Abstract

Glaucoma is a leading cause of loss of sight. High intraocular pressure (IOP) is the most critical risk factor. However, glaucoma develops even within a normal IOP range. Normal tension glaucoma (NTG) is more common in Asia, whereas high tension glaucoma is more common in Western countries. The pathogenesis of glaucoma, especially NTG, is poorly understood. We evaluated the correlation between dietary nutrient intake and glaucoma using data from subjects ≥40 years old from the ongoing, nationwide, population-based study, the Korean National Health and Nutrition Examination Survey V (2008–2012). Dietary intake was determined using the 24 h recall method. Fiber (g/day), ash (g/day), calcium (mg/day), phosphorus (mg/day), iron (mg/day), sodium (mg/day), potassium (mg/day), β-Carotene (μg/day), retinol (μg/day), vitamin A (μg Retinol Equivalents/day), thiamine (mg/day), riboflavin (mg/day), niacin (mg/day), and vitamin C (mg/day) were included in nutrient intake data. All nutrient intake was divided into quartiles. The mean IOP did not differ according to quartiles from any nutrients (all p > 0.05). After adjusting for age, gender, income status, education level, smoking, alcohol consumption, physical activity, diabetes, hypertension, IOP, and total energy, the intake of niacin was associated with glaucoma (p = 0.013). Among subjects with IOP ≤ 21 mmHg, only niacin was related to glaucoma in a multivariate analysis (p = 0.022). Dietary nutrient intake was associated with open-angle glaucoma independent of IOP. Individuals with NTG showed lower intake of niacin among nutrients. This finding suggests the possibility that proper diet counseling may be another modifiable factor, aside from IOP, particularly among patients with NTG.

Highlights

  • Glaucoma is a leading cause of loss of sight, affecting more than 70 million people worldwide [1,2].The pathogenesis of glaucoma is not fully established, intraocular pressure (IOP) is the most critical and treatable risk factor

  • We investigated the potential impact of dietary nutrients on glaucoma using the Korean National Health and Nutrition Examination Survey (KNHANES), a large population-based study

  • The proportion of individuals with glaucoma diagnosis made in the absence of visual field defects and/or abnormal optic disc parameters was 47.4%

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Summary

Introduction

The pathogenesis of glaucoma is not fully established, intraocular pressure (IOP) is the most critical and treatable risk factor. Glaucoma develops even within a normal IOP range and can progress, even with a substantial decrease in IOP. Excitotoxicity, unstable blood flow and oxidative stress can affect the development and progression of glaucoma [3]. A family history of glaucoma is one of the risk factors for primary open-angle glaucoma (POAG) [4]. Members have a high probability of having common genetic susceptibility or similar lifestyles, such as diet. Given those findings, different genes or environmental factors may be linked to the development of glaucoma.

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