Gurung Nanda K, Alsoudi Amer F, Gautam Prachand, Kandel Ram Prasad, O'Brien Kieran S, Wittberg Dionna M, Moe Caitlin A, Stamper Robert L, Keenan Jeremy D
Department of Glaucoma, Lumbini Eye Institute, Bhairahawa, Nepal.
School of Medicine, University of California, San Francisco (Medical Student), California, USA.
Curr Eye Res. 2021 Sep;46(9):1428-1431. doi: 10.1080/02713683.2021.1887274. Epub 2021 Feb 22.
: Previous studies have used subjective assessments to implicate darker skin color as a risk factor for glaucoma. This study used objective measurements to determine whether skin melanin is a risk factor for glaucoma. In a case-control study conducted at a tertiary eye hospital in Nepal, patients aged 40 years or older from the glaucoma clinic were enrolled as cases and age-matched patients without glaucoma from other clinics at the eye hospital were enrolled as controls. A colorimeter was used to capture melanin measurements in triplicate from the inner arm and forehead of each participant. The exposure variable of interest was the median skin melanin value, in arbitrary units. The outcome of interest was the presence of glaucoma. 100 glaucoma cases and 100 matched controls were enrolled. Agreement between the triplicate melanin measurements was high, with an intra-class correlation of 0.99 (95% CI, 0.99-0.99) for inner arm measurements and 0.97 (95% CI 0.96-0.98) for forehead measurements. Mean inner arm melanin values were 604 units (standard deviation [SD] 177) in cases and 602 units (SD 179) in controls; forehead values were 650 (SD 146) in cases and 652 (SD 152) in controls. After adjusting for sex and country of residence, skin melanin was not associated with the presence of glaucoma (odds ratio 1.04, 95%CI 0.78-1.38 for inner arm values and 0.97, 95%CI 0.70-1.35 for forehead values). This study failed to find a significant association between skin pigmentation and glaucoma.
以往的研究使用主观评估表明较深的肤色是青光眼的一个风险因素。本研究采用客观测量方法来确定皮肤黑色素是否为青光眼的风险因素。在尼泊尔一家三级眼科医院进行的一项病例对照研究中，青光眼门诊40岁及以上的患者被纳入病例组，眼科医院其他门诊年龄匹配的非青光眼患者被纳入对照组。使用色度计从每位参与者的上臂内侧和前额采集黑色素测量值，共测量三次。感兴趣的暴露变量是皮肤黑色素值的中位数，单位为任意单位。感兴趣的结果是青光眼的存在。共纳入了100例青光眼病例和100例匹配的对照。三次黑色素测量之间的一致性很高，上臂内侧测量的组内相关性为0.99（95%CI，0.99 - 0.99），前额测量的组内相关性为0.97（95%CI，0.96 - 0.98）。病例组上臂内侧黑色素平均值得分为604单位（标准差[SD]177），对照组为602单位（SD 179）；病例组前额黑色素平均值得分为650（SD 146），对照组为652（SD 152）。在对性别和居住国家进行调整后，皮肤黑色素与青光眼存在与否无关（上臂内侧值的比值比为1.04，95%CI为0.78 - 1.38；前额值的比值比为0.97，95%CI为0.70 - 1.35）。本研究未发现皮肤色素沉着与青光眼之间存在显著关联。
