Association of socioeconomic status, polygenic risk, and glaucoma

Abstract

Purpose : To 1) assess the association of socioeconomic status (SES) with glaucoma and related traits, and 2) establish whether these associations are modified by a glaucoma polygenic risk score (PRS).

Methods : We performed cross-sectional and gene-environment interaction analyses of 60,715 European-descent English residents in the UK Biobank. SES was assessed through the English Index of Multiple Deprivation (IMD), an official composite measure of small-area deprivation, and self-reported annual household income as an indicator of individual SES. Glaucoma case ascertainment was based on a combination of self-report and record-linkage. Glaucoma-related traits were measured as part of a standardized eye examination and a glaucoma PRS (2,673 variants) was calculated for each participant. Associations were modelled using multivariable regression with adjustment for age, sex, and potential medical and lifestyle confounders.

Results : In maximally adjusted models, a one standard deviation increase in the total IMD score (indicating relatively greater deprivation) was associated with a greater prevalence of glaucoma (OR 1.07; 95% CI 1.01, 1.13; P=0.028), higher intraocular pressure (IOP; 0.04mmHg; 95% CI 0.02, 0.07; P=0.001), a thinner macular retinal nerve fiber layer (mRNFL; -0.13µm; 95% CI -0.18, -0.08, P<0.001) and a thinner ganglion cell-inner plexiform layer (-0.14µm; 95% CI -0.20, -0.07; P<0.001). Similarly, compared to those in the lowest household income category, those in the highest category had a lower prevalence of glaucoma (OR 0.65; 95% CI 0.47, 0.90; P=0.010), lower IOP (-0.32mmHg; 95% CI -0.44, -0.19; P<0.001) and a thicker mRNFL (0.40µm; 95% CI 0.18, 0.62; P<0.001) (P trend<0.001 for all). There was no relationship between SES and glaucoma PRS, and no significant gene-environment interactions.

Conclusions : In this racially and ethnically homogeneous population, both individual- and neighborhood-level SES were adversely associated with glaucoma prevalence. Consistent population-level associations were observed for all glaucoma-related traits, lending further support to the main finding. These relationships were not confounded by race/ethnicity and did not appear to be related to differences in genetic susceptibility to glaucoma. This suggests that greater socioeconomic deprivation may represent an independent risk factor for glaucoma, potentially reflecting a combination of unmeasured environmental risk factors for disease.

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