Abstract
Purpose :
Previous reports have examined the associations between fruit and vegetable intake, dietary fat consumption, and open-angle glaucoma (OAG). Antioxidants were thought to be neuroprotective while a higher ratio of omega-3 to omega-6 fatty acids diet was associated with an increased risk for OAG. We conducted a secondary analysis of a randomized intervention trial to test if dietary modification (DM) altered the risk of OAG.
Methods :
Our analyses were based on an intent-to-treat design, with a follow up to the end of continuous coverage in Medicare part B, death, or the last date that Medicare claims data was available (12/31/2018), whichever occurred first. We linked Medicare claims data to 45,203 women in the Women's Health Initiative Dietary Modification Trial, of which 23,776 participants were enrolled in fee-for-service Medicare Part B and had physician claims. Women were randomized to follow either dietary modification (DM) (a diet low in fat, with increased vegetable, fruit, and grain intake) or the usual diet with no modifications. Primary OAG was defined as the first claim with the International Classification of Diseases (ICD)-9 or ICD-10 codes. We used Cox proportional hazards models to calculate hazard ratios (HR) and 95% confidence interval for risk of OAG in intervention and control groups. Subgroup analyses were performed and P-interaction values were evaluated for selected characteristics.
Results :
After exclusion of women with Medicare-derived glaucoma prior to randomization, the final analysis included 23,217 women (mean age = 68.5 ± 4.8 years). Baseline characteristics including diabetes, hypertension, BMI ≥ 30 were balanced between the intervention and control groups. The final models were adjusted for age and race/ethnicity. As reported in Table 1, OAG incidence was 12.9% (mean follow-up = 11.6 ± 7.4 years; mean DM duration = 5.2 ± 3.2 years). After adjusting for BMI ≥30, hypertension, diabetes, and statin use, we found no overall benefit of DM in reducing incident OAG (HR = 1.04, 95% CI = 0.96-1.12). Race and participant age did not modify the relation between DM intervention and OAG risk (P interaction 0.25 and 0.44, respectively).
Conclusions :
Analysis suggests that DM does not reduce the risk of incident OAG among women regardless of age or race.
This is a 2021 ARVO Annual Meeting abstract.