Abstract
Purpose :
To investigate the relationship between skin autofluorescence (SAF) and circumpapillary retinal nerve fiber layer thickness (cpRNFLT) in glaucoma patients, in response to recent studies showing that glaucoma is affected by multiple factors, including oxidative stress.
Methods :
This was a prospective study of 235 consecutive Japanese patients with NTG. We used an AGE Reader to measure SAF, an indicator of advanced glycation end products, and optical coherence tomography to measure cpRNFLT. Next, we selected the youngest quartile of patients (male ≤ 55 YO, female ≤ 54 YO) and investigated the association of SAF and cpRNFLT, both with each other and with other factors. Intergroup comparisons used the Mann-Whitney U test and Fisher’s exact test. Spearman’s rank correlation test was used to evaluate single correlations between SAF and other variables. A series of multiple linear regression analyses were performed to determine independent variables affecting cpRNFLT.
Results :
This study included 235 eyes of Japanese normal-tension glaucoma patients (104 male and 131 female) and 65 normal control subjects (22 male and 43 female). We observed a negative correlation between SAF and cpRNFLT only in male NTG patients (r =-0.26, P=0.01), not in female NTG patients. Including only younger male NTG patients in the analysis strengthened this correlation (r=-0.44, p=0.02). Performing the analysis separately in each quadrant of the optic nerve head showed that temporal cpRNFLT had the strongest correlation with SAF (r=-0.41, p=0.03). Finally, we observed the strongest correlations between SAF and cpRNFLT in the temporal, inferior, and nasal quadrants in a group of younger male, patients with early and moderate NTG(r=-0.55, p=0.01, r=-0.52, p=0.01, and r=-0.47, p=0.03, respectively). Multiple regression analysis revealed that SAF was an independent contributing factor to cpRNFLT (p=0.01), and that temporal and inferior cpRNFLT were independent contributing factors in younger male NTG patients (p=0.02 and p=0.02).
Conclusions :
We found a close relationship between SAF and cpRNFLT, especially temporal and inferior cpRNFLT, in young male NTG patients. These results suggest that systemic oxidative stress is associated with glaucoma. Thus, biomarkers of systemic oxidative stress should enable the discovery of new antioxidant treatments for glaucoma.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.