Sex differences in the association between systemic oxidative stress status and optic nerve head blood flow in normal-tension glaucoma

Abstract

Purpose To investigate the association of systemic oxidative stress markers and optic nerve head (ONH) blood flow in normal-tension glaucoma (NTG) patients, as well as sex differences in this association. Methods This was a cross-sectional study of 235 eyes with NTG of 134 patients (56 male, 78 female; mean age, 60.9±14.1 years). Laser speckle flowgraphy (LSFG) was used to measure ONH blood flow (mean blur rate in the tissue area of the ONH; MBR-T) and LSFG pulse-waveform parameters, including flow acceleration index in the tissue area of the ONH (FAI-T). Oxidative stress markers, diacron-reactive oxygen metabolites (d-ROMs), and biological antioxidant potential (BAP) were measured with a free radical elective evaluator. Spearman’s rank correlation test and a multivariate linear mixed-effect model were used to investigate factors associated with ONH blood flow. Results MBR-T was significantly correlated with age (rs = -0.28, p < 0.001), mean arterial pressure (rs = -0.20, p = 0.002), intraocular pressure (rs = 0.24, p < 0.001), peripapillary retinal nerve fiber layer thickness (rs = 0.62, p < 0.001), and disc area (rs = -0.26, p < 0.001), but not with serum d-ROM level. Separate analyses of the subjects divided by sex showed that BAP was positively correlated to MBR-T (rs = 0.21, p = 0.036) and FAI-T (rs = 0.36, p < 0.001) only in male subjects. Similarly, BAP was significantly associated with MBR-T (β = 0.25, p = 0.026) and FAI-T (β = 0.37, p < 0.001) in male subjects in a multivariate linear mixed-effect model. Conclusion A lower serum antioxidant level, as indicated by BAP, was associated with reduced ONH blood flow only in male NTG patients. Our findings suggest that there are sex differences in the involvement of oxidative stress in the pathogenesis of reduced ocular blood flow in NTG.

Factors Associated With Visual Acuity Decline in Glaucoma Patients With Loss of Ganglion Cell Complex Thickness

“…The parameters were selected based on various factors that we have previously reported that affect visual acuity and that we routinely measure in our outpatient clinic, including aging, 12 corneal thickness, 13 CH, 15 ocular blood flow, 12 blood pressure, 13 pulse rate, 12 and oxidative stress, as represented by dROM level and BAP. 14 , 23 The results showed that age, BAP, CH, and MBR-T were significant parameters even after conducting a multiple linear regression analysis. These factors have been reported as glaucoma risk factors.…”

The association between intraocular pressure dynamics during dark-room prone testing and intraocular pressure over a relatively long-term follow-up period in primary open-glaucoma patients

“…All data are presented as the mean ± SD. A multivariable linear mixed-effects model was employed, setting the “subject” variable as a random effect [ 22 – 24 ], to evaluate the association of IOP dynamics during the follow-up term and DRPT with other variables while adjusting for potential confounding factors, including age, gender, DRPT baseline IOP, axial length, and the number of eyedrops. All statistical analyses were conducted using R software version 4.1.1 (R Core Team 2021).…”