Risk Factor For Primary Open-angle Glaucoma Research Articles

Potential Causal Association Between Atrial Fibrillation/Flutter and Primary Open-Angle Glaucoma: A Two-Sample Mendelian Randomisation Study.

Background: A few studies have reported controversial relationships between atrial fibrillation/flutter (AF/L) and primary open-angle glaucoma (POAG). This study aimed to investigate the potential causal relationship between AF/L and POAG. Methods: Single-nucleotide polymorphisms associated with exposure to AF/L were selected as instrumental variables with significance (p < 5.0 × 10-8) from a genome-wide association study (GWAS) by FinnGen. The GWAS summary of POAG from the UK Biobank was used as the outcome dataset. A two-sample Mendelian randomisation (MR) study was performed to assess the causal effects of AF/L on POAG. In addition, potential confounders, including hypertension, autoimmune hyperthyroidism, sleep apnoea, and alcohol use disorder, were assessed using multivariable MR analysis. Results: There was a significant causal association of AF/L with POAG (odds ratio [OR] = 1.26, 95% confidence interval [CI] = 1.07-1.48, p = 0.005 using inverse-variance weighting [IVW]). Multivariable MR analysis confirmed a causal association of AF/L with POAG (OR = 1.24, 95% CI = 1.02-1.51, p = 0.034 using IVW), but hypertension, hyperthyroidism, sleep apnoea and alcohol use disorder did not show significant causal associations with POAG (all p > 0.05). Conclusions: This established causal relationship between AF/L and POAG supports the need for further investigation into the role of AF/L as a possible risk factor for POAG. Further research is required to confirm these findings.

Candidate SNP Markers Significantly Altering the Affinity of the TATA-Binding Protein for the Promoters of Human Genes Associated with Primary Open-Angle Glaucoma.

Primary open-angle glaucoma (POAG) is the most common form of glaucoma. This condition leads to optic nerve degeneration and eventually to blindness. Tobacco smoking, alcohol consumption, fast-food diets, obesity, heavy weight lifting, high-intensity physical exercises, and many other bad habits are lifestyle-related risk factors for POAG. By contrast, moderate-intensity aerobic exercise and the Mediterranean diet can alleviate POAG. In this work, we for the first time estimated the phylostratigraphic age indices (PAIs) of all 153 POAG-related human genes in the NCBI Gene Database. This allowed us to separate them into two groups: POAG-related genes that appeared before and after the phylum Chordata, that is, ophthalmologically speaking, before and after the camera-type eye evolved. Next, in the POAG-related genes' promoters, we in silico predicted all 3835 candidate SNP markers that significantly change the TATA-binding protein (TBP) affinity for these promoters and, through this molecular mechanism, the expression levels of these genes. Finally, we verified our results against five independent web services-PANTHER, DAVID, STRING, MetaScape, and GeneMANIA-as well as the ClinVar database. It was concluded that POAG is likely to be a symptom of the human self-domestication syndrome, a downside of being civilized.

Assessing Serum Lipid Levels in Patients Diagnosed With Primary Open-Angle Glaucoma.

The main purpose of this study is to assess serum lipid levels in patients diagnosed with primary open-angle glaucoma (POAG). The secondary objective is to explore the association between these lipid levels, namely serum cholesterol, serum triglycerides, serum low-density lipoprotein (LDL), and serum high-density lipoprotein (HDL), and the development of POAG. Glaucoma is a major contributor to global blindness, with elevated intraocular pressure as a key risk factor. However, in some cases, the disease advances even when pressure levels are well controlled, suggesting that additional independent risk factors may play a role in its development. Previous epidemiological studies have shown a potential link between serum lipids and glaucoma, but the findings are contradictory, leading to this investigation into the relationship between serum lipid levels and POAG. The study involved 60 patients with POAG and a control group of 60 individuals without POAG. All individuals underwent a detailed ophthalmic examination, and fasting serum lipid levels were measured, including total serum cholesterol, serum triglycerides, LDL, and HDL. The lipid levels of the glaucoma group were then compared to those of the control group. The findings revealed that total cholesterol, triglycerides, and LDL levels were significantly higher in POAG patients compared to the control group (p < 0.05). Although HDL levels were lower in POAG patients, the difference was not statistically significant. Dyslipidemia appears to be an independent risk factor for POAG, with higher serum lipid levels strongly linked to the presence of the condition.

Global incidence and risk factors for glaucoma: A systematic review and meta-analysis of prospective studies.

This study aims to estimate global incidence and assess risk factors for glaucoma subtypes. The literature search was performed in three English (PubMed, Embase, MEDLINE) and three Chinese (China National Knowledge Infrastructure, Wanfang, China Science and Technology Journal Database) databases to identify prospective studies on glaucoma incidence between 1 January 1990 and 29 November 2022. We used a multilevel mixed-effects meta-regression to estimate the age- and sex-specific incidence rate of primary open-angle glaucoma (POAG). The global and regional incidence rate of POAG in 2022 were respectively estimated. The annual cumulative incidence (ACI) of POAG and primary angle-closure glaucoma (PACG), and risk factors for POAG were pooled using a random-effects meta-analysis, respectively. The heterogeneity of the included articles was tested using the Q statistic and measured by I2 index. Publication bias was detected by funnel plots, Egger's regression test, and Begg's rank correlation test. A total of 9050 articles were identified in literature search, and 50 articles provided incidence data of glaucoma subtypes. In 2022, the global incidence rate of POAG was 23.46 (95% confidence interval (CI) = 15.68-32.91) per 10 000 person-years among 40-79 years. An increase from 5.51 (95% CI = 1.63-11.12) per 10 000 person-years in 40-44 years to 64.36 (95% CI = 49.82-80.70) per 10 000 person-years in 75-79 years was noted between the year 1990 and 2019. Across sociodemographic index (SDI) and World Health Organization (WHO) regions, the incidence rate was the highest in low SDI region and Africa, respectively. The pooled ACI of POAG was 0.21% (95% CI = 0.13%-0.30%). Six risk factors for POAG were identified, including intraocular pressure (IOP) treatment (meta-odds ratio (OR) = 3.69; 95% CI = 2.64-5.15), a family history of glaucoma (meta-OR = 2.49; 95% CI = 1.92-3.24), myopia (meta-OR = 2.08; 95% CI = 1.59-2.70), elevated IOP (meta-OR = 1.13; 95% CI = 1.11-1.15), advanced age (meta-OR = 1.07; 95% CI = 1.05-1.08), male (female: meta-OR = 0.76; 95% CI = 0.66-0.88). The pooled ACI of PACG was 0.05% (95% CI = 0.00%-0.16%). Significant disparities existed in incidence rates for glaucoma across geographic regions and age groups. Further research is needed to understand which risk factors drive glaucoma incidence in different socioeconomic strata for tailored health policy on preventing glaucoma. This study is registered with PROSPERO (number CRD42023434203).

The Multifaceted Nongenetic Risk Factors for Primary Open-angle Glaucoma: An Overview of Systematic Reviews

TopicA synthesis of the current knowledge on risk factors for primary open-angle glaucoma (POAG). MethodWe conducted a systematic search of PubMed, Embase, Web of Science, and the Cochrane Library to identify relevant systematic reviews (SR) published in English after 2012. The inclusion criteria focused on SRs investigating risk factors for POAG. We registered the study prospectively in the PROSPERO database (CRD42022351372) and used Covidence and the Risk Of Bias In Systematic reviews (ROBIS) tool to manage article selection and assess the risk of bias in the included SRs. Data was extracted independently by two authors. ResultsAfter removing duplicate SRs, we assessed 2,542 SRs. Of these, 2,396 were determined to be irrelevant, leaving 138 for a full text review. Following this, 78 were excluded with reasons, resulting in 57 SRs. Of these, 30 had a low risk of bias. In our bias assessment, SRs categorized as high risk of bias were characterized by 1) lack of sufficient detail in the bias assessment of the SR and 2) insufficient information or missing calculations of heterogeneity among the included studies. In our study, we identified 22 risk factors associated with POAG. The SRs covered a wide range of risk factors for POAG. Among these, the strongest associations with glaucoma, based on effect size, were observed in two SRs related to obstructive sleep apnea (OSA), with a pooled odds ratio (OR) of 3.66 (95% CI: 1.70-7.90) and an adjusted OR of 2.46 (95% CI: 1.32-4.59). Similarly, two SRs investigating Helicobacter pylori (H. pylori) infections showed significant associations, with pooled ORs of 2.08 (95% CI: 1.48-2.93) and 2.08 (95% CI: 1.42-3.04), respectively. ConclusionThis article summarizes the current knowledge on risk factors for POAG from published SRs. Our findings highlight the complexity of the disease and the nature of the factors that may affect various populations.Among the reported associations with low risk of bias, we found the highest effect estimates for OSA and H. pylori infections in relation to POAG. Our review helps advance understanding, guide future research and inform strategies for the prevention and treatment of POAG.

The TGFβ Induced MicroRNAome of the Trabecular Meshwork.

Primary open-angle glaucoma (POAG) is a progressive optic neuropathy with a complex, multifactorial aetiology. Raised intraocular pressure (IOP) is the most important clinically modifiable risk factor for POAG. All current pharmacological agents target aqueous humour dynamics to lower IOP. Newer therapeutic agents are required as some patients with POAG show a limited therapeutic response or develop ocular and systemic side effects to topical medication. Elevated IOP in POAG results from cellular and molecular changes in the trabecular meshwork driven by increased levels of transforming growth factor β (TGFβ) in the anterior segment of the eye. Understanding how TGFβ affects both the structural and functional changes in the outflow pathway and IOP is required to develop new glaucoma therapies that target the molecular pathology in the trabecular meshwork. In this study, we evaluated the effects of TGF-β1 and -β2 treatment on miRNA expression in cultured human primary trabecular meshwork cells. Our findings are presented in terms of specific miRNAs (miRNA-centric), but given miRNAs work in networks to control cellular pathways and processes, a pathway-centric view of miRNA action is also reported. Evaluating TGFβ-responsive miRNA expression in trabecular meshwork cells will further our understanding of the important pathways and changes involved in the pathogenesis of glaucoma and could lead to the development of miRNAs as new therapeutic modalities in glaucoma.

The association between perceived cause of glaucoma and illness perceptions.

The perceived cause of disease is an important factor that has been linked with treatment outcomes but has not been fully assessed in primary open-angle glaucoma (POAG). This study assessed the accuracy of patients' perceived cause of POAG and identified associations between accuracy, illness perceptions, medication adherence, and quality of life (QoL). The Brief Illness Perception Questionnaire (BIPQ) was used to assess illness perceptions and asked patients to rank the three most important causes of their disease in order of importance. POAG risk factors recognized by the American Academy of Ophthalmology were used to code responses as accurate or inaccurate based on the following three methods: (1) coding any reported cause, regardless of rank, (2) coding only the first-ranked cause, and (3) coding and weighting all reported causes. Medication adherence was measured electronically. QoL was measured using the Glaucoma Quality of Life questionnaire. Mann-Whitney U test was used to detect differences in illness perceptions, medication adherence, and QoL between accuracy groups. A total of 97 patients identified a cause of their POAG and were included in this analysis. A higher proportion of patients reported an accurate cause (86.6% using method 1, 78.4% using method 2, and 79.4% using method 3; all p < 0.001). Mean medication adherence was 86.0% ± 17.8 and was similar across accuracy groups (all p > 0.05). Using method 2 (p = 0.045) and method 3 (p = 0.028), patients who reported an accurate cause of their POAG believed that their illness would last for a longer time compared to patients who reported an inaccurate cause. Method 3 also revealed that patients who reported an accurate cause of their POAG had lower perceived understanding of their illness (p = 0.048) compared to patients who reported an inaccurate cause. There were no differences in QoL between accuracy groups (all p > 0.05). This study highlights the association between perceived cause of POAG and illness perceptions related to knowledge level and POAG duration. Future studies should assess associations between perceived cause of disease and other critical dimensions of illness perception.

High throughput functional profiling of genes at intraocular pressure loci reveals distinct networks for glaucoma.

Primary open angle glaucoma (POAG) is a leading cause of blindness globally. Characterized by progressive retinal ganglion cell degeneration, the precise pathogenesis remains unknown. Genome-wide association studies (GWAS) have uncovered many genetic variants associated with elevated intraocular pressure (IOP), one of the key risk factors for POAG. We aimed to identify genetic and morphological variation that can be attributed to trabecular meshwork cell (TMC) dysfunction and raised IOP in POAG. 62 genes across 55 loci were knocked-out in a primary human TMC line. Each knockout group, including five non-targeting control groups, underwent single-cell RNA-sequencing (scRNA-seq) for differentially-expressed gene (DEG) analysis. Multiplexed fluorescence coupled with CellProfiler image analysis allowed for single-cell morphological profiling. Many gene knockouts invoked DEGs relating to matrix metalloproteinases and interferon-induced proteins. We have prioritized genes at four loci of interest to identify gene knockouts that may contribute to the pathogenesis of POAG, including ANGPTL2, LMX1B, CAV1, and KREMEN1. Three genetic networks of gene knockouts with similar transcriptomic profiles were identified, suggesting a synergistic function in trabecular meshwork cell physiology. TEK knockout caused significant upregulation of nuclear granularity on morphological analysis, while knockout of TRIOBP, TMCO1 and PLEKHA7 increased granularity and intensity of actin and the cell-membrane. High-throughput analysis of cellular structure and function through multiplex fluorescent single-cell analysis and scRNA-seq assays enabled the direct study of genetic perturbations at the single-cell resolution. This work provides a framework for investigating the role of genes in the pathogenesis of glaucoma and heterogenous diseases with a strong genetic basis.

Mitochondrial DNA D-loop variants correlate with a primary open-angle glaucoma subgroup.

Primary open-angle glaucoma (POAG) is a characteristic optic neuropathy, caused by degeneration of the optic nerve-forming neurons, the retinal ganglion cells (RGCs). High intraocular pressure (IOP) and aging have been identified as major risk factors; yet the POAG pathophysiology is not fully understood. Since RGCs have high energy requirements, mitochondrial dysfunction may put the survivability of RGCs at risk. We explored in buffy coat DNA whether mtDNA variants and their distribution throughout the mtDNA could be risk factors for POAG. The mtDNA was sequenced from age- and sex-matched study groups, being high tension glaucoma (HTG, n=71), normal tension glaucoma patients (NTG, n=33), ocular hypertensive subjects (OH, n=7), and cataract controls (without glaucoma; n=30), all without remarkable comorbidities. No association was found between the number of mtDNA variants in genes encoding proteins, tRNAs, rRNAs, and in non-coding regions in the different study groups. Next, variants that controls shared with the other groups were discarded. A significantly higher number of exclusive variants was observed in the D-loop region for the HTG group (~1.23 variants/subject), in contrast to controls (~0.35 variants/subject). In the D-loop, specifically in the 7S DNA sub-region within the Hypervariable region 1 (HV1), we found that 42% of the HTG and 27% of the NTG subjects presented variants, while this was only 14% for the controls and OH subjects. As we have previously reported a reduction in mtDNA copy number in HTG, we analysed if specific D-loop variants could explain this. While the majority of glaucoma patients with the exclusive D-loop variants m.72T>C, m.16163 A>G, m.16186C>T, m.16298T>C, and m.16390G>A presented a mtDNA copy number below controls median, no significant association between these variants and low copy number was found and their possible negative role in mtDNA replication remains uncertain. Approximately 38% of the HTG patients with reduced copy number did not carry any exclusive D-loop or other mtDNA variants, which indicates that variants in nuclear-encoded mitochondrial genes, environmental factors, or aging might be involved in those cases. In conclusion, we found that variants in the D-loop region may be a risk factor in a subgroup of POAG, possibly by affecting mtDNA replication.

Single-nucleotide polymorphisms of TLR4 and GAS7 linked to primary open-angle glaucoma among patients of Shenyang, China.

The potential for adverse outcomes and classifications of glaucoma differ among race, country, gender, and family medical history. Nearly, 50 represent candidate genes are considered as potential contributors to the happening for the primary open-angle glaucoma (POAG) since the advent of GWASs. Our investigation is the first to report the Toll-like receptor 4 (TLR4) and growth arrest-specific 7 (GAS7) among people in Shenyang, China; to investigate whether single-nucleotide polymorphisms (SNPs) in (TLR4) or GAS7 gene are risk factors for POAG among people in Shenyang, China; and also to explore their potential pathogenic mechanisms. POAG patients from July 2015 to June 2019 at Shenyang Fourth People's Hospital were selected. A total of 218 POAG patients and 252 controls were enrolled. Eight potentially functional SNPs of TLR4 (rs7868859, rs7873784, rs77358523, and rs752998) and GAS7 (rs8012311, rs11656696, rs74629981, and rs9900085) were genotyped. Multifactor analysis was conducted to evaluate the correlation between TLR4, GAS7, and POAG. The allele frequency of rs7873784 of TLR4 demonstrated that the GC (P = 0.030), CC (P = 0.040), and GC + CC genotypes (P = 0.009) were significantly higher compared with CC genotype for POAG patients than that for controls. The rs8072311 and rs9900085 of GAS7 gene also were significantly associated with POAG. Haplotype analysis found that the C-A-T-A haplotype (order: rs7873784-rs77358523-rs752998-rs7868859) of TLR4 gene and the two haplotypes A-C-C-A and C-C-A-C of GAS7 (order: rs9900085-rs74629981-rs8072311-rs11656696) were associated with an elevated susceptibility to POAG (P < 0.05). In this study, rs7868859 of TLR4 and rs8012311 and rs9900085 polymorphisms of GAS7 were first identified to be related to POAG among people in Shenyang, China.

Polymorphism of proinflammatory inerleukin genes in primary open-angle glaucoma

Glaucoma is a degenerative disease of the optic nerve, accompanied by the death of retinal ganglion cells (RGCs) and loss of vision. An important role in the pathogenesis of glaucoma is ascribed to activated microglia, which produce pro-inflammatory interleukins and initiate GCS apoptosis. It has been established that single nucleotide polymorphisms of interleukin genes modify the development of neuroinflammation, but their effect on the risk of developing glaucoma is not yet fully established. Our aim was to determine the pathogenetic role of gene polymorphisms in TNFα and IL1β in the development of primary open-angle glaucoma.We have observed 56 patients of Russian nationality from the South of Russia with primary open-angle glaucoma (POAG), 28 patients with stage I, 16 with stage II, 12 with stage III POAG. The single nucleotide polymorphisms TNFα 308G&gt;A (rs1800629) and IL1β -31 Т&gt;С (rs1143627) were studied by restriction fragment analysis of PCR products. The level of pro-inflammatory cytokines (TNFα and IL1β) in the lacrimal fluid of patients with POAG was evaluated by enzyme-linked immunosorbent assay (Vector-Best test system). To perform optical coherence tomography by analysing the thickness of retinal nerve fiber layer (RNFL) with volume and area of the neuroretinal rim using Torson 3D OST 1000 apparatus.Results: in patients with POAG, we have found more common incidence of TNFα 308A (OR = 5.21, p = 0.001), and IL1β-31 T alleles (OR = 1.99, p = 0.04). An increased risk of developing POAG was found in carriers of genotypes 308A/A (OR = 6.30, p = 0.049), 308G/A (OR = 3.60, p = 0.049) and -31T/T (OR = 2.67, p = 0.04). The highest levels of TNFα were determined in the 308A/A group (190 (153.0-220.0) pg/mL), IL1β were in the group (-31) T/T – 6.50 (4.10-7.00) pg/mL. A decreased thickness of the retinal nerve fibers was observed in the patients with TNFα G308A genotype (59.5; 40.0 to 78.0 µm, p = 0.03), and in TNFα A308A carriers (79.0; 65.0 to 80.0 µm, p = 0.001).The TNFα 308 G/A (rs1800629), along with IL1β, -31Т/C (rs1143627) cytokine gene polymorphisms are associated with development of primary open-angle glaucoma. TNFα 308A, IL1β -31T alleles, as well as the 308G/A, 308A/A and -31T/T genotypes seem to be the risk factors for POAG in Russian population. High content of TNFα in the lacrimal fluid was found in the carriers of 308A/A genotype and -31T/T IL1β genotype. The lowest thickness of the retinal nerve fiber layer was observed in the carriers of tTNFα A308A and TNFα G308A genotypes.

Hypertension as a Risk Factor for Primary Open-angle Glaucoma: A Meta-analysis.

Hypertension (HTN) is not recognised as an independent risk factor for primary open-angle glaucoma (POAG). A search of PubMed, Embase, Medline, Wanfang, and Cochrane Library databases from the time each database was established up to July 2022 was performed. All studies were pooled and assessed for heterogeneity and the quality of the literature. Five cross-sectional studies were included in the meta-analysis with 1144 individuals with POAG and 29, 373 without POAG. The combined analysis found that the incidence of HTN was higher among the individuals with POAG than among those without (OR 1.55; p <0.001). There was also a significant difference in the incidence of diabetes among individuals with POAG compared with those without (OR: 1.31; p=0.002). A meta-analysis of cross-sectional studies revealed that the incidence of HTN and diabetes was significantly greater among individuals with POAG. HTN and diabetes were found to be independent risk factors for POAG. Key Words: Primary open-angle glaucoma (POAG), Hypertension (HTN), Diabetes, Meta-analysis.

Racial and Ethnic Differences in the Roles of Myopia and Ocular Biometrics as Risk Factors for Primary Open-Angle Glaucoma.

Assess how the roles of refractive error (RE) and ocular biometrics as risk factors for primary open-angle glaucoma (POAG) differ by race and ethnicity. Data from the Los Angeles Latino Eye Study (LALES) and the Chinese American Eye Study (CHES), two population-based epidemiological studies, were retrospectively analyzed. Multivariable logistic regression and interaction term analyses were performed to assess relationships between POAG and its risk factors, including RE and axial length (AL), and to assess effect modification by race/ethnicity. Analysis included 7601 phakic participants of LALES (47.3%) and CHES (52.7%) with age ≥ 50 years. Mean age was 60.6 ± 8.3 years; 60.9% were female. The prevalence and unadjusted risk of POAG were higher in LALES than CHES (6.0% and 4.0%, respectively; odds ratio [OR] = 1.55; P < 0.001). In the multivariable analysis, significant risk factors for POAG included Latino ethnicity (OR = 2.25; P < 0.001), refractive myopia (OR = 1.54 for mild, OR = 2.47 for moderate, OR = 3.94 for high compared to non-myopes; P ≤ 0.003), and longer AL (OR = 1.37 per mm; P < 0.001). AL (standardized regression coefficient [SRC] = 0.3) was 2.7-fold more strongly associated with POAG than high myopia status (SRC = 0.11). There was no modifying effect by race/ethnicity on the association between RE (per diopter) or AL (per millimeter) and POAG (P = 0.49). Although the POAG risk conferred by myopic RE and longer AL is similar between Latino and Chinese Americans, the difference in POAG prevalence between the two groups is narrowed by higher myopia prevalence among Chinese Americans. Racial/ethnic populations with higher myopia incidence may become disproportionately affected by POAG in the context of the global myopia epidemic.

Frequency of moderate to high myopia in primary open-angle glaucoma in tertiary care hospital

Introduction: Glaucoma is one of the leading causes of irreversible blindness in the adult population worldwide with Primary Open-Angle Glaucoma being its most common type. Moderate to high myopia is one of the various risk factors associated with POAG. Early detection and management of glaucoma in patients can slow down its progression and prevent vision loss.&#x0D; Objective: To evaluate the frequency of moderate to high myopia in Primary Open Angle Glaucoma (POAG) and to find out the association between myopia and POAG.&#x0D; Methodology: A total of 100 participants were included in this cross-sectional study through consecutive sampling techniques. Refractive error was measured through an auto refractometer. Glaucomatous Patients were diagnosed as POAG on clinical findings (elevated IOP and optic nerve changes), visual field loss, and/or retinal nerve fiber layer (RNFL) defects. The anterior chamber angle was evaluated with the Van Herrick technique. Association between myopia and independent variables were statistically determined.&#x0D; Results: The mean age of all the participants was 52.36 ± 15.350. The frequencies of low, moderate, and high myopia were 34%, 12.5%, and 4% respectively. Male gender had a significant association with the high prevalence of low myopia in patients with POAG (p-value &lt;0.05). Illiteracy and low and middle-class socioeconomic background were the other significant risk factors. &#x0D; Conclusion: Myopia is the major risk factor in POAG and other factors like illiteracy and a poor socioeconomic background attributed to it should be screened and assessed so that earlier detection in the population can prevent vision loss.

Investigating the Association of IL12B and INFG Polymorphisms with the Risk of Pseudoexfoliation Syndrome and Glaucoma

Background: Immune responses may be involved in the development of pseudoexfoliation (PEX), pseudoexfoliation glaucoma (PEXG), and primary open-angle glaucoma (POAG) pathogenesis. The aim of the present study was to evaluate the association of IL12B rs3212227 A/C and INFG rs1861494 T/C polymorphisms with the risk of PEX, PEXG, and POAG in an Iranian population. Methods: Totally, 55 POAG, 57 PEX, and 78 PEXG patient cases as well as 79 healthy controls were included in this study. Genotyping of the IL12B and INFG polymorphisms was performed by polymerase chain reaction and restriction fragment length polymorphism methods using TaqI and FauI restriction enzyme, respectively. Results: Results indicated that IL12B AC genotype was significantly higher in POAG (36.4%; P &lt; 0.001; odds ratio [OR] = 4.0, 95% confidence interval [CI]: 1.7–10.0) and PEX patients (36.4%; P = 0.023; OR = 2.7, 95% CI: 1.1–6.9) compared to the control group (12.6%). The C allele could be considered a risk factor for POAG (P = 0.002; OR = 3.1, 95% CI: 3.1–6.8) and PEX (P &lt; 0.001; OR = 3.4, 95% CI: 3.4–7.3). INFG TC genotype was significantly higher in PEX (38.6%; P = 0.007; OR = 2.8, 95% CI: 1.3–6.3) and PEXG patients (37.2%; P = 0.009; OR = 2.7, 95% CI: 1.1–6.9) compared to the control group (19.0%). The C allele seemed to be a risk factor for PEX (P = 0.002; OR = 2.8, 95% CI: 1.4–5.7) and PEXG (P = 0.009; OR = 2.4, 95% CI: 1.2–4.7). Conclusion: Overall, IL12B was associated with susceptibility to POAG and PEX, and IL12B C allele increased the risk of POAG and PEX. In addition, INFG was associated with susceptibility to PEX and PEXG, and the INFG C allele seemed to be a risk factor for PEX and PEXG.

Prevalence of Glaucoma and Its Systemic Risk Factors in a General Japanese Population: The Hisayama Study.

To estimate the prevalence of glaucoma and its risk factors in a Japanese community. This study included 3405 Japanese community dwellers who were ≥40 years of age and enrolled in the Hisayama Study. This population-based, cross-sectional study was conducted from 2017 to 2018. A glaucoma screening test was performed using stereo fundus images and swept-source optical coherence tomography. Glaucoma was defined based on the International Society of Geographical and Epidemiological Ophthalmology criteria. The prevalence of glaucoma was 7.6% (95% confidence interval [CI], 6.7-8.6) overall. The prevalence of primary open-angle glaucoma (POAG) was 5.8% (95% CI, 5.0-6.6); that of primary angle-closure glaucoma (PACG) was 0.7% (95% CI, 0.5-1.1); and that of exfoliation glaucoma was 1.1% (95% CI, 0.7-1.4). In addition to aging, lower estimated glomerular filtration rate (eGFR) (odds ratio [OR] = 1.15; 95% CI, 1.02-1.33), higher intraocular pressure (OR = 1.06; 95% CI, 1.01-1.12), longer axial length (OR = 1.44; 95% CI, 1.31-1.59), and thinner central corneal thickness (CCT) (OR = 1.09; 95% CI, 1.04-1.15) were significant risk factors for POAG. Diabetes (OR = 2.81; 95% CI, 1.19-6.62) was a significant risk factor for PACG, and diabetes (OR = 2.15; 95% CI, 1.03-4.47) and thinner CCT (OR = 1.14; 95% CI, 1.02-1.28) were significant risk factors for exfoliation glaucoma. The prevalence of glaucoma was approximately 8%, probably due to the increase in the Japanese aging population. Not only ocular factors but also lower eGFR for POAG and diabetes for PACG and exfoliation glaucoma were risk factors in a general Japanese population. Systemic factors such as eGFR and diabetes must also be considered when implementing preventive measures against glaucoma.

Meta-Analysis of Dyslipidemia and Blood Lipid Parameters on the Risk of Primary Open-Angle Glaucoma.

Objective We aimed to explore the effect of blood lipid parameters on the risk of primary open-angle glaucoma (POAG) by meta-analysis. Methods The databases of PubMed, Scopus, CNKI, and Wanfang were systematically searched from inception to April 2022, and the relevant research literature was obtained, screened, and analyzed. Results A total of 15 studies were included in this meta-analysis, including 11 reporting dyslipidemia and risk of POAG and 5 reporting specific lipid level and risk of POAG. Dyslipidemia increased the risk of POAG with an odd ratio (OR) of 1.25 (95% CI: 1.23, 1.26). Total triglyceride and total cholesterol were not related to the prevalence of POAG, but high-density lipoprotein cholesterol was significantly negatively correlated with the risk of POAG with an OR of 0.96 (95% CI: 0.94, 0.99). Conclusion Dyslipidemia is a risk factor for POAG. Given the small sample size and significant interstudy heterogeneity, additional studies are needed to establish this conclusion.

The functional polymorphism -863 C/A in the TNF-α gene is associated with primary open-angle glaucoma development in Iraqi patients

Glaucoma is one of the main causes of irreversible blindness. The most common type of glaucoma is primary open-angle glaucoma (POAG). This study aimed to evaluate the possible association between the −863 C/A TNF-α (tumor necrosis factor-alpha) gene polymorphism and −1562 C/T MMP9 (matrix metallopeptidase 9) gene polymorphisms in POAG. Blood samples from apparently healthy controls and patients (40–70 years) with POAG were taken from Baghdad's Ibn Al-Haitham Teaching Eye Hospital. For detecting TNF-α serum levels in peripheral blood, enzyme-linked immunosorbent assay (ELISA) approaches are utilized. Sequence-specific primers with 3 end mismatches were used to amplify the specific allelic variants of −863 C/A TNF-α by sequence-specific primers -polymerase chain reaction (SSP-PCR). The −1562 C/T MMP9 gene polymorphisms were genotyped by the PCR-restriction fragment length polymorphism (PCR-RFLP) method. The mean TNF-α level was significantly elevated in POAG patients (132.85 ± 5.18 pg/ml, P = 0.001) than in the controls (71.52 ± 2.07). The CC genotype of TNF-α is a risk factor for the development of POAG (56, 74.7 %, OR: 2.3158, 95 % CI: 1.1594–4.6256, p = 0.0174) as compared with CA and AA genotypes. The TNF-α (−863) C allele is a risk factor for POAG development (OR: 2.1095, 95 % CI: 1.2207–3.6452, p = 0.0075). The TNF-α (−863) A allele is protective (OR: 0.4741, 95 % CI: 0.2743–0.8192). The results of MMP9 genotyping reveal that none of the three genotypes (TT, TC, and CC) or the two alleles (T and C) are related to POAG development. In conclusion, High levels of TNF-α are associated with POAG. The CC genotype of TNF-α is a risk factor for the development of POAG as compared with CA and AA genotypes. The TNF-α (−863) C allele is a risk factor for POAG while the TNF-α (−863) A allele is protective. No significant difference among the three genotypes (CC, CT, and TT) with POAG development was observed.

Assessment of visual field defects and optic disc changes in patients with high myopia

Glaucoma is a leading cause of global irreversible blindness. Primary open angle glaucoma (POAG) is the most common form of glaucoma and affects 44.1 million individuals worldwide. Furthermore, there is a disproportionate burden of POAG in Asia, with Asians accounting for 53% (23.5 million) of POAG cases worldwide. While early detection of POAG is important in delaying or halting the progression of the disease, a better understanding of the interplay between major risk factors for POAG is crucial. aim of this study is to assess the effects of myopia on POAG in the patient attending MYH Indore OPD (central India). It is a hospital based, prospective, non-randomised case study. 60 eyes of high myopic patients and 60 eyes of general Ophthal OPD patients were evaluated. The statistical software namely SPSS 19.0, were used for the analysis of the data and Microsoft word and Excel have been used to generate graphs, tables etc. In our study, we found that, in high myopic patient, there were increase in chances of glaucomatous optic disc changes, and these changes were influenced by age and not influenced with gender, degree of myopia.

Degeneration of retina-brain components and connections in glaucoma: Disease causation and treatment options for eyesight preservation.

Eyesight is the most important of our sensory systems for optimal daily activities and overall survival. Patients who experience visual impairment due to elevated intraocular pressure (IOP) are often those afflicted with primary open-angle glaucoma (POAG) which slowly robs them of their vision unless treatment is administered soon after diagnosis. The hallmark features of POAG and other forms of glaucoma are damaged optic nerve, retinal ganglion cell (RGC) loss and atrophied RGC axons connecting to various brain regions associated with receipt of visual input from the eyes and eventual decoding and perception of images in the visual cortex. Even though increased IOP is the major risk factor for POAG, the disease is caused by many injurious chemicals and events that progress slowly within all components of the eye-brain visual axis. Lowering of IOP mitigates the damage to some extent with existing drugs, surgical and device implantation therapeutic interventions. However, since multifactorial degenerative processes occur during aging and with glaucomatous optic neuropathy, different forms of neuroprotective, nutraceutical and electroceutical regenerative and revitalizing agents and processes are being considered to combat these eye-brain disorders. These aspects form the basis of this short review article.