吸烟和饮酒与开角型青光眼发展的关联：一项回顾性队列研究。
Associations of smoking and alcohol consumption with the development of open angle glaucoma: a retrospective cohort study.
机构信息
Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA.
Department of Biomedical Informatics, University of California San Diego, La Jolla, CA, USA.
出版信息
BMJ Open. 2023 Oct 4;13(10):e072163. doi: 10.1136/bmjopen-2023-072163.
OBJECTIVES
To investigate the associations of alcohol consumption and smoking with the development of perimetric glaucoma in patients with suspected glaucoma.
DESIGN
A retrospective cohort study of patients suspected to have glaucoma enrolled in the Diagnostic Innovations in Glaucoma Study (DIGS) and the African Descent and Glaucoma Evaluation Study (ADAGES).
SETTING
Three tertiary glaucoma centres in the USA.
PARTICIPANTS
825 eyes of 610 patients with glaucoma suspect eyes with normal visual fields (VF) at baseline were followed over an average of 9 years from the DIGS and ADAGES studies.
OUTCOME MEASURES
Development of glaucoma was defined as occurrence of three consecutive abnormal VF tests during follow-up. Univariable and multivariable Cox regression models were used to investigate lifestyle-related factors associated with development of VF loss over time.
RESULTS
VF tests were abnormal three times in a row in 235 (28.5%) eyes. Alcohol consumption was associated with a higher risk of developing glaucoma (HR 1.57, 95% CI 1.03 to 2.38, p=0.037). In men, the risk of developing glaucoma in alcohol drinkers (HR 1.92, 95% CI 1.00 to 3.68, p=0.048) was greater than non-alcohol drinkers. In individuals of African descent, the risk of developing glaucoma in alcohol drinkers (HR 1.79, 95% CI 1.02 to 3.15, p=0.043) was greater than non-alcohol drinkers. Age was a modifier of the relationship between smoking and glaucomatous VF defects (p=0.048). The risk of developing glaucoma in smokers (HR 1.73, 95% CI 1.10 to 2.72, p=0.019) was greater than never smokers after adjustment for confounding factors in older patients (age >61 years).
CONCLUSION
Alcohol consumption was associated with an increased risk of developing glaucoma, particularly in men and individuals of African descent. The risk of developing glaucoma among smokers suspected of having glaucoma was influenced by age, with older individuals having a higher risk than younger people.
TRIAL REGISTRATION NUMBER
NCT00221897 and NCT00221923.
目的
探讨饮酒和吸烟与疑似青光眼患者周边视野青光眼发展的关系。
设计
对参加诊断性青光眼创新研究（DIGS）和非裔美国人青光眼评估研究（ADAGES）的疑似青光眼患者进行的回顾性队列研究。
地点
美国三家三级青光眼中心。
参与者
610 例患者 825 只眼，基线时视野正常。在 DIGS 和 ADAGES 研究中，这些患者的平均随访时间为 9 年。
结局测量
青光眼的发展定义为随访期间连续 3 次出现异常视野检查。使用单变量和多变量 Cox 回归模型，调查与随时间推移视野丧失相关的生活方式因素。
结果
235 只眼（28.5%）连续 3 次视野检查异常。饮酒与青光眼发病风险增加相关（HR 1.57，95%CI 1.03 至 2.38，p=0.037）。在男性中，饮酒者（HR 1.92，95%CI 1.00 至 3.68，p=0.048）比非饮酒者发生青光眼的风险更高。在非裔美国人中，饮酒者（HR 1.79，95%CI 1.02 至 3.15，p=0.043）发生青光眼的风险高于非饮酒者。年龄是吸烟与青光眼视野缺损关系的修饰因素（p=0.048）。在调整了年龄较大患者的混杂因素后，吸烟者（HR 1.73，95%CI 1.10 至 2.72，p=0.019）比从不吸烟者发生青光眼的风险更高。
结论
饮酒与青光眼发病风险增加相关，尤其是在男性和非裔美国人中。疑似青光眼吸烟者发生青光眼的风险受年龄影响，年龄较大的个体比年龄较小的个体风险更高。
临床试验注册号
NCT00221897 和 NCT00221923。
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