Social, health and ocular factors associated with primary open-angle glaucoma amongst Chinese Singaporeans

Abstract

Importance: There is limited literature on lifestyle and health factors related to primary open-angle glaucoma amongst Asians.

Background: This study evaluated the association of primary open-angle glaucoma with smoking, health and ocular factors amongst Chinese Singaporeans.

Design: Case-control study.

Participants: The study used 711 primary open-angle glaucoma patients from a Singapore hospital and 2788 population-based controls.

Methods: Subjects underwent clinical examination and completed a questionnaire with details on family history of glaucoma, comorbidities, smoking and alcohol consumption. Glaucoma cases were subclassified as normal or high-tension glaucoma according to their untreated intraocular pressures.

Main outcome measures: The association of various health and lifestyle factors, with normal-tension and high-tension glaucoma was evaluated.

Results: Using multiple logistic regression, primary open-angle glaucoma was associated with older age (odds ratio 1.12 per year older; 95% confidence interval 1.10-1.15; P < 0.001), family history of glaucoma (odds ratio 7.86; 95% confidence interval 4.48-13.79; P < 0.001), higher intraocular pressure (odds ratio 1.75 per 1 mmHg; 95% confidence interval 1.64-1.87; P < 0.001) and thinner central corneal thickness (odds ratio 1.01; 95% confidence interval 1.01-1.02; P < 0.001). Myopes were more likely to have primary open-angle glaucoma (P < 0.001). A current smoking habit was protective against normal-tension glaucoma (odds ratio 0.30; 95% confidence interval 0.10-0.92; P = 0.035).

Conclusions and relevance: Older age, family history of glaucoma, higher intraocular pressure, thinner central corneal thickness and myopia were significantly associated with primary open-angle glaucoma amongst Chinese Singaporeans.

Keywords: epidemiology; myopia; normal tension glaucoma; primary open-angle glaucoma; smoking.