Abstract
While exposure to pesticides is a known risk factor for neurodegenerative brain diseases, little is known about the influence of environment on glaucoma neuropathy. We aimed to determine whether farmers are at higher risk of developing severe primary open-angle glaucoma (POAG). This retrospective cohort study (tertiary referral center, Reims University Hospital, France) included patients diagnosed with POAG in the last two years. Univariate analysis and adjusted multivariate logistic regression were performed to evaluate the association between agricultural profession and all recorded data. Glaucoma severity (primary outcome) and the number of patients who underwent filtering surgery (secondary outcome) were analyzed. In total, 2065 records were screened, and 772 patients were included (66 in the farmer group and 706 in the nonfarmer group). The risk of severe glaucoma was higher in the farmer group (adjusted odds ratio (aOR) 1.87, p = 0.03). More patients underwent filtering surgery in the farmer group in univariate analysis (p = 0.02) but with no statistical significance after adjustment (p = 0.08). These results suggest pesticide exposure may be a factor accelerating the neurodegeneration in POAG, although a direct link between the agricultural profession and the disease requires further extended studies to be demonstrated.
Highlights
Glaucoma is the leading cause of irreversible blindness in the world
We excluded patients with nonglaucomatous pathology leading to best-corrected visual acuity (BCVA) worse than 20/40, an unrealizable or uninterpretable visual field (VF), and patients unregistered under the social security system
We analyzed 2065 medical records of patients initially diagnosed for glaucoma and who underwent one automated visual field at least in the last two years
Summary
75% of glaucoma cases are primary open-angle glaucoma (POAG) [1]. POAG is a multifactorial pathology with some well-identified risk factors, such as age, intraocular pressure (IOP), first-degree family history with POAG [2], ethnicity, myopia [3], obstructive sleep apnea syndrome (OSAS) [4], and corneal thickness [5]. Other factors are still debated, such as sex, socioeconomic status, cultural level, diabetes, dysthyroidism, tobacco [6,7], alcohol, vascular factors, nutritional factors [8,9], neurotoxic factors [10], etc. Known risk factors for glaucoma progression are age, IOP, OSAS, and vascular factors (diabetes, systolic arterial hypotension [11]). POAG is a chronic optic neuropathy characterized by retinal neurodegeneration [10]
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