School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE On Risk Interconnectivity and Governance On Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China.
Department of Ophthalmology & Visual Science, Eye Institute, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, China.
Environ Sci Pollut Res Int. 2023 Apr;30(19):56513-56521. doi: 10.1007/s11356-023-26235-7. Epub 2023 Mar 15.
The prevalence of glaucoma has seasonal variation in population, but the role of ambient temperature and its variation remains unclear in this seasonal trend. So, we conducted a time-stratified case-crossover study to examine the association of ambient temperature and temperature change between neighboring days (TCN) with the risk of acute glaucoma. Data on meteorological parameters and glaucoma outpatient visit between 2015 and 2021 covered all districts of Shanghai. Conditional logistic regression with distributed lag nonlinear model was applied to estimate the association of temperature or TCN with the risk of acute glaucoma. A total of 7,746 patients diagnosed with acute primary angle-closure glaucoma (APACG) were included in this analysis. We observed a significant increase in the risk of acute glaucoma with cold temperature and temperature drop. Compared with the referent temperature (32℃), moderate low (12 °C) and extreme low (4 °C) temperature exposures were associated with higher risk of acute glaucoma outpatient visit, with the highest cumulative OR of 1.46 (95% CI: 1.11, 1.91) and 1.50 (95% CI: 1.09, 2.06) over lag 0-2 days. Temperature drop (TCN = - 4 °C) also increases the risk of acute glaucoma (OR = 1.34, 95% CI: 1.07, 1.67) over lag 0-7 days, comparing with no temperature change. Patients of female and above age 65 were more vulnerable to cold exposure and temperature drop. This case-crossover study provided novel and robust individual-level evidence that low ambient temperature and temperature drop significantly increase the acute glaucoma risk. The findings provide protective strategies for glaucoma patient, especially for female and the old, under cold exposure and sudden temperature decline.
青光眼的患病率在人群中有季节性变化，但环境温度及其变化在这种季节性趋势中的作用尚不清楚。因此，我们进行了一项时间分层病例交叉研究，以检查环境温度和相邻两天（TCN）温度变化与急性青光眼风险之间的关系。2015 年至 2021 年期间，气象参数和青光眼门诊就诊的数据覆盖了上海所有区。应用条件逻辑回归分布滞后非线性模型来估计温度或 TCN 与急性青光眼风险之间的关联。共纳入 7746 例急性原发性闭角型青光眼（APACG）患者进行分析。我们观察到低温和温度下降与急性青光眼风险显著增加有关。与参照温度（32℃）相比，中度低温（12℃）和极端低温（4℃）暴露与急性青光眼门诊就诊风险增加相关，滞后 0-2 天的累积 OR 最高为 1.46（95%CI：1.11，1.91）和 1.50（95%CI：1.09，2.06）。温度下降（TCN=−4℃）也会增加急性青光眼的风险（OR=1.34，95%CI：1.07，1.67），滞后 0-7 天。与无温度变化相比。女性和 65 岁以上的患者更容易受到低温和温度下降的影响。这项病例交叉研究提供了新的、强有力的个体水平证据，表明环境温度低和温度下降会显著增加急性青光眼的风险。这些发现为青光眼患者，特别是女性和老年人，在寒冷暴露和突然降温时提供了保护策略。
