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Fridbert Jonasson, Geir Tryggvason, Gudny Eiriksdottir, Mary Frances Cotch, Tamara B Harris, Lenore J Launer, Chuang-Ming Li, Howard J Hoffman, Vilmundur Gudnason, Hannes Petersen; Exfoliation syndrome and primary open angle glaucoma are not associated with hearing loss in an Icelandic older adult case-control study. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4293.
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To determine if older adults with exfoliation syndrome (XFS), exfoliation glaucoma (XFG) or primary open angle glaucoma (POAG) are more hearing impaired than control subjects.
Individuals who participated in the Reykjavik Eye and Reykjavik Glaucoma studies and the Age Gene Environment Susceptibility (AGES) Reykjavik Study were eligible. Case status (XFS/XFG or POAG) was determined from the Reykjavik Eye studies augmented by information from AGES. Exfoliation syndrome was detected on retroilluminated fundus images and confirmed on slit-lamp examination. Exfoliation glaucoma and primary open angle glaucoma were diagnosed after repeated visual field testing and fundus photography of the optic nerve head. The remaining subjects were controls, none of whom had evidence of XFS/XFG or POAG. Otoscopy was performed and hearing thresholds obtained at 0.5, 1, 2, 3, 4, 6 and 8 kHz. Hearing outcomes were better ear pure-tone average (PTA) of all thresholds and the WHO-recommended four-frequency PTA (0.5, 1, 2, and 4 kHz). Multivariable logistic regression was used to test for differences in hearing between cases and controls, while controlling for age, sex, education, general health, chronic conditions (diabetes, hypertension), lifestyle (cigarette smoking, alcohol use), noise exposure, and ear-related conditions (ear infections, ear operations, and tinnitus).
There were 167 subjects with XFS/XFG (mean age 77.2 years), 100 subjects having POAG (mean age 77.8 years) and 128 controls (mean age 76.7 years). The male/female ratio for XFS/XFG was 1:2.3, for POAG 1:1.8 and 1:1.2 for controls, and the prevalence of hearing aid use was 17.4%, 22.2% and 14.8%, respectively. The prevalence of glaucoma in XFS subjects was 47%. Multivariable logistic regression results indicated there were no significant differences in hearing impairment between either of the two case groups and controls. Factors independently associated with hearing impairment were age, sex, fair/poor health, noise exposure, and history of ear infections.
Older adults with exfoliation syndrome, exfoliation glaucoma or primary open angle glaucoma did not have more hearing impairment than controls. Older adults with XFS or POAG do not require referral for audiological workup by their ophthalmologist.
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