ASSOCIATION OF ADVANCED GLYCATION END PRODUCTS WITH OPEN ANGLE GLAUCOMA: THE ALIENOR STUDY.

Abstract

Purpose : to analyze the association between open-angle glaucoma (OAG) and skin autofluorescence (sAF), which reflects tissue accumulation of advanced glycation end products (AGEs), in elderly subjects.

Methods : The ALIENOR (Antioxydants, Lipides Essentiels, Nutrition and maladies OculaiRes) Study is a population-based cohort study on age-related eye diseases performed in elderly residents of Bordeaux, aged 75 years and older. In 2009-2010, glaucoma diagnosis was made using retinophotography of the optic nerve head and ISGEO (international society for epidemiologic and geographical ophthalmology) criteria. sAF was measured with an autofluorescence reader (DiagnOpticsTechnologies B.V., Groningen, Netherlands) in 467 subjects and was divided in tertiles. In 1999-2000 and 2009-2010, fasting plasma glucose (FPG) was measured and diabetes was defined by self-reported diabetes or diabetic treatment or FPG ≥7 mmol/L. Associations between OAG and sAF or the glycemic status were estimated using generalized estimating equation logistic regressions adjusted for age, sex, family history of glaucoma and presence of ocular hypertension.

Results : The mean age was 82.3+/- 4.2 years, 459 subjects had complete data and 31 had a glaucoma diagnosis. The mean sAF was 2.8+/-0.7 arbitrary units (AU). In multivariate analysis, subjects with high tertile of sAF exhibited significantly higher risk for OAG (odds-ratio (OR): 3.32, 95% confidence interval (CI): 1.02;10.73). FPG measured 10 years before the eye examination was significantly associated with higher risk of OAG (OR: 1.25, 95%CI: 1.01;1.55) but not FPG measured at the same time as eye examination (OR: 1.26, 95%CI: 0.95;1.67), although ORs were similar . No significant associations were found between diabetes at the same time as eye examination and 10 years before with OAG (OR: 1.07, 95%CI: 0.41;2.79; OR: 1.50, 95%CI: 0.45;5.03, respectively).

Conclusions : Our study is the first to demonstrate an association between OAG and higher level of sAF, which may act as a long-term biomarker of metabolic memory. As AGEs have been associated with oxidative stress, inflammation and metabolic disorders as diabetes or cardiovascular diseases, our results suggest an accelerated aging process involved in the glaucomatous optic neuropathy.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.