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International Journal of Environmental... Feb 2022This study aimed to investigate the associated risk between using fibrate and open-angle glaucoma (OAG) in hyperlipidemic patients from the National Health Insurance...
BACKGROUND
This study aimed to investigate the associated risk between using fibrate and open-angle glaucoma (OAG) in hyperlipidemic patients from the National Health Insurance Research Database (NHIRD).
METHODS
We collected data over a 16-year period from the NHIRD, and used the Fisher's exact test and Pearson chi-square test to analyze variables. Adjusted hazard ratios (aHR) were used to examine the risk factors for disease development. We applied Kaplan-Meier analysis to compare the cumulative incidence of OAG.
RESULTS
A total of 10,011 patients using fibrate were enrolled in the study cohort, and 40,044 patients not using fibrate were enrolled in the control cohort. The incidence of OAG was lower in the study cohort than in the control cohort (aHR = 0.624, = 0.007). The overall incidence of OAG was 463.02 per 100,000 person-years in the study cohort and 573.65 per 100,000 person-years in the control cohort. We used the Kaplan-Meier method to calculate the cumulative risk of developing OAG. The results revealed that after using fibrate for over seven years, the study cohort had a greatly lower rate of developing OAG than the control cohort (log-rank test = 0.050).
CONCLUSIONS
Our studies showed that using fibrate for over seven years may lead to a lower risk of OAG in patients with hyperlipidemia. Nevertheless, further prospective studies that comprehensively investigate the relationship between using fibrate and OAG are needed.
Topics: Cohort Studies; Fibric Acids; Glaucoma, Open-Angle; Humans; Incidence; Prospective Studies; Retrospective Studies; Risk Factors
PubMed: 35206602
DOI: 10.3390/ijerph19042415 -
Eye (London, England) Jan 2020Evidence for the effectiveness of interventions to prevent the progression of optic nerve damage in open angle glaucoma has evolved over the last 25 years. We describe... (Review)
Review
Evidence for the effectiveness of interventions to prevent the progression of optic nerve damage in open angle glaucoma has evolved over the last 25 years. We describe that evolution through the systematic reviews on various aspects of the topic and how those reviews have highlighted the need for new trials. Though we can be confident that lowering pressure does indeed reduce the risk of progression, we still lack good evidence on the comparative effectiveness of different treatments not so much on lowering pressure but on preventing progression of the disease. This is true for different medicines, types of laser and especially for different surgical interventions. As always there is a need for more research, but this needs to be focussed on key uncertainties using core outcome sets which avoid research waste. Ultimately, our guidelines can be based on sound and comprehensive evidence of effectiveness.
Topics: Glaucoma, Open-Angle; Humans; Randomized Controlled Trials as Topic
PubMed: 31796882
DOI: 10.1038/s41433-019-0687-5 -
Progress in Retinal and Eye Research May 2017Primary open-angle glaucoma (POAG) is a genetically, physiologically, and phenotypically complex neurodegenerative disorder. This study addressed the expanding... (Review)
Review
Primary open-angle glaucoma (POAG) is a genetically, physiologically, and phenotypically complex neurodegenerative disorder. This study addressed the expanding collection of genes associated with POAG, referred to as the "POAGome." We used bioinformatics tools to perform an extensive, systematic literature search and compiled 542 genes with confirmed associations with POAG and its related phenotypes (normal tension glaucoma, ocular hypertension, juvenile open-angle glaucoma, and primary congenital glaucoma). The genes were classified according to their associated ocular tissues and phenotypes, and functional annotation and pathway analyses were subsequently performed. Our study reveals that no single molecular pathway can encompass the pathophysiology of POAG. The analyses suggested that inflammation and senescence may play pivotal roles in both the development and perpetuation of the retinal ganglion cell degeneration seen in POAG. The TGF-β signaling pathway was repeatedly implicated in our analyses, suggesting that it may be an important contributor to the manifestation of POAG in the anterior and posterior segments of the globe. We propose a molecular model of POAG revolving around TGF-β signaling, which incorporates the roles of inflammation and senescence in this disease. Finally, we highlight emerging molecular therapies that show promise for treating POAG.
Topics: Computational Biology; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Retinal Ganglion Cells
PubMed: 28223208
DOI: 10.1016/j.preteyeres.2017.02.001 -
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 -
BMJ Open Feb 2018Glaucoma is the second leading cause of age-related vision loss worldwide; it is an umbrella term that is used to describe a set of complex ocular disorders with a... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Glaucoma is the second leading cause of age-related vision loss worldwide; it is an umbrella term that is used to describe a set of complex ocular disorders with a multifactorial aetiology. Both genetic and lifestyle risk factors for glaucoma are well established. Thus far, however, systematic reviews on the heritability of glaucoma have focused on the heritability of primary open-angle glaucoma only. No systematic review has comprehensively reviewed or meta-analysed the heritability of other types of glaucoma, including glaucoma-related endophenotypes. The aim of this study will be to identify relevant scientific literature regarding the heritability of both glaucoma and related endophenotypes and summarise the evidence by performing a systematic review and meta-analysis.
METHODS AND ANALYSIS
This systematic review will follow the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols 2015 checklist, which provides a standardised approach for carrying out systematic reviews. To capture as much literature as possible, a comprehensive step-by-step systematic search will be undertaken in MEDLINE (PubMed), EMBASE, Web of Science and ScienceDirect, and studies published until 31 December 2017 will be included. Two reviewers will independently search the articles for eligibility according to predefined selection criteria. A database will be used for screening of eligible articles. The quality of the included studies will be rated independently by two reviewers, using the National Health Institute Quality Assessment tool for Observational Cohort and Cross-Sectional Studies. A random-effects model will be used for the meta-analysis. This systematic review is registered with the International Prospective Register of Systematic Reviews with a registration number: CRD42017064504.
ETHICS AND DISSEMINATION
We will use secondary data from peer-reviewed published articles, and hence there is no requirement for ethics approval. The results of this systematic review will be disseminated through publication in a peer-reviewed scientific journal.
Topics: Endophenotypes; Glaucoma, Open-Angle; Humans; Research Design; Risk Factors; Systematic Reviews as Topic
PubMed: 29490960
DOI: 10.1136/bmjopen-2017-019049 -
Human Mutation Feb 2022Juvenile open-angle glaucoma (JOAG) is a severe type of glaucoma with onset before age 40 and dominant inheritance. Using exome sequencing we identified 3 independent...
Juvenile open-angle glaucoma (JOAG) is a severe type of glaucoma with onset before age 40 and dominant inheritance. Using exome sequencing we identified 3 independent families from the Philippines with novel EFEMP1 variants (c.238A>T, p.Asn80Tyr; c.1480T>C, p.Ter494Glnext*29; and c.1429C>T, p.Arg477Cys) co-segregating with disease. Affected variant carriers (N = 34) exhibited severe disease with average age of onset of 16 years and with 76% developing blindness. To investigate functional effects, we transfected COS7 cells with vectors expressing the three novel EFEMP1 variants and showed that all three variants found in JOAG patients caused significant intracellular protein aggregation and retention compared to wild type and also compared to EFEMP1 variants associated with other ocular phenotypes including an early-onset form of macular degeneration, Malattia Leventinese/Doyne's Honeycomb retinal dystrophy. These results suggest that rare EFEMP1 coding variants can cause JOAG through a mechanism involving protein aggregation and retention, and that the extent of intracellular retention correlates with disease phenotype. This is the first report of EFEMP1 variants causing JOAG, expanding the EFEMP1 disease spectrum. Our results suggest that EFEMP1 mutations appear to be a relatively common cause of JOAG in Filipino families, an ethnically diverse population.
Topics: Extracellular Matrix Proteins; Glaucoma, Open-Angle; Heterozygote; Humans; Macular Degeneration; Mutation
PubMed: 34923728
DOI: 10.1002/humu.24320 -
Eye (London, England) Jan 2020Over the last decade, genetic studies, including genome-wide association studies (GWAS), have accelerated the discovery of genes and genomic regions contributing to... (Review)
Review
Over the last decade, genetic studies, including genome-wide association studies (GWAS), have accelerated the discovery of genes and genomic regions contributing to primary open-angle glaucoma (POAG), a leading cause of irreversible vision loss. Here, we review the findings of genetic studies of POAG published in English prior to September 2019. In total, 74 genomic regions have been associated at a genome-wide level of significance with POAG susceptibility. Recent POAG GWAS provide not only insight into global and ethnic-specific genetic risk factors for POAG susceptibility across populations of diverse ancestry, but also important functional insights underlying biological mechanisms of glaucoma pathogenesis. In this review, we also summarize the genetic overlap between POAG, glaucoma endophenotypes, such as intraocular pressure and vertical cup-disc ratio (VCDR), and other eye disorders. We also discuss approaches recently developed to increase power for POAG locus discovery and to predict POAG risk. Finally, we discuss the recent development of POAG gene-based therapies and future strategies to treat glaucoma effectively. Understanding the genetic architecture of POAG is essential for an earlier diagnosis of this common eye disorder, predictive testing of at-risk patients, and design of gene-based targeted medical therapies none of which are currently available.
Topics: Genome-Wide Association Study; Glaucoma; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Tonometry, Ocular
PubMed: 31645673
DOI: 10.1038/s41433-019-0632-7 -
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 -
Ugeskrift For Laeger Feb 2022This review provides an update on open-angle glaucoma with a special focus on the current non-invasive treatment modalities, side effects and interactions to topical... (Review)
Review
This review provides an update on open-angle glaucoma with a special focus on the current non-invasive treatment modalities, side effects and interactions to topical pressure-lowering eye drops that all treatment providers should be aware of. We highlight current challenges in terms of timely diagnosis and compliance and outline promising areas of research within the field.
Topics: Antihypertensive Agents; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Ophthalmic Solutions
PubMed: 35179112
DOI: No ID Found -
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