Abstract
Purpose :
To investigate the metabolic risk factors for open-angle glaucoma (OAG) in a large community-based high myopic population.
Methods :
The Tongren Health Care Study is a community-based study based on annual health checkup, with all participants underwent detailed systematic and ophthalmic examinations, while current participants were cross-sectionally selected from the examination between 2020 and 2022. High myopia was defined as a refractive error ≤ -5.00 diopters. Glaucoma was assessed by an experienced ophthalmologist based on color fundus photographs. Basal metabolic rate (BMR) was assessed by resting energy expenditure calculated from fat-free mass. Individuals below 20 years old and those with other types of glaucoma were excluded from the analysis.
Results :
A total of 3197 patients with high myopia (mean age: 37.8 ± 9.3 years; 45.9% male; mean myopia: -6.3 ± 1.5 Diopters) were enrolled in the study, of whom 197 were identified as having glaucoma (6.2%, 95% CI: 5.3%, 7.0%) (Figure 1). In univariate analysis (with adjustment for age and sex), the presence of OAG was associated with higher degree in myopic refractive error, higher intraocular pressure (IOP), higher body height, greater body weight, higher BMR, having diabetes, having high blood pressure, and higher serum concentration of HbA1c, calcium, alkaline phosphatase (ALP), and alanine transaminase (all P<0.05) in high myopic population. After multivariate analysis adjusting for age, sex, IOP, and myopic refraction, OAG was still associated with a higher body height (P=0.032, odds ratio (OR): 1.01 (1.00, 1.03)), a greater body weight (P<0.001, OR: 1.06 (1.03, 1.08)), a higher BMR (P=0.011, OR: 1.02 (1.00, 1.03) per 10 kcal/d), and a higher serum concentration of ALP (P=0.019, OR: 1.01 (1.00, 1.02)) (Figure 2a). Compared with participants with serum ALP <65 U/L, participants with serum ALP ≥105 U/L had a 2.11-fold increased risk for glaucoma (P=0.005, OR: 2.11 (1.25, 3.57)) (Figure 2b).
Conclusions :
In our study involving a significant high myopic population, we observed a correlation between the presence of OAG and elevated risk factors, including higher body weight, body height, BMR and increased serum ALP levels. Given that high prevalence of normal tension glaucoma in myopia related OAG, our results hint at a potential metabolic basis for OAG, particularly in high myopia.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.