Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.
JAMA Netw Open. 2023 Oct 2;6(10):e2338526. doi: 10.1001/jamanetworkopen.2023.38526.
Recent studies indicate that alcohol consumption is linked to increased intraocular pressure and higher prevalence of open-angle glaucoma (OAG). However, there is insufficient evidence to establish any correlation between alcohol abstinence and improved outcomes in patients with OAG.
To evaluate the association between alcohol consumption status (and its changes) and risk of incident severe visual impairment (VI) or blindness in patients with newly diagnosed OAG.
DESIGN, SETTING, AND PARTICIPANTS: This retrospective, nationwide, population-based cohort study used the Korean National Health Insurance Service's claims and health examination database to enroll patients who were newly diagnosed with OAG between January 1, 2010, and December 31, 2011, and had been alcohol drinkers before their OAG diagnosis. The cohort was followed up until December 2020. The data were analyzed from February to December 2022.
The patients were categorized into 2 groups based on their post-OAG diagnosis alcohol consumption status: sustainers and abstainers. The risks of severe VI or blindness were compared using weighted Cox proportional hazards regression models along with inverse probability of treatment weighting.
Incident severe VI or blindness.
Among 13 643 patients with newly diagnosed OAG (mean [SD] age, 53.7 [11.9] years; 12 066 men [88.4%]) who were drinkers, 2866 (21.0%) quit drinking after the diagnosis. During 91 366 person-years of follow-up, patients abstaining from alcohol after their OAG diagnosis had a lower risk of severe VI or blindness than did those who had sustained drinking (adjusted hazard ratio [AHR] after inverse probability of treatment weighting, 0.63; 95% CI, 0.45-0.87). Among the sustained drinkers, both mild consumption (<105 g/wk; AHR, 1.52; 95% CI, 1.01-2.28) and moderate to heavy consumption (≥105 g/wk; AHR, 1.78; 95% CI, 1.11-2.86) after OAG diagnosis were associated with higher risk of severe VI or blindness relative to abstainers. Frequent drinking (≥4 d/wk) also was associated with a higher risk of severe VI or blindness (AHR, 2.56; 95% CI, 1.52-4.33) compared with abstinence.
In this cohort study of patients with OAG who were drinkers, abstaining from alcohol after an OAG diagnosis was associated with lower risk of severe VI or blindness. These findings suggest that lifestyle interventions, such as alcohol abstinence, could be essential for patients with newly diagnosed OAG.
最近的研究表明，饮酒与眼内压升高和开角型青光眼（OAG）患病率升高有关。然而，目前还没有足够的证据来确定酒精戒断与 OAG 患者的治疗结果改善之间存在任何关联。
评估酒精摄入状态（及其变化）与新诊断为 OAG 的患者发生严重视力损害（VI）或失明的风险之间的关联。
设计、地点和参与者：这项回顾性的、全国性的、基于人群的队列研究使用了韩国国家健康保险服务的索赔和健康检查数据库，纳入了 2010 年 1 月 1 日至 2011 年 12 月 31 日期间新诊断为 OAG 的患者，这些患者在 OAG 诊断前为饮酒者。该队列随访至 2020 年 12 月。数据从 2022 年 2 月至 12 月进行分析。
根据 OAG 诊断后的饮酒状况，将患者分为 2 组：维持饮酒者和戒酒者。使用加权 Cox 比例风险回归模型和逆概率治疗加权法比较严重 VI 或失明的风险。
严重 VI 或失明的发生。
在 13643 名新诊断为 OAG 的患者（平均[标准差]年龄为 53.7[11.9]岁；12066 名男性[88.4%]）中，有 2866 名（21.0%）在诊断后停止饮酒。在 91366 人年的随访中，与继续饮酒的患者相比，OAG 诊断后戒酒的患者发生严重 VI 或失明的风险较低（经逆概率治疗加权后的调整后危险比，0.63；95%置信区间，0.45-0.87）。在继续饮酒的患者中，与戒酒者相比，轻度饮酒（<105 g/周；调整后危险比，1.52；95%置信区间，1.01-2.28）和中重度饮酒（≥105 g/周；调整后危险比，1.78；95%置信区间，1.11-2.86）与严重 VI 或失明的风险增加相关。与戒酒者相比，频繁饮酒（≥4 天/周）也与严重 VI 或失明的风险增加相关（调整后危险比，2.56；95%置信区间，1.52-4.33）。
在这项对饮酒的 OAG 患者进行的队列研究中，OAG 诊断后戒酒与严重 VI 或失明风险降低相关。这些发现表明，生活方式干预，如戒酒，可能对新诊断为 OAG 的患者至关重要。
