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Upsala Journal of Medical Sciences 2021Open-angle glaucoma (OAG) and Alzheimer's disease (AD) are two age-related neurodegenerative diseases of significant public health importance. Epidemiological studies...
BACKGROUND
Open-angle glaucoma (OAG) and Alzheimer's disease (AD) are two age-related neurodegenerative diseases of significant public health importance. Epidemiological studies have indicated that there might be an association between the disorders.
METHODS
Predictors of AD, including mixed and unspecified dementia, were analysed in a cohort of 712 residents aged 65-74 years, examined in a population survey in the rural district of Tierp, Sweden, from 1984 to 1986. To expand the sample size, 821 people were recruited by means of glaucoma case records established at the Eye Department in Tierp from 1978 to 2007. In this way, the cohort comprised 1,533 people, representing more than 21,000 person-years at risk. Medical records were reviewed to identify subjects diagnosed with dementia. Those with a follow-up duration shorter than 2 years were excluded.
RESULTS
By the conclusion of the study, in August 2020, 307 subjects had received a diagnosis of AD, including mixed and unspecified dementia. Of these cases, 55 were affected with definite OAG at baseline. Higher age and ischemic heart disease were the only predictors of AD identified. In multivariate analysis, adjusting for age, participation in the population survey and competing events, no association was found between OAG and AD (hazard ratio 1.08; 95% confidence interval: 0.80-1.47).
CONCLUSION
In this long-term follow-up study of subjects aged 65-74 years old in Sweden, OAG was not associated with AD.
Topics: Aged; Alzheimer Disease; Follow-Up Studies; Glaucoma, Open-Angle; Humans; Risk Factors; Sweden
PubMed: 34349887
DOI: 10.48101/ujms.v126.7819 -
Journal of Glaucoma Jul 2022In the Thessaloniki Eye Study (TES) incidence phase population, frequent dietary salt intake was potentially associated with increased risk of open angle glaucoma in...
PRCIS
In the Thessaloniki Eye Study (TES) incidence phase population, frequent dietary salt intake was potentially associated with increased risk of open angle glaucoma in antihypertensive users.
PURPOSE
The aim was to examine the association between dietary salt intake and glaucoma by antihypertensive use in the TES population.
MATERIALS AND METHODS
The study population included TES incidence phase participants. Dietary salt intake frequency was assessed by self-report. Outcomes included prevalence of any open angle glaucoma (OAG), primary open angle glaucoma (POAG), and pseudoexfoliation (PEX). Covariates included demographics, cardiovascular disease, migraines, diabetes, steroid use, smoking, history of cataract surgery, central corneal thickness, intraocular pressure, blood pressure, and antihypertensive use. Logistic regression was used to examine associations between frequency of salt intake and glaucoma, controlling for covariates and stratified by antihypertensive use.
RESULTS
The study included 1076 participants 80.5±4.4 years old, of whom 518 were female. There were 89/1076 (8.3%) participants with any OAG, 46/789 (5.8%) with POAG, and 287/1030 (27.9%) with PEX. In participants with antihypertensive use, frequent versus never salt intake was associated with increased risk of any OAG [adjusted odds ratio (aOR)=2.65, 95% confidence interval (CI)=1.12, 6.28; n=784] and POAG (aOR=3.59, 95% CI=1.16, 11.11; n=578) overall, and additionally in participants with diastolic blood pressure <90 mm Hg (aOR=2.42, 95% CI=1.00, 5.84; n=735) for OAG. There were no statistically significant adjusted associations between salt intake and PEX, or in participants without antihypertensive use.
CONCLUSIONS
In TES participants assessed for OAG in the prevalence and incidence phases, frequent salt intake may be associated with increased OAG in those who take antihypertensive medication. Further investigation is needed of salt intake and glaucoma in hypertensive individuals.
Topics: Aged; Aged, 80 and over; Antihypertensive Agents; Cross-Sectional Studies; Exfoliation Syndrome; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Risk Factors; Sodium Chloride, Dietary
PubMed: 35474047
DOI: 10.1097/IJG.0000000000002044 -
Korean Journal of Ophthalmology : KJO Feb 2022Investigation of myopic open-angle glaucoma (OAG) prevalence in Northeast Asia by systematic review and meta-analysis. (Meta-Analysis)
Meta-Analysis
PURPOSE
Investigation of myopic open-angle glaucoma (OAG) prevalence in Northeast Asia by systematic review and meta-analysis.
METHODS
Systematic PubMed, Embase and Cochrane database searches for Northeast Asian population-based studies published up to 30 November 2020 and reporting on myopia and OAG diagnosis. By random-effect models, pooled OAG prevalence in a myopic population and pooled myopic OAG prevalence in a general population were generated, with 95% confidence intervals (CIs).
RESULTS
The meta-analysis encompassed five population-based studies in four countries (12,830 individuals, including 7,723 patients with myopia and 1,112 patients with OAG). In a myopic population, OAG prevalence was 4.10% (95% CI, 3.00-5.70; I2 = 93%); in a general population, myopic OAG prevalence was 1.10% (95% CI, 0.60-1.70; I2 = 94%). A visual examination of funnel plot symmetry raised a suspicion of publication bias. Notwithstanding, Begg and Mazumbar's adjusted rank correlation test showed no such evidence (p = 0.6242).
CONCLUSIONS
Our systematic review and meta-analysis returned an estimate of OAG prevalence in a myopic Northeast Asian population. Our findings will inform future glaucoma studies as well as public health guidelines for Northeast Asian populations.
Topics: Asia; Glaucoma, Open-Angle; Humans; Myopia; Prevalence
PubMed: 34743493
DOI: 10.3341/kjo.2021.0089 -
Middle East African Journal of... 2015Surgical options for glaucoma have expanded in recent years. This article provides an evidence-based update on the novel or emerging surgical techniques for the... (Review)
Review
Surgical options for glaucoma have expanded in recent years. This article provides an evidence-based update on the novel or emerging surgical techniques for the treatment of open-angle glaucoma that are based on the Schlemm's canal (SC). Canaloplasty is an ab externo approach and was developed as an alternative to traditional filtering surgeries. The Hydrus microstent (Ivantis Inc., Irvine, CA) is a so-called SC scaffold that directly bypasses the trabecular meshwork to drain aqueous humor into the SC, which it keeps dilated over approximately one quadrant. Canaloplasty has also been shown to lower intraocular pressure (IOP) by up to 40% and combined with cataract surgery. IOP was lowered 44% at 24 months while maintaining a favorable safety profile. The Hydrus device has been proposed as an adjunct to cataract extraction surgery. To date, no published evidence from clinical trials is available on its in vivo safety and efficacy. Schlemm's canal based glaucoma procedures show promise as alternative treatments to traditional glaucoma surgery. Surgeons must be comfortable with angle anatomy. A prerequisite for functionality of these techniques is the integrity of the distal outflow system. At present, however, it is not possible to conclude whether these novel procedures will be viable alternatives to standard filtering surgery over the long-term.
Topics: Aqueous Humor; Filtering Surgery; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Limbus Corneae
PubMed: 25624672
DOI: 10.4103/0974-9233.148347 -
Scientific Reports Jul 2023The association between statins and open-angle glaucoma (OAG) remains controversial. This study investigated the relationship between statins and OAG in Japanese...
The association between statins and open-angle glaucoma (OAG) remains controversial. This study investigated the relationship between statins and OAG in Japanese patients with dyslipidemia using the Japanese administrative claims database. A nested case-control study using two models was conducted using the JMDC claims database (01/2005-01/2020). The onset of OAG: index date was defined as the diagnosis of glaucoma, prescription of anti-glaucoma drugs, or surgery of glaucoma. For each case, a maximum of 10 age-, sex-, and calendar year/month-matched controls were randomly selected by risk-set sampling with replacement. The number of statin prescriptions during the exposure assessment period, which was identified as the 12-month (model 1) or 24-month (model 2) periods prior to the index date, was used as an indicator for statin exposure. Adjusted odds ratios (aORs) and 95% confidence interval (CI) were estimated using conditional logistic regression analyses. We identified 375,373 patients with newly diagnosed dyslipidemia. Of these, 6180 cases and 61,792 controls (model 1) and 4153 cases and 41,522 controls (model 2) were selected. Statin use was not identified as a significant risk factor for OAG (model 1: aOR 0.98, 95% CI 0.93-1.03, model 2: aOR 0.97, 95% CI 0.91-1.04). Compared with nonexposure, short-term exposure (< 2 years) to statins was not related to an increased risk of OAG in the Japanese working-age population with dyslipidemia.
Topics: Humans; Case-Control Studies; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Retrospective Studies; Glaucoma, Open-Angle; East Asian People; Risk Factors
PubMed: 37468563
DOI: 10.1038/s41598-023-38957-2 -
Scientific Reports Aug 2017Although intraocular pressure is the main the risk factor for the development of glaucoma, other risk factors such as vascular dysfunction might play an additional... (Meta-Analysis)
Meta-Analysis
Although intraocular pressure is the main the risk factor for the development of glaucoma, other risk factors such as vascular dysfunction might play an additional pathogenic role. Hypertriglyceridemia, which may lead to vascular dysfunction, has been implicated in the development of glaucoma. The objective of this meta-analysis was to investigate the association of triglyceride levels with the risk of glaucoma in case-control studies. Seventeen case-control studies were included investigating the difference in triglyceride levels in patients with glaucoma (N = 1 391) compared to subjects without glaucoma (N = 25 575). In random effects meta-analysis, the pooled mean triglyceride level across all studies and patients with and without glaucoma was 132.9 mg/dL (95%CI: 124.0-141.7). Patients with glaucoma had significantly higher mean triglyceride levels than patients without glaucoma (absolute difference = 14.2 mg/dL, 95%CI: 5.8-22.5, p < 0.0001). A considerable amount of heterogeneity of included studies was observed (I = 66.2%, heterogeneity χ = 47.4 on 16 degrees of freedom, p < 0.0001). In conclusion, this meta-analysis of case-control studies found that patients with glaucoma had higher mean triglyceride levels than patients without glaucoma. This finding is consistent with the concept that hypertriglyceridemia represents an additional risk factor for glaucoma. Whether this association is causal and/or might be modified by glaucoma medications remains to be investigated.
Topics: Case-Control Studies; Glaucoma, Open-Angle; Humans; Risk Factors; Triglycerides
PubMed: 28798341
DOI: 10.1038/s41598-017-08295-1 -
Indian Journal of Ophthalmology Dec 2022To evaluate the safety and efficacy of ultrasound cycloplasty in eyes with primary or secondary open-angle glaucoma, not amenable to adequate control of intra-ocular...
PURPOSE
To evaluate the safety and efficacy of ultrasound cycloplasty in eyes with primary or secondary open-angle glaucoma, not amenable to adequate control of intra-ocular pressure (IOP) with medical treatment.
METHODS
Prospective interventional cohort study of 28 eyes of 28 subjects in a tertiary eye care centre in India in patients with open-angle glaucoma. All enrolled eyes underwent ultrasound cycloplasty with the second-generation probe with six shots of 8 s each, operated by a single surgeon between November 2018 and January 2020. They were followed up for a period of 12 months. The primary treatment outcome was IOP and the secondary outcomes were vision and postoperative complications.
RESULTS
A total of 28 eyes of 28 patients were studied, and the mean age was 63.82 ± 6.46 years. Primary open-angle glaucoma (75%) was the most common etiology. There was significant reduction in IOP from the baseline (24.93 ± 4.27 mmHg) to the postoperative value (15.82 ± 3.14 mmHg) at the end of 12 months (P < 0.00001). Mean reduction in IOP was 9.14 ± 4.09 mmHg at 12 months (36.66%). Number of ocular hypotensives reduced significantly from baseline (3.32 ± 0.47) to 12-month postoperative follow-up (0.68 ± 0.74) (P < 0.00001). Qualified success was achieved in 89.28% eyes. No major complications were noted.
CONCLUSION
Ultrasound cycloplasty is found to be effective and safe in eyes with open-angle glaucoma because of the primary or secondary etiology, being more effective in the former.
Topics: Humans; Middle Aged; Aged; Glaucoma, Open-Angle; Cohort Studies; Prospective Studies; Eye; Tonometry, Ocular
PubMed: 36453307
DOI: 10.4103/ijo.IJO_827_22 -
BioMed Research International 2015Glaucoma is the second leading cause of blindness worldwide. Although the mechanism of the development of primary open-angle glaucoma (POAG) is not fully understood,... (Review)
Review
Glaucoma is the second leading cause of blindness worldwide. Although the mechanism of the development of primary open-angle glaucoma (POAG) is not fully understood, elevated intraocular pressure (IOP) is considered the most important risk factor. Several vascular factors have also been identified as risk factors and can lead to hypoperfusion of the optic nerve head and thus may play an important role in the pathogenesis and progression of POAG. The results of the present study suggest that both high and low blood pressure (BP) are associated with an increased risk of POAG based on a comprehensive literature review. Elevated BP is associated with elevated IOP, leading to increased risk of glaucoma, but excessive BP lowering in glaucoma patients may cause a drop in ocular perfusion pressure (OPP) and subsequent ischemic injury. The relationship between IOP, OPP, and BP suggests that the relationship between BP and glaucoma progression is U-shaped.
Topics: Blood Pressure; Glaucoma, Open-Angle; Humans; Hypertension; Hypotension
PubMed: 26557702
DOI: 10.1155/2015/827516 -
JAMA May 2022Glaucoma affects an estimated 2.7 million people in the US. It is the second-leading cause of irreversible blindness in the US and the leading cause of blindness in...
IMPORTANCE
Glaucoma affects an estimated 2.7 million people in the US. It is the second-leading cause of irreversible blindness in the US and the leading cause of blindness in Black and Hispanic/Latino persons.
OBJECTIVE
To update its 2013 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for glaucoma in adults.
POPULATION
Adults 40 years or older who present in primary care and do not have signs or symptoms of open-angle glaucoma.
EVIDENCE ASSESSMENT
The USPSTF concludes that the evidence is insufficient to assess the balance of benefits and harms of screening for glaucoma in adults. The benefits and harms of screening for glaucoma in adults are uncertain. More research is needed.
RECOMMENDATION
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for primary open-angle glaucoma in adults. (I statement).
Topics: Adult; Advisory Committees; Blindness; Glaucoma, Open-Angle; Humans; Mass Screening; Practice Guidelines as Topic; Preventive Health Services; Risk Assessment; United States
PubMed: 35608574
DOI: 10.1001/jama.2022.7013 -
European Journal of Ophthalmology Sep 2020The aim of this study was to compare the efficacy and safety of the XEN45 gel stent implant in patients with primary open-angle glaucoma or secondary open-angle glaucoma.
PURPOSE
The aim of this study was to compare the efficacy and safety of the XEN45 gel stent implant in patients with primary open-angle glaucoma or secondary open-angle glaucoma.
PATIENTS AND METHODS
This is a retrospective, single-center, and comparative study conducted in consecutive primary open-angle glaucoma or secondary open-angle glaucoma patients, who underwent a XEN45 implant, alone or in combination with phacoemulsification. The primary end point was the intraocular pressure at the end of the follow-up period. Complete success was defined as an intraocular pressure reduction of ⩾20% from baseline to month 12 without antiglaucoma treatment.
RESULTS
Of the 69 patients (74 eyes) who were screened, 68 patients (73 eyes) were included in this study. In the overall study population, XEN gel stent significantly reduced intraocular pressure from 22.3 (21.0-23.5) mmHg at baseline to 15.3 (14.3-16.3) mmHg, < 0.0001. As compared to baseline, mean intraocular pressure reduction was -7.3 (-9.7 to -5.0) and -6.6 (-8.4 to -4.8) mmHg in the primary open-angle glaucoma and secondary open-angle glaucoma groups, respectively, = 0.6357. At month 12, 53 (72.6%) eyes were classified as success. The mean number of antiglaucoma medications was significantly reduced in both groups ( < 0.0001, each). Complications included anterior chamber flattening (one eye), XEN implant extrusion (four eyes), one of whom had an endophthalmitis that required vitrectomy, and one eye underwent a trabeculectomy due to inadequate intraocular pressure control.
CONCLUSION
XEN gel stent, either alone or in combination with phacoemulsification, provided a significant reduction in both intraocular pressure and medical antiglaucoma treatment, but with some safety concerns, in a cohort of patients with open-angle glaucoma (primary or secondary).
Topics: Aged; Aged, 80 and over; Female; Follow-Up Studies; Glaucoma Drainage Implants; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Phacoemulsification; Prosthesis Implantation; Retrospective Studies; Stents; Tonometry, Ocular; Trabeculectomy; Treatment Outcome
PubMed: 31018685
DOI: 10.1177/1120672119845226