [Indexed: 11/30/2022] Open
Abstract
Glaucoma is the leading cause of irreversible blindness. It is estimated that as many as 3.2 million people worldwide experience blindness due to glaucoma, including open-angle glaucoma (OAG). Until now, there is no definite mechanism related to the incidence of OAG. However, increased intraocular pressure (IOP) is considered to be the most important risk factor. Several current studies show that there is a significant relationship between hypertension (HTN) and IOP. In particular, several epidemiological studies have shown that an increase in systemic blood pressure (BP) is associated with an increase in IOP. However, several studies report that high BP provides a protective effect at a young age against the incidence of OAG. Therefore, this literature aims to explore the effect of HTN on the incidence of OAG. In this review, search for the literature using keywords that match the topic, then a gradual screening was carried out with the predetermined eligibility criteria. From 3711 studies, 16 studies matched the criteria having a total sample size of 72 212 and then a quantitative meta-analysis was conducted. The results showed a risk ratio of 1.69 (95% CI 1.50 to 1.90) in the HTN group. However, from our qualitative synthesis, we found that people who have an unstable diastolic blood pressure (DBP), either high or low, are both able to increase the risk of OAG events. In conclusion, we found that HTN was able to increase the risk of OAG and DBP instability, whether high or low, can also increase the risk of OAG incidence.
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Affiliation(s)
- Ririn Nislawati
- Department of Ophthalmology, Hasanuddin University, Makassar, Indonesia
| | | | - Abrar Ismail
- Department of Ophthalmology, Hasanuddin University, Makassar, Indonesia
| | - Noro Waspodo
- Department of Ophthalmology, Hasanuddin University, Makassar, Indonesia
| | - Firdaus Kasim
- Department of Community Medicine, Hasanuddin University, Makassar, Indonesia
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Li W, Pan J, Wei M, Lv Z, Chen S, Qin Y, Li N. Nonocular Influencing Factors for Primary Glaucoma: An Umbrella Review of Meta-Analysis. Ophthalmic Res 2021; 64:938-950. [PMID: 34517373 DOI: 10.1159/000519247] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 08/22/2021] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Glaucoma is the main cause of irreversible blindness worldwide. Still, little is known about nonocular risk factors. We use an umbrella review to examine the meta-analytic evidence of the correlation between nonocular factors and glaucoma. METHOD We searched PubMed and Embase databases up to July 24, 2020. Eligible meta-analyses (MAs) included cohort, case-control, and randomized controlled study designs. Two authors independently extracted the data and evaluated the methodological quality of the MAs. AMSTAR 2 was used to assess the methodological quality of each included MA. RESULTS This umbrella review contains 22 MAs with 22 unique nonocular factors in total. We identified 11 factors that increase the risk of glaucoma: hyperlipidemia, nocturnal dip in blood pressure, infection with Helicobacter pylori, myopia, obstructive sleep apnea syndrome, corneal properties, diabetes, hypertension, hypothyroidism, migraine, and plasma homocysteine. We identified 3 factors that reduce the risk of glaucoma: dietary intake of vitamin A, dietary intake of vitamin C, and short-term statin use. We identified 8 factors that had no association with glaucoma: dietary intake of vitamin B, dietary intake of vitamin E, cigarette smoking, Alzheimer's disease, serum folic acid, serum vitamin B6, serum vitamin B12, and serum vitamin D. CONCLUSIONS In this umbrella review of MAs, evidence was found for associations of various nonocular factors with glaucoma to different degrees. However, risk factors were only mildly associated, suggesting low impact of systemic risk factors. Additional higher quality studies are needed to provide robust evidence.
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Affiliation(s)
- Wenman Li
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China,
| | - Jiaxing Pan
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Maoling Wei
- The Center for Evidence-Based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhiqing Lv
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Sijie Chen
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Yang Qin
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Ni Li
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
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Ireka OJ, Ogbonnaya CE, Arinze OC, Ogbu N, Chuka-Okosa CM. Comparing posture induced intraocular pressure variations in normal subjects and glaucoma patients. Int J Ophthalmol 2021; 14:399-404. [PMID: 33747816 DOI: 10.18240/ijo.2021.03.11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/06/2020] [Indexed: 11/23/2022] Open
Abstract
AIM To compare the posture-induced variations in intraocular pressure (IOP) between the primary open angle glaucoma (POAG) and non-glaucomatous eyes. METHODS A case-controlled age matched study was conducted in 55 successive newly diagnosed POAG and 56 non-glaucomatous patients seen in glaucoma clinic and general outpatient eye clinic in the Alex Ekwueme University Teaching Hospital, Abakaliki. The IOPs of eligible correspondents were measured with Perkin's hand-held tonometer in the sitting, supine flat and supine with pillow positions respectively. Measurement of IOP in each position was done after 15min of assuming such posture. RESULTS The IOP difference between the sitting and supine flat position was significantly higher in the POAG than non-glaucoma subjects (7.68±2.08 vs 4.03±0.13 mm Hg, P<0.001). The IOP difference between the sitting and supine with pillow positions was 2.61±1.49 mm Hg for POAG and 1.44±0.70 mm Hg in non-glaucoma (P<0.001), while difference between supine flat and supine with pillow positions was 5.07±2.24 mm Hg in POAG and 2.59±0.66 mm Hg in non-glaucomatous patients (P<0.001). CONCLUSION Greater variations in posture induced IOP occurred in POAG patients than non-glaucomatous. The posture induced IOP variation is lowest in the sitting position and highest in the supine flat position. Evaluation of posture induced IOP changes may be an important tool in the management of glaucoma.
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Affiliation(s)
- Onyekachi Jane Ireka
- Department of Ophthalmology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State 48028, Nigeria
| | - Chimdia E Ogbonnaya
- Department of Ophthalmology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State 48028, Nigeria
| | - Obinna C Arinze
- Department of Ophthalmology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State 48028, Nigeria
| | - Nneka Ogbu
- Department of Ophthalmology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State 48028, Nigeria
| | - Chimdi M Chuka-Okosa
- Department of Ophthalmology, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu 01129, Nigeria
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13
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Yu L, Yang J. MiR-29 increases apoptosis of retinal ganglion cells in rat glaucoma model through AKT signaling pathway. Panminerva Med 2021; 63:90-91. [PMID: 31262145 DOI: 10.23736/s0031-0808.19.03670-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Li Yu
- Corneal and External Disease, Shenzhen Key Laboratory of Ophthalmology, Shenzhen Eye Hospital, School of Optometry, Jinan University, Shenzhen, China
- Corneal and External Disease, Shenzhen Key Laboratory of Ophthalmology, Shenzhen Eye Hospital, School of Optometry, Shenzhen University, Shenzhen, China
| | - Jie Yang
- Department of Ophthalmology, Hebei Medical University Affiliate Hospital, Shijiazhuang, China -
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14
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Gombe A, Kabiru I, Anas I, Adamu Y, Sadiq H. A comparative control study of ophthalmic artery Doppler velocimetry in patients with primary open angle glaucoma in Kano, Nigeria. WEST AFRICAN JOURNAL OF RADIOLOGY 2021. [DOI: 10.4103/wajr.wajr_27_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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15
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Harris A, Guidoboni G, Siesky B, Mathew S, Verticchio Vercellin AC, Rowe L, Arciero J. Ocular blood flow as a clinical observation: Value, limitations and data analysis. Prog Retin Eye Res 2020; 78:100841. [PMID: 31987983 PMCID: PMC8908549 DOI: 10.1016/j.preteyeres.2020.100841] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/14/2020] [Accepted: 01/16/2020] [Indexed: 12/24/2022]
Abstract
Alterations in ocular blood flow have been identified as important risk factors for the onset and progression of numerous diseases of the eye. In particular, several population-based and longitudinal-based studies have provided compelling evidence of hemodynamic biomarkers as independent risk factors for ocular disease throughout several different geographic regions. Despite this evidence, the relative contribution of blood flow to ocular physiology and pathology in synergy with other risk factors and comorbidities (e.g., age, gender, race, diabetes and hypertension) remains uncertain. There is currently no gold standard for assessing all relevant vascular beds in the eye, and the heterogeneous vascular biomarkers derived from multiple ocular imaging technologies are non-interchangeable and difficult to interpret as a whole. As a result of these disease complexities and imaging limitations, standard statistical methods often yield inconsistent results across studies and are unable to quantify or explain a patient's overall risk for ocular disease. Combining mathematical modeling with artificial intelligence holds great promise for advancing data analysis in ophthalmology and enabling individualized risk assessment from diverse, multi-input clinical and demographic biomarkers. Mechanism-driven mathematical modeling makes virtual laboratories available to investigate pathogenic mechanisms, advance diagnostic ability and improve disease management. Artificial intelligence provides a novel method for utilizing a vast amount of data from a wide range of patient types to diagnose and monitor ocular disease. This article reviews the state of the art and major unanswered questions related to ocular vascular anatomy and physiology, ocular imaging techniques, clinical findings in glaucoma and other eye diseases, and mechanistic modeling predictions, while laying a path for integrating clinical observations with mathematical models and artificial intelligence. Viable alternatives for integrated data analysis are proposed that aim to overcome the limitations of standard statistical approaches and enable individually tailored precision medicine in ophthalmology.
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Affiliation(s)
- Alon Harris
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA.
| | | | - Brent Siesky
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Sunu Mathew
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Alice C Verticchio Vercellin
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA; University of Pavia, Pavia, Italy; IRCCS - Fondazione Bietti, Rome, Italy
| | - Lucas Rowe
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Julia Arciero
- Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
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16
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The Association Between Body Mass Index and Open-angle Glaucoma in a South Korean Population-based Sample. J Glaucoma 2019; 27:239-245. [PMID: 29303872 DOI: 10.1097/ijg.0000000000000867] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
PURPOSE The purpose of this article is to investigate the association between body mass index (BMI) and open-angle glaucoma (OAG) in a sample of the South Korean population. MATERIALS AND METHODS The sample consisted of a cross-sectional, population-based sample of 10,978 participants, 40 years of age and older, enrolled in the 2008 to 2011 Korean National Health and Nutrition Examination Survey. All participants had measured intraocular pressure <22 mm Hg and open anterior chamber angles. OAG was defined using disc and visual field criteria established by the International Society for Geographical and Epidemiological Ophthalmology. Multivariable analyses were performed to determine the association between BMI and OAG. These analyses were also performed in a sex-stratified and age-stratified manner. RESULTS After adjusting for potential confounding variables, lower BMI (<19 kg/m) was associated with greater risk of OAG compared with normal BMI (19 to 24.9 kg/m) [odds ratio (OR), 2.28; 95% confidence interval (CI), 1.22-4.26]. In sex-stratified analyses, low BMI remained adversely related to glaucoma in women (OR, 3.45; 95% CI, 1.42-8.38) but not in men (OR, 1.72; 95% CI, 0.71-4.20). In age-stratified analyses, lower BMI was adversely related to glaucoma among subjects 40- to 49-year old (OR, 5.16; 95% CI, 1.86-14.36) but differences in glaucoma prevalence were not statistically significant between those with low versus normal BMI in other age strata. CONCLUSIONS Lower BMI was associated with increased odds of OAG in a sample of the South Korean population. Multivariate analysis revealed the association to be statistically significant in women and those in the youngest age stratum.
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17
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Barbosa‐Breda J, Abegão‐Pinto L, Van Keer K, Jesus DA, Lemmens S, Vandewalle E, Rocha‐Sousa A, Stalmans I. Heterogeneity in arterial hypertension and ocular perfusion pressure definitions: Towards a consensus on blood pressure-related parameters for glaucoma studies. Acta Ophthalmol 2019; 97:e487-e492. [PMID: 30315616 DOI: 10.1111/aos.13942] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 09/14/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE Glaucoma studies have long taken into account the blood pressure (BP) status of patients. This study summarizes and evaluates the impact of the different criteria that have been used for BP-related variables in glaucoma research. METHODS Studies included in two meta-analyses that reviewed the role of BP in glaucoma were analyzed. Additional studies published after the search periods of the meta-analyses were also included. Criteria for the definition of arterial hypertension and other BP-related variables, such as mean arterial pressure (MAP) and mean ocular perfusion pressure (MOPP), were retrieved. RESULTS Sixty-four studies were evaluated. One-third used 140 mmHg as a systolic BP cut-off to define hypertension, 20% used 160 mmHg and the remaining half used various other criteria. Less than 20% of studies reported MAP and/or MOPP. While eight of the ten studies reporting MAP used a correct formula that only happened for five of the eleven studies reporting MOPP. Using as an example average blood pressure values, incorrectly used formulas could have led to an overestimation of more than 100% of the expected values. CONCLUSION Considerable heterogeneity exists in BP-related variables in glaucoma research and different definitions can lead to large disparities. Glaucoma research would benefit from a consensus regarding blood pressure parameters.
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Affiliation(s)
- João Barbosa‐Breda
- Research Group Ophthalmology Department of Neurosciences KULeuven Leuven Belgium
- Faculty of Medicine of the University of Porto Ophthalmology Unit, Surgery and Physiology Porto Portugal
| | - Luis Abegão‐Pinto
- Faculty of Medicine of the University of Lisbon Visual Sciences Study Center Lisbon Portugal
| | - Karel Van Keer
- Research Group Ophthalmology Department of Neurosciences KULeuven Leuven Belgium
- Department of Ophthalmology University Hospitals Leuven Leuven Belgium
| | - Danilo A. Jesus
- Research Group Ophthalmology Department of Neurosciences KULeuven Leuven Belgium
| | - Sophie Lemmens
- Research Group Ophthalmology Department of Neurosciences KULeuven Leuven Belgium
- Department of Ophthalmology University Hospitals Leuven Leuven Belgium
| | - Evelien Vandewalle
- Research Group Ophthalmology Department of Neurosciences KULeuven Leuven Belgium
- Department of Ophthalmology University Hospitals Leuven Leuven Belgium
| | - Amândio Rocha‐Sousa
- Faculty of Medicine of the University of Porto Ophthalmology Unit, Surgery and Physiology Porto Portugal
| | - Ingeborg Stalmans
- Research Group Ophthalmology Department of Neurosciences KULeuven Leuven Belgium
- Department of Ophthalmology University Hospitals Leuven Leuven Belgium
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18
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Okoye RS, Bell L, Papadopoulos I. Investigating the level of glaucoma awareness and perception of its risk factors in Anambra State, Nigeria. Public Health 2018; 160:100-107. [PMID: 29800791 DOI: 10.1016/j.puhe.2018.03.025] [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: 06/24/2017] [Revised: 03/18/2018] [Accepted: 03/20/2018] [Indexed: 10/16/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the level of awareness of glaucoma and perception of its risk factors in Anambra State, and to examine and evaluate the health seeking behaviour of this target population and its relationship with the development glaucoma. STUDY DESIGN This is a qualitative study that utilised face-to-face semi-structured interviews to investigate the level of glaucoma awareness in the state. METHODS Purposive, non-random sampling technique was used to recruit the participants, and data were collected from 28 participants [aged 21-73 years] using semi-structured interview. The resulting data were analysed using Nvivo 10 software and Interpretative phenomenological analysis framework. RESULTS Of the 28 interviewees, 15 (53.6%) live in urban areas, and 13 (46.4%) live in the rural areas; 11 (39.3%) of the participants were male and 17 (60.7%) were females. In this study, people with more education, and people that live in the urban areas tend to have heard about glaucoma compared with people with less education, and who live in the rural areas; although this sample was too small to make substantive claims. Glaucoma was perceived as 'a dangerous eye disease that can cause blindness if not treated early; serious eye problem; an incurable eye problem that can eventually result to blindness, and a dangerous eye problem that can easily render a person blind'. Four a priori themes and ten emergent themes were identified. CONCLUSIONS There is low awareness of glaucoma in this population, and this encourages people to indulge in certain risk behaviours that could predispose them to glaucoma. Therefore, providing sustained health promotion programmes and improved eye care services could help this population immensely in the current struggle against glaucoma blindness.
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Affiliation(s)
- R S Okoye
- School of Health and Education, Middlesex University, The Burroughs, London NW4 4BT, UK; St Patricks International College, School of Health and Social Care, 40 Tower Hill, London EC3N 4DX, UK.
| | - L Bell
- School of Health and Education, Middlesex University, The Burroughs, London NW4 4BT, UK.
| | - I Papadopoulos
- Research Centre for Transcultural Studies in Health, Middlesex University, The Burroughs, London NW4 4BT, UK.
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19
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Shao Y, Bao J, Huang X, Zhou FQ, Ye L, Min YL, Yang L, Sethi Z, Yuan Q, Zhou Q. Comparative study of interhemispheric functional connectivity in left eye monocular blindness versus right eye monocular blindness: a resting-state functional MRI study. Oncotarget 2018; 9:14285-14295. [PMID: 29581843 PMCID: PMC5865669 DOI: 10.18632/oncotarget.24487] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 01/25/2018] [Indexed: 11/25/2022] Open
Abstract
Objective In the present study, we investigated the brain interhemispheric functional connectivity changes in left eye MB versus right eye MB patients by voxel-mirrored homotopic connectivity (VMHC) methods. Methods A total of 31 patients with MB (15 with left eye MB and 16 with right eye MB), and 31 healthy controls (HCs) closely matched for age were recruited. All subjects underwent functional magnetic resonance imaging (fMRI) examinations. The VMHC method was used to evaluate directly functional interactions between the hemispheres. A one-way ANOVA was performed to determine the regions in which the VMHC differs between the three groups. Patients with MB were distinguished from HCs by a receiver operating characteristic (ROC) curve. The relationships between the mean VMHC signal values in many brain regions and clinical features in MB patients were calculated by pearson correlation analysis. Results Compared with HCs, MB patients had significantly decreased VMHC values in the cuneus/calcarine/lingual gyrus. Furthermore, left eye MB showed decreased VMHC values in the cuneus/calcarine/lingual gyrus and showed increased VMHC values in the insula and middle frontal gyrus compared with HC. In addition, right eye MB showed decreased VMHC values in the cuneus/calcarine/lingual gyrus, primary motor cortex (M1)/primary somatosensory cortex (S1) and superior parietal lobule. Conclusion MB subjects showed abnormal brain interhemispheric functional connectivity in visual pathways. Furthermore, different patterns of brain interhemispheric functional connectivity occurred in the left eye and right eye MB. These VMHC values provide much useful information to explain the neural mechanism changes in MB.
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Affiliation(s)
- Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
| | - Jing Bao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
| | - Xin Huang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China.,Department of Ophthalmology, The People's Hospital of Hubei Province, Wuhan 430060, Hubei, China
| | - Fu-Qing Zhou
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
| | - Lei Ye
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
| | - You-Lan Min
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
| | - Lin Yang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
| | - Zubin Sethi
- University of Miami, Miami, Florida 33146, USA
| | - Qing Yuan
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
| | - Qiong Zhou
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
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Momoh RO, Bunce C, Oko-oboh GA, Gilbert CE. Advanced glaucoma at presentation is associated with poor follow-up among glaucoma patients attending a tertiary eye facility in Southern Nigeria. Ophthalmic Epidemiol 2018; 25:266-272. [DOI: 10.1080/09286586.2018.1424345] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Rita Omoso Momoh
- Department of Ophthalmology, University of Benin Teaching Hospital, Benin City, Nigeria
| | - Catey Bunce
- Department of Primary Care & Public Health, Kings College London, London, United Kingdom
| | | | - Clare E. Gilbert
- London School of Hygiene & Tropical Medicine, International Centre for Eye Health (ICEH), London, United Kingdom
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21
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Multiple deprivation, vision loss, and ophthalmic disease in adults: global perspectives. Surv Ophthalmol 2017; 63:406-436. [PMID: 29100897 DOI: 10.1016/j.survophthal.2017.10.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 10/19/2017] [Accepted: 10/19/2017] [Indexed: 12/19/2022]
Abstract
The association between socioeconomic position and morbidity and mortality has long been recognized. We evaluate the evidence for an association between multiple aspects of deprivation and ocular health in a global context. This is a systematic review of studies that evaluated deprivation in the adult population in the context of the major acquired causes of visual loss such as cataract, diabetic eye disease, glaucoma, age-related macular degeneration, and ocular trauma. The search strategy identified relevant studies reported between 1946 and August 2016, with randomized control trials, case-control, cohort, and cross-sectional study designs being selected for inclusion. The studies identified in this review from across the world demonstrate the extent to which the common themes such as low educational attainment and low income may be associated with increased incidence of various sight-threatening conditions and may adversely affect access to specialist assessment and delivery of treatment. Health inequality may always persist, but an increased recognition of the importance of the various impacts of deprivation may empower policy makers to target limited resources to the most vulnerable groups in order to deliver the greatest benefit.
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22
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The Association between Adiposity and the Risk of Glaucoma: A Meta-Analysis. J Ophthalmol 2017; 2017:9787450. [PMID: 28695005 PMCID: PMC5485359 DOI: 10.1155/2017/9787450] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 05/06/2017] [Accepted: 05/18/2017] [Indexed: 11/26/2022] Open
Abstract
Purpose This meta-analysis was conducted to determine the potential association between adiposity and glaucoma incidence. Materials and Methods A comprehensive literature search was performed in PubMed and ISI Web of Science. A meta-analysis was conducted using STATA software. Results Fifteen eligible studies involving 2,445,980 individuals were included to investigate the association between adiposity and glaucoma incidence. The relative risks (RRs) were pooled with 95% confidence intervals (CI) by using a random-effects model. The pooled RR between adiposity and elevated intraocular pressure (IOP) was 1.73 (95% CI, 1.18–2.54), whereas that between adiposity and open-angle glaucoma (OAG) was 0.97 (95% CI, 0.83–1.13). The pooled RR between abdominal adiposity and glaucoma was 1.28 (95% CI, 1.15–1.41), whereas that between general adiposity and glaucoma was 1.09 (95% CI, 0.87–1.37). Results of subgroup analysis by sex indicated the association between adiposity and glaucoma in the female group (RR, 1.31; 95% CI, 1.05–1.64), but not in the male group (RR, 1.11; 95% CI, 0.77–1.60). The pooled RR of cohort studies and cross-sectional studies were 1.00 (95% CI, 0.84–1.20) and 1.22 (95% CI, 0.89–1.66), respectively. Conclusions Adiposity has a higher risk of elevated IOP, and abdominal adiposity has a positive association with glaucoma, especially in female patients.
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Kyari F, Gilbert C, Blanchet K, Wormald R. Improving services for glaucoma care in Nigeria: implications for policy and programmes to achieve universal health coverage. Br J Ophthalmol 2017; 101:543-547. [PMID: 28202479 DOI: 10.1136/bjophthalmol-2016-310040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 01/17/2017] [Accepted: 01/21/2017] [Indexed: 01/23/2023]
Abstract
Glaucoma in Africa is sometimes referred to as the silent thief of sight. In Nigeria, glaucoma is common, it is serious, ophthalmologists face many constraints in managing it, people do not even know they have it until it is advanced, patients do not understand or comply with treatment after they are diagnosed and the poor are more likely to be glaucoma blind. Available evidence indicates that the health system in Nigeria is failing to meet the needs of patients with glaucoma. Based on evidence, we propose future directions for improving services for glaucoma care in Nigeria, and the implications for policy and programmes to control glaucoma blindness, using a health system-oriented approach. Three complementary strategies are required: (i) strengthening clinical services for glaucoma-by developing models of glaucoma care, improving clinical treatment options, making medicines and equipment available, financing glaucoma care and training eye care workers; (ii) introducing initiatives for earlier detection of glaucoma in the clinic and approaches in the community and (iii) strengthening health system governance. Glaucoma is a complex disease to manage and addressing it as a public health problem is challenging. However, we need to change the paradigm to recognise that glaucoma is a potentially avoidable cause of blindness in Africa.
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Affiliation(s)
- Fatima Kyari
- Department of Clinical Research, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK.,Baze University, Abuja, Nigeria
| | - Clare Gilbert
- Department of Clinical Research, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Karl Blanchet
- Department of Global Health and Development, Health in Humanitarian Crisis Centre, London School of Hygiene and Tropical Medicine, London, UK
| | - Richard Wormald
- Department of Clinical Research, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK.,Department of Ophthalmology, Moorfields Eye Hospital, London, UK
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