Risk factors for primary open-angle glaucoma and pseudoexfoliative glaucoma in the thessaloniki eye study

Fotis Topouzis, M. Roy Wilson, Alon Harris, Panayiota Founti, Fei Yu, Eleftherios Anastasopoulos, Theofanis Pappas, Archimidis Koskosas, Angeliki Salonikiou, Anne L. Coleman

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Abstract

Purpose: To investigate risk factors for primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEXG) in the Thessaloniki Eye Study. Design: Cross-sectional, population-based study. Methods: Randomly selected subjects 60 years of age and older (n = 2554) participated in the Thessaloniki Eye Study. Glaucomatous damage and presence of pseudoexfoliation (PEX) were defined according to specific criteria. Open-angle glaucoma (OAG) subjects were compared with nonglaucoma subjects (controls), POAG subjects were compared with controls without PEX, and PEXG subjects were compared with controls with PEX for demographic, lifestyle, ophthalmic, and systemic factors. Factors with P <.2 in the univariate analysis were retained for multivariate analyses. Results: In multivariate analysis restricted to persons who participated in clinic visits and who had at least 1 phakic eye (n = 2078), intraocular pressure (odds ratio [OR], 1.21 per 1 mm Hg; P <.001), PEX (OR, 2.81; P <.001), history of coronary artery bypass or vascular surgery (OR, 1.95; P =.017), and moderate-to-high myopia (< -3 diopters; OR, 2.40; P =.009) were associated with higher odds for OAG. In analysis including all clinic visits (n = 2261), age became significantly associated (OR, 1.05; P =.004). In multivariate analysis for POAG (n = 1840), associations were found for age (OR, 1.04 per year; P =.048), IOP (OR, 1.19 per 1 mm Hg; P <.001), history of coronary artery bypass or vascular surgery (OR, 2.09; P =.01), and history of diabetes treated with insulin (OR, 3.05; P =.045). In multivariate analysis for PEXG (n = 238), the latter was associated with increased IOP (OR, 1.25 per 1 mm Hg; P <.001). Conclusions: IOP was the only factor associated with both POAG and PEXG, whereas moderate-to-high myopia showed borderline significance in both. Vascular systemic diseases and their treatment were associated only with POAG. The implications of these differences for the pathogenesis between the 2 common types of OAG should be explored further.

Original languageEnglish
JournalAmerican Journal of Ophthalmology
Volume152
Issue number2
DOIs
StatePublished - Aug 2011

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Glaucoma
Odds Ratio
Open Angle Glaucoma
Multivariate Analysis
Myopia
Ambulatory Care
Coronary Artery Bypass
Blood Vessels
Primary Open Angle Glaucoma
Intraocular Pressure
Vascular Diseases
Life Style
Demography
Insulin

ASJC Scopus subject areas

  • Ophthalmology

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Risk factors for primary open-angle glaucoma and pseudoexfoliative glaucoma in the thessaloniki eye study. / Topouzis, Fotis; Wilson, M. Roy; Harris, Alon; Founti, Panayiota; Yu, Fei; Anastasopoulos, Eleftherios; Pappas, Theofanis; Koskosas, Archimidis; Salonikiou, Angeliki; Coleman, Anne L.

In: American Journal of Ophthalmology, Vol. 152, No. 2, 08.2011.

Research output: Contribution to journalArticle

Topouzis, F, Wilson, MR, Harris, A, Founti, P, Yu, F, Anastasopoulos, E, Pappas, T, Koskosas, A, Salonikiou, A & Coleman, AL 2011, 'Risk factors for primary open-angle glaucoma and pseudoexfoliative glaucoma in the thessaloniki eye study', American Journal of Ophthalmology, vol. 152, no. 2. https://doi.org/10.1016/j.ajo.2011.01.032
Topouzis, Fotis ; Wilson, M. Roy ; Harris, Alon ; Founti, Panayiota ; Yu, Fei ; Anastasopoulos, Eleftherios ; Pappas, Theofanis ; Koskosas, Archimidis ; Salonikiou, Angeliki ; Coleman, Anne L. / Risk factors for primary open-angle glaucoma and pseudoexfoliative glaucoma in the thessaloniki eye study. In: American Journal of Ophthalmology. 2011 ; Vol. 152, No. 2.
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abstract = "Purpose: To investigate risk factors for primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEXG) in the Thessaloniki Eye Study. Design: Cross-sectional, population-based study. Methods: Randomly selected subjects 60 years of age and older (n = 2554) participated in the Thessaloniki Eye Study. Glaucomatous damage and presence of pseudoexfoliation (PEX) were defined according to specific criteria. Open-angle glaucoma (OAG) subjects were compared with nonglaucoma subjects (controls), POAG subjects were compared with controls without PEX, and PEXG subjects were compared with controls with PEX for demographic, lifestyle, ophthalmic, and systemic factors. Factors with P <.2 in the univariate analysis were retained for multivariate analyses. Results: In multivariate analysis restricted to persons who participated in clinic visits and who had at least 1 phakic eye (n = 2078), intraocular pressure (odds ratio [OR], 1.21 per 1 mm Hg; P <.001), PEX (OR, 2.81; P <.001), history of coronary artery bypass or vascular surgery (OR, 1.95; P =.017), and moderate-to-high myopia (< -3 diopters; OR, 2.40; P =.009) were associated with higher odds for OAG. In analysis including all clinic visits (n = 2261), age became significantly associated (OR, 1.05; P =.004). In multivariate analysis for POAG (n = 1840), associations were found for age (OR, 1.04 per year; P =.048), IOP (OR, 1.19 per 1 mm Hg; P <.001), history of coronary artery bypass or vascular surgery (OR, 2.09; P =.01), and history of diabetes treated with insulin (OR, 3.05; P =.045). In multivariate analysis for PEXG (n = 238), the latter was associated with increased IOP (OR, 1.25 per 1 mm Hg; P <.001). Conclusions: IOP was the only factor associated with both POAG and PEXG, whereas moderate-to-high myopia showed borderline significance in both. Vascular systemic diseases and their treatment were associated only with POAG. The implications of these differences for the pathogenesis between the 2 common types of OAG should be explored further.",
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AU - Topouzis, Fotis

AU - Wilson, M. Roy

AU - Harris, Alon

AU - Founti, Panayiota

AU - Yu, Fei

AU - Anastasopoulos, Eleftherios

AU - Pappas, Theofanis

AU - Koskosas, Archimidis

AU - Salonikiou, Angeliki

AU - Coleman, Anne L.

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N2 - Purpose: To investigate risk factors for primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEXG) in the Thessaloniki Eye Study. Design: Cross-sectional, population-based study. Methods: Randomly selected subjects 60 years of age and older (n = 2554) participated in the Thessaloniki Eye Study. Glaucomatous damage and presence of pseudoexfoliation (PEX) were defined according to specific criteria. Open-angle glaucoma (OAG) subjects were compared with nonglaucoma subjects (controls), POAG subjects were compared with controls without PEX, and PEXG subjects were compared with controls with PEX for demographic, lifestyle, ophthalmic, and systemic factors. Factors with P <.2 in the univariate analysis were retained for multivariate analyses. Results: In multivariate analysis restricted to persons who participated in clinic visits and who had at least 1 phakic eye (n = 2078), intraocular pressure (odds ratio [OR], 1.21 per 1 mm Hg; P <.001), PEX (OR, 2.81; P <.001), history of coronary artery bypass or vascular surgery (OR, 1.95; P =.017), and moderate-to-high myopia (< -3 diopters; OR, 2.40; P =.009) were associated with higher odds for OAG. In analysis including all clinic visits (n = 2261), age became significantly associated (OR, 1.05; P =.004). In multivariate analysis for POAG (n = 1840), associations were found for age (OR, 1.04 per year; P =.048), IOP (OR, 1.19 per 1 mm Hg; P <.001), history of coronary artery bypass or vascular surgery (OR, 2.09; P =.01), and history of diabetes treated with insulin (OR, 3.05; P =.045). In multivariate analysis for PEXG (n = 238), the latter was associated with increased IOP (OR, 1.25 per 1 mm Hg; P <.001). Conclusions: IOP was the only factor associated with both POAG and PEXG, whereas moderate-to-high myopia showed borderline significance in both. Vascular systemic diseases and their treatment were associated only with POAG. The implications of these differences for the pathogenesis between the 2 common types of OAG should be explored further.

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