Is normal-tension glaucoma a risk factor for stroke?—A 10-year follow-up study

Lee, Meng Sheng; Kuo, Li-Lin; Tan, Elise Chia‐Hui; Lee, Oscar K.

doi:10.1371/journal.pone.0179307

Cited by 18 publications

(15 citation statements)

References 64 publications

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“…Meta-regression also failed to distinguish the exact source of the heterogeneity. Several factors, such as different characteristics of the populations, different quality of the included studies, different methods used to ascertain outcomes and exposure, different sample 44 Age, sex Chen (2005) 9 Age, SBP, DBP, glucose Motsko (2008) 54 Age, sex Lin (2010) 8 Age, gender, monthly income, and level of urbanization of the community in which the patient resided Lin (2010) 45 Age, sex Imai (2010) 42 Age, maximum temperature, increased abdominal circumference, elevated fasting glucose level, BP Ishikawa (2011) 52 Age, sex, DBP, IOP, and ocular perfusion pressure Newman-Casey (2011) 7 Age, sex, race, education level, household net worth, region of residence at the time of enrollment in the medical plan, cataract, pseudophakia or aphakia, macular degeneration, diabetic retinopathy, systemic hypotension, sleep apnea, and migraine headache Lee (2012) 46 Age, sex, SBP Lin (2012) 33 Age, sex, BMI, waist, SBP, DBP, fasting sugar, and postprandial sugar Kim (2014) 34 Age, sex, impaired glucose tolerance, hypertension, and baseline IOP Aptel (2014) 47 Age, sex, BMI, hypertension, and thyroid dysfunction Kim (2014) 43 Age, sex Chung (2014) 53 Age, sex Kim (2014) 55 Age, sex, myopia, fasting blood glucose Chen (2014) 48 Age, sex, hypertension, diabetes, CAD, and obstructive sleep apnea Sahinoglu-Keskek (2014) 41 Age Fujiwara (2015) 49 Age, sex, SBP, diabetes, cholesterol, HDLcholesterol, BMI, waist circumference, smoking habits, alcohol intake, and regular exercise Shim (2015) 32 Age, sex Chen (2016) 50 Age, sex Chen (2016) 51 Age, gender, and comorbidities of diabetes, hypertension, and CAD Ko (2016) 35 Age, gender, ethnicity, education, insurance, diabetes duration, BMI, hypertension, obstructive sleep apnea, and current smoker Kim (2016) 36 Age, sex, IOP, household income, exercise, education level, smoking status, alcohol consumption, and BMI Yokomichi (2016) 10 Age, sex, SBP, DBP, fasting plasma glucose Rim (2017) 37 Age, sex, hypertension, DM, chronic renal failure, atrial fibrillation, residence, income Lee (2017) 38 Age, sex, hypertension, DM, congestive heart failure, ischemic heart disease, atrial fibrillat...…”

Section: Discussionmentioning

confidence: 99%

Hyperlipidemia, Blood Lipid Level, and the Risk of Glaucoma: A Meta-Analysis

Wang

Bao

2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. Previous studies reported that hyperlipidemia and blood lipid levels were associated with glaucoma, ocular hypertension (OHT), and intraocular pressure (IOP). However, studies aimed at investigating this association have yielded conflicting results. Therefore, to shed light on these inconclusive findings, we performed multiple distinct meta-analyses to clarify the association of hyperlipidemia and blood lipid levels with glaucoma, OHT, and IOP. METHODS. A systematic literature search from Embase, Web of Science, and PubMed was performed to identify relevant studies. To assess the association between hyperlipidemia and glaucoma, we used the pooled odds ratio (OR) with 95% confidence interval (CI). When we assessed the association between blood lipid levels and IOP levels, the pooled mean difference in IOP associated with a 10 mg/dL increase in the blood lipid level was estimated. The pooled difference in IOP was also estimated between patients with and without hyperlipidemia. All the papers that assessed the correlation between hyperlipidemia and glaucoma, between blood lipid levels and IOP levels, and between hyperlipidemia and IOP were included in this meta-analysis. RESULTS. We detected a marked association between hyperlipidemia and glaucoma (OR ¼ 1.37; 95% CI ¼ 1.16-1.61), with significant heterogeneity among studies. However, hyperlipidemia was not significantly associated with glaucoma in our analysis of only crosssectional studies, studies that reported only on hypercholesterolemia patients, studies that were conducted only in North America and Europe, or studies in which normal-tension glaucoma (NTG) patients were included only in the subgroup analyses. The pooled results showed that an increase of 10 mg/dL in blood triglyceride levels would increase the IOP by 0.016 mm Hg (95% CI ¼ 0.009-0.024), with evident heterogeneity between studies (P < 0.001; I 2 ¼ 92.0%). The pooled results showed that the blood total cholesterol and lowdensity lipoprotein-cholesterol (LDL-c) level both had a significant association with IOP. When compared to the patients with nonhyperlipidemia, those with hyperlipidemia had a significantly higher IOP of 0.51 mm Hg (95% CI ¼ 0.18-0.83) (P ¼ 0.001 for heterogeneity; I 2 ¼ 81.6%). CONCLUSIONS. The evidence suggests that hyperlipidemia is significantly associated with an increased risk of glaucoma and that hyperlipidemia and the increased blood lipid levels are associated with increased IOP.

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Section: Discussionmentioning

confidence: 99%

Hyperlipidemia, Blood Lipid Level, and the Risk of Glaucoma: A Meta-Analysis

Wang

Bao

2019

Invest. Ophthalmol. Vis. Sci.

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“…Besides, the diagnostic prevalence of glaucoma in the younger age categories was almost the same as that in the older age categories. One reason is that the prevalence of open-angle glaucoma (including normal tension glaucoma) has been higher than that of angle-closure glaucoma since 2005 [ 21 ], and patients with normal tension glaucoma generally have a younger age than those with angle-closure glaucoma [ 22 ], thus lowering the average age of glaucoma patients. Another reason is the high accessibility of healthcare achieved by the Taiwan NHI system [ 23 ], thus glaucoma can be diagnosed at an earlier age.…”

Section: Discussionmentioning

confidence: 99%

The association between glaucoma and risk of depression: a nationwide population-based cohort study

et al. 2018

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BackgroundPrevious cross-sectional studies revealed a higher prevalence of depression among glaucoma patients. However, cohort studies were in lack to build the risk of incident depression after the diagnosis of glaucoma. The aim of our study was to investigate the association between glaucoma and the subsequent risk of developing depression and to assess risk factors associated with depression in glaucoma patients.MethodsA population-based retrospective cohort study using the Taiwan National Health Insurance Research Database was conducted from January 1, 2001 through December 31, 2011. Glaucoma patients (n = 8777) and age- and gender-matched control subjects without glaucoma (n = 35,108) were enrolled in the study. Kaplan-Meier curves were generated to compare the cumulative hazard of subsequent depression between the glaucoma and control groups. A Cox regression analysis estimated the crude and adjusted hazard ratios (HRs) for depression. Risk factors leading to depression were investigated among the glaucoma patients.ResultsGlaucoma patients had a significantly higher cumulative hazard of depression compared to the control group (p-value < 0.0001). The Cox regression model indicated that the glaucoma group had a significantly higher risk of depression (adjusted HR = 1.71). Within the glaucoma group, significant risk factors for depression included age, female, low income, substance abuse, and living alone. However, the use of β-blocker eye drops and the number of glaucoma medications were not significant risk factors for depression.ConclusionPatients with glaucoma are at significantly greater risk of developing depression. Among glaucoma patients, age, female, low income, substance abuse, and living alone were significant risk factors for depression.

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“…Cerebrovascular disease plays a critical role in the pathogenesis of glaucoma 28 and is more frequent in patients with NTG than in patients with HTG or healthy subjects. 29 Thus, our prospective clinical research provides evidence of cerebrovascular dysfunction in patients with NTG. Recent studies have shown reduced cerebrovascular blood flow velocities 30 , 31 and increased risk of Alzheimer disease or other dementia in patients with NTG.…”

Section: Discussionmentioning

confidence: 86%

Prospective Pilot Clinical Study of Noninvasive Cerebrovascular Autoregulation Monitoring in Open-Angle Glaucoma Patients and Healthy Subjects

Hamarat

Deimantavičius

Dambrauskas

et al. 2022

Trans. Vis. Sci. Tech.

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Purpose To analyze the cerebrovascular autoregulation (CA) dynamics in patients with normal-tension glaucoma (NTG) and high-tension glaucoma (HTG) as well as healthy subjects using noninvasive ultrasound technologies for the first time. Methods The CA status of 10 patients with NTG, 8 patients with HTG, and 10 healthy subjects was assessed, using an innovative noninvasive ultrasonic technique, based on intracranial blood volume slow-wave measurements. Identified in each participant were intraocular pressure, ocular perfusion pressure, and CA-related parameter volumetric reactivity index (VRx), as well as the duration and doses of the longest cerebral autoregulation impairment (LCAI). In addition, we calculated the associations of these parameters with patients’ diagnoses. Results The VRx value, the LCAI dose, and duration in healthy subjects were significantly lower than in patients with NTG ( P < 0.05). However, no significant differences were noted in these parameters between healthy subjects and HTG and between NTG and HTG groups. Conclusions NTG is associated with the disturbed cerebral blood flow and could be diagnosed by performing noninvasive CA assessments. Translational Relevance The VRx monitoring method can be applied to a wider range of patient groups, especially patients with normal-tension glaucoma.

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Is normal-tension glaucoma a risk factor for stroke?—A 10-year follow-up study

Cited by 18 publications

References 64 publications

Hyperlipidemia, Blood Lipid Level, and the Risk of Glaucoma: A Meta-Analysis

Hyperlipidemia, Blood Lipid Level, and the Risk of Glaucoma: A Meta-Analysis

The association between glaucoma and risk of depression: a nationwide population-based cohort study

Prospective Pilot Clinical Study of Noninvasive Cerebrovascular Autoregulation Monitoring in Open-Angle Glaucoma Patients and Healthy Subjects

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