Long-Term Alcohol Consumption and Risk of Exfoliation Glaucoma among US Health Professionals

Abstract

Purpose : High alcohol consumption decreases the bioavailability of dietary folate, a possible factor important for exfoliation glaucoma (XFG). We assessed the association between alcohol intake and incidence of XFG in a prospective study.

Methods : We followed 195,408 participants of the Nurses’ Health Study (1980–2018), the Health Professionals Follow-up Study (1986–2018), and the Nurses’ Health Study II (1991–2019) biennially. Eligible subjects at each 2-year risk period were 40+ years old and free of XFG with available data on diet and ophthalmic examinations. We evaluated cumulatively-averaged total alcohol (primary exposure); information for individual alcoholic beverages including beer, wine, and liquor were obtained from validated dietary food frequency questionnaires repeated every 2-4 years. The main outcome of XFG incidence was confirmed by medical records. We used per-eye Cox proportional hazards models, accounting for inter-eye correlations, to estimate multivariable-adjusted relative risks (MVRRs) and 95% confidence intervals (CIs)

Results : During 6,878,075 eye-years of follow-up, 702 eyes with XFG were documented. Greater total alcohol consumption was significantly associated with XFG risk: the MVRR for cumulatively averaged alcohol consumption ≥15+ g/day vs. non-drinking was 1.54 (95% CI, 1.16–2.05; P_trend=.02). Long- and short-term alcohol intake was significantly associated with XFG risk, with the strongest associations with cumulatively-averaged alcohol intake as of 4 years before diagnosis (MVRR ≥15+ g/day vs. non-drinking=1.62 [95% CI, 1.23–2.14; P_trend=.003]). Stratifying alcohol consumption by type of beverage revealed a significant trend for liquor. Compared to non-drinkers, consuming 3.6+ drinks per week of beer, total wine or liquor was associated with the following MVRRs for XFG: 1.25 (95% CI, 0.88–1.77; P_trend=.43), 1.34 (95% CI, 1.03–1.73; P_trend=.10) and 1.41 (95% CI, 1.11–1.79; P_trend=.02), respectively. We did not observe interactions by age, latitude, residential tier, intakes of folate or vitamin A (P_interaction>.40); however, the association between alcohol and XFG was suggestively stronger for those without family history of glaucoma (P_interaction=.10).

Conclusions : Alcohol consumption was associated with higher risk of XFG, an association that provides more clues regarding the etiology of XFG

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.