The Association of Refractive Error with Glaucoma in a Multiethnic Population.
The Association of Refractive Error with Glaucoma in a Multiethnic Population.
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DOI：
10.1016/j.ophtha.2015.07.002
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发表时间：
2016-01
期刊：
影响因子：
13.7
通讯作者：
Jorgenson E
中科院分区：
文献类型：
--
作者：
Shen L;Melles RB;Metlapally R;Barcellos L;Schaefer C;Risch N;Herrinton LJ;Wildsoet C;Jorgenson E
评估不同种族或民族的屈光不正与青光眼患病率之间的关联。横断面研究。 2008 年至 2014 年间，年龄在 35 岁或以上且没有白内障手术、屈光手术或角膜疾病史的 Kaiser Permanente 北加州健康计划会员。我们确定了 34 040 名患有青光眼或高眼压症的会员（OHTN；病例）和 403 398 名没有青光眼的会员（对照）。青光眼病例被分类为原发性闭角型青光眼（PACG）；开角型青光眼 4 种形式中的 1 种：原发性开角型青光眼 (POAG)、正常眼压性青光眼 (NTG)、色素性青光眼 (PIGM) 和假性剥脱性青光眼 (PEX)；或 OHTN。屈光不正以球镜当量 (SE) 表示，被编码为连续特征和类别。使用逻辑回归分析来估计屈光不正与整体和特定种族或民族群体中青光眼患病率之间的关联。屈光不正与青光眼亚型之间的关联以优势比 (OR) 和 95% 置信区间 (CI) 进行评估。在对照组中，平均 SE 为 -0.59 屈光度 (D)（标准差，2.62 D）。 SE 每降低一维，PACG 发生率就会降低 22%（OR，0.78；95% CI，0.77-0.80），并且开角型青光眼发生率增加，PIGM 为 1.23（95% CI，1.20-1.26）至 1.07（95% CI，1.03-1.11）对于 PEX，对于 OHTN，为 1.05（95% CI，1.04–1.06）。此外，我们观察到非西班牙裔白人（OR，1.12；95% CI，1.11-1.13）近视与 POAG 之间的关联性更强，亚洲人（OR，1.17；95% CI，1.15-1.20）和非西班牙裔白人（OR，1.19；95% CI，1.15-1.22）中 NTG 之间的关联性更强。近视与所有形式的开角型青光眼和 OHTN 患病率增加相关，而远视与 PACG 患病率大幅增加相关。尽管高度近视是青光眼亚型的重要危险因素，但低度和中度近视对青光眼风险也有显着影响。此外，近视与 POAG 和 NTG 风险之间的关联存在中等程度的种族差异。
To evaluate the association between refractive error and the prevalence of glaucoma by race or ethnicity. Cross-sectional study. Kaiser Permanente Northern California Health Plan members with refractive error measured at 35 years of age or older between 2008 and 2014 and with no history of cataract surgery, refractive surgery, or a corneal disorder. We identified 34 040 members with glaucoma or ocular hypertension (OHTN; cases) and 403 398 members without glaucoma (controls). Glaucoma cases were classified as primary angle-closure glaucoma (PACG); 1 of the 4 forms of open-angle glaucoma: primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), pigmentary glaucoma (PIGM), and pseudoexfoliation glaucoma (PEX); or OHTN. Refractive error, expressed as spherical equivalent (SE), was coded as a continuous trait and also as categories. Logistic regression analyses were used to estimate the association between refractive error and the prevalence of glaucoma overall and in specific racial or ethnic groups. The association between refractive error and glaucoma subtypes evaluated as odds ratios (ORs) with 95% confidence intervals (CIs). In controls, the mean SE was −0.59 diopters (D) (standard deviation, 2.62 D). Each 1-D reduction in SE was associated with a 22% decrease in the odds of PACG (OR, 0.78; 95% CI, 0.77–0.80) and with increases in the odds of open-angle glaucoma ranging from 1.23 (95% CI, 1.20–1.26) for PIGM, to 1.07 (95% CI, 1.03–1.11) for PEX, and to 1.05 (95% CI, 1.04–1.06) for OHTN. In addition, we observed a stronger association between myopia and POAG among non-Hispanic whites (OR, 1.12; 95% CI, 1.11–1.13) and NTG among Asians (OR, 1.17; 95% CI, 1.15–1.20) and non-Hispanic whites (OR, 1.19; 95% CI, 1.15–1.22). Myopia was associated with an increased prevalence of all forms of open-angle glaucoma and OHTN, whereas hyperopia was associated with a substantially increased prevalence of PACG. Although high myopia is a strong risk factor for glaucoma subtypes, low and moderate myopia also have a significant effect on glaucoma risk. Additionally, there were moderate racial differences in the association of myopia with the risk of POAG and NTG.