Edokpa Genesis Daniel, McFarlane Shelly Rose-Marie
Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica.
Front Nutr. 2024 Dec 10;11:1497366. doi: 10.3389/fnut.2024.1497366. eCollection 2024.
Studies have suggested that dietary intake may influence the incidence and progression of open-angle glaucoma. However, dietary modification is not usually included in the clinical management of glaucoma. The aim of this scoping review was therefore to map the evidence and determine the nature and extent of research done on "diet and glaucoma" and identify any gaps in this area of scholarship.
A comprehensive search of academic literature was conducted from two relevant electronic databases: PubMed and ScienceDirect. Primary studies that explored the relationship between dietary intake and glaucoma were included if the principal exposure was "diet" and if dietary habits were assessed with dietary questionnaires. The glaucoma outcomes of interest were visual field, retinal nerve fibre layer and/or optic nerve head features.
Nineteen studies were included in the final qualitative synthesis. The dates of publication ranged from 2003 to 2023. About 80% of the studies found some significant associations between glaucoma and dietary intake. However, most studies (95%) were observational, i.e., 7 (37%) used a cross-sectional design, 10 (53%) used a prospective cohort design; and 1 (or 5%) used a nested case-control study design. Only 1 study (or 5%) used a randomized intervention trial. Furthermore, while all studies investigated dietary intake with questionnaires, only 2 studies (or 11%) went further to include assessment of nutritional biomarkers.
Although miscellaneous evidence supports the concept that diet may play a role in glaucoma, most data are unfortunately observational without proven causality, reporting associations from subjective dietary questionnaires. More well-designed studies are required, especially randomized controlled trials that can prove causality.
研究表明，饮食摄入可能会影响开角型青光眼的发病率和病情进展。然而，饮食调整通常并不包含在青光眼的临床管理中。因此，本范围综述的目的是梳理相关证据，确定关于“饮食与青光眼”的研究性质和范围，并找出该学术领域存在的空白。
从两个相关电子数据库——PubMed和ScienceDirect对学术文献进行全面检索。如果主要暴露因素为“饮食”，且通过饮食问卷评估饮食习惯，则纳入探索饮食摄入与青光眼之间关系的原发性研究。感兴趣的青光眼结局包括视野、视网膜神经纤维层和/或视神经乳头特征。
最终的定性综合分析纳入了19项研究。发表时间跨度为2003年至2023年。约80%的研究发现青光眼与饮食摄入之间存在一些显著关联。然而，大多数研究（95%）为观察性研究，即7项（37%）采用横断面设计，10项（53%）采用前瞻性队列设计；1项（或5%）采用巢式病例对照研究设计。只有1项研究（或5%）采用了随机干预试验。此外，虽然所有研究都通过问卷调查饮食摄入情况，但只有2项研究（或11%）进一步纳入了营养生物标志物的评估。
尽管有各种各样的证据支持饮食可能在青光眼发病中起作用这一观点，但遗憾的是，大多数数据都是观察性的，没有证实因果关系，只是通过主观的饮食问卷报告关联。需要更多设计良好的研究，尤其是能够证明因果关系的随机对照试验。
