Association of Ambient Particulate Matter (PM2.5) Exposure and Glaucoma Incidence: A Prospective UK Biobank Study

Abstract

Purpose : Glaucoma is one of the leading causes of irreversible blindness worldwide. Despite increasing concern about air quality and its impact on ocular health, a knowledge gap exists regarding the long-term association between air pollution and glaucoma. This study examines the relationship between ambient particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) exposure and incident glaucoma in UK Biobank.

Methods : This was a prospective, observational study. Levels of air pollution were estimated using land use regression models for the year of 2010. [PM2.5] was selected as the air quality exposure of interest. Incident glaucoma events were identified through hospital inpatient admission records. Time to incident glaucoma and follow-up time were recorded from baseline (January 1, 2010) until the last censored event, which could be death, end of data linkage (November 30, 2020), or loss to follow-up, whichever occurred first. Cox proportional hazards models were used to examine the associations between PM2.5 exposure and incident glaucoma, adjusting for potentially confounding sociodemographic and lifestyle factors.

Results : Over a median follow-up of 10.9 years in a study cohort of 451,873 participants, we identified 4,728 new cases of glaucoma, resulting in an incidence rate of 95.9 per 100,000 person-years. Data showed there was a 4% increase in the risk of glaucoma (hazard ratio [HR] 1.04, 95% confidence interval [CI] 1.01-1.08, P = 0.032) per interquartile range increase in PM2.5 level. Participants in the highest quartile (10.6 to 21.3 ug/m³) of PM2.5 exposure had a 11% greater risk of developing glaucoma compared to those in the lowest quartile (8.2 to 9.3 ug/m³) (HR 1.11, 95% CI 1.01-1.21, P = 0.025). No statistically significant differences in glaucoma risk were observed in the second (HR 1.00, 95% CI 0.92-1.09, P = 0.982) and third (HR 1.03, 95% CI 0.94-1.11, P = 0.561) quartiles of PM2.5 exposure. However, the overall trend across quartiles (P for trend = 0.026) is statistically significant, indicating there is an increase in glaucoma risk as PM2.5 exposure levels rise.

Conclusions : Greater PM2.5 exposure was associated with a greater risk of developing glaucoma. Our findings underscore the potential public health implications of ambient air pollution in increasing glaucoma risk, emphasizing the necessity for studies of targeted environmental interventions.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.