Maltish M Lorenzo1, Julia Devlin1, Chhavi Saini1, Kin-Sang Cho2, Eleftherios I Paschalis2, Dong Feng Chen2, Rafaella Nascimento E Silva1, Sherleen H Chen1, Milica A Margeta1, Courtney Ondeck3, David Solá-Del Valle1, James Chodosh1, Joseph B Ciolino1, Roberto Pineda1, Louis R Pasquale4, Lucy Q Shen5. 1. Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts. 2. Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts; Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts. 3. Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts; VA Boston Hospital, Boston, Massachusetts. 4. Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York. 5. Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts. Electronic address: lucy_shen@meei.harvard.edu.
Abstract
PURPOSE: To assess the prevalence of autoimmune disease (AiD) in patients with primary open-angle glaucoma (POAG) undergoing ophthalmic surgery. DESIGN: Retrospective, cross-sectional study. PARTICIPANTS: Patients with POAG undergoing any ophthalmic surgery and control subjects undergoing cataract surgery at the Massachusetts Eye and Ear from March 2019 to April 2020. METHODS: All available medical records with patient demographics, ocular, and medical conditions were reviewed. Differences in AiD prevalence were assessed and adjusted for covariates using multiple logistic regression. Additionally, a subgroup analysis comparing the POAG patients with and without AiD was performed. MAIN OUTCOME MEASURES: To assess the prevalence of AiD based on the American Autoimmune Related Diseases Association list. RESULTS: A total of 172 patients with POAG and 179 controls were included. The overall prevalence of AiD was 17.4% in the POAG group and 10.1% in the controls (P = 0.044); 6.4% of POAG patients and 3.4% of controls had more than 1 AiD (P = 0.18). The most prevalent AiDs in POAG group were rheumatoid arthritis (4.6%) and psoriasis (4.1%), which were also the most common in controls (2.8% each). In a fully adjusted multiple logistic regression analysis accounting for steroid use, having an AiD was associated with 2.62-fold increased odds of POAG relative to controls (95% confidence interval, 1.27-5.36, P = 0.009); other risk factors for POAG derived from the analysis included age (odds ratio [OR], 1.04, P = 0.006), diabetes mellitus (OR, 2.31, P = 0.008), and non-White ethnicity (OR, 4.75, P < 0.001). In a case-only analysis involving the eye with worse glaucoma, there was no statistical difference in visual field mean deviation or retinal nerve fiber layer (RNFL) thickness in POAG patients with AiD (n = 30) and without AiD (n = 142, P > 0.13, for both). CONCLUSIONS: A higher prevalence of AiD was found in POAG patients compared with control patients undergoing ophthalmic surgery. The presence of AiD was associated with increased risk for POAG after adjusting for covariates. Additional factors may have prevented a difference in RNFL thickness in POAG patients with and without AiD. Autoimmunity should be explored further in the pathogenesis of POAG.
PURPOSE: To assess the prevalence of autoimmune disease (AiD) in patients with primary open-angle glaucoma (POAG) undergoing ophthalmic surgery. DESIGN: Retrospective, cross-sectional study. PARTICIPANTS: Patients with POAG undergoing any ophthalmic surgery and control subjects undergoing cataract surgery at the Massachusetts Eye and Ear from March 2019 to April 2020. METHODS: All available medical records with patient demographics, ocular, and medical conditions were reviewed. Differences in AiD prevalence were assessed and adjusted for covariates using multiple logistic regression. Additionally, a subgroup analysis comparing the POAG patients with and without AiD was performed. MAIN OUTCOME MEASURES: To assess the prevalence of AiD based on the American Autoimmune Related Diseases Association list. RESULTS: A total of 172 patients with POAG and 179 controls were included. The overall prevalence of AiD was 17.4% in the POAG group and 10.1% in the controls (P = 0.044); 6.4% of POAG patients and 3.4% of controls had more than 1 AiD (P = 0.18). The most prevalent AiDs in POAG group were rheumatoid arthritis (4.6%) and psoriasis (4.1%), which were also the most common in controls (2.8% each). In a fully adjusted multiple logistic regression analysis accounting for steroid use, having an AiD was associated with 2.62-fold increased odds of POAG relative to controls (95% confidence interval, 1.27-5.36, P = 0.009); other risk factors for POAG derived from the analysis included age (odds ratio [OR], 1.04, P = 0.006), diabetes mellitus (OR, 2.31, P = 0.008), and non-White ethnicity (OR, 4.75, P < 0.001). In a case-only analysis involving the eye with worse glaucoma, there was no statistical difference in visual field mean deviation or retinal nerve fiber layer (RNFL) thickness in POAG patients with AiD (n = 30) and without AiD (n = 142, P > 0.13, for both). CONCLUSIONS: A higher prevalence of AiD was found in POAG patients compared with control patients undergoing ophthalmic surgery. The presence of AiD was associated with increased risk for POAG after adjusting for covariates. Additional factors may have prevented a difference in RNFL thickness in POAG patients with and without AiD. Autoimmunity should be explored further in the pathogenesis of POAG.
Authors: A Gregorio; C Gambini; V Gerloni; A Parafioriti; M P Sormani; S Gregorio; G De Marco; F Rossi; A Martini; M Gattorno Journal: Rheumatology (Oxford) Date: 2006-07-28 Impact factor: 7.580
Authors: R Meliconi; L Pulsatelli; M Uguccioni; C Salvarani; P Macchioni; C Melchiorri; M C Focherini; L Frizziero; A Facchini Journal: Arthritis Rheum Date: 1996-07
Authors: Puya Gharahkhani; Eric Jorgenson; Pirro Hysi; Anthony P Khawaja; Sarah Pendergrass; Xikun Han; Jue Sheng Ong; Alex W Hewitt; Ayellet V Segrè; John M Rouhana; Andrew R Hamel; Robert P Igo; Helene Choquet; Ayub Qassim; Navya S Josyula; Jessica N Cooke Bailey; Pieter W M Bonnemaijer; Adriana Iglesias; Owen M Siggs; Terri L Young; Veronique Vitart; Alberta A H J Thiadens; Juha Karjalainen; Steffen Uebe; Ronald B Melles; K Saidas Nair; Robert Luben; Mark Simcoe; Nishani Amersinghe; Angela J Cree; Rene Hohn; Alicia Poplawski; Li Jia Chen; Shi-Song Rong; Tin Aung; Eranga Nishanthie Vithana; Gen Tamiya; Yukihiro Shiga; Masayuki Yamamoto; Toru Nakazawa; Hannah Currant; Ewan Birney; Xin Wang; Adam Auton; Michelle K Lupton; Nicholas G Martin; Adeyinka Ashaye; Olusola Olawoye; Susan E Williams; Stephen Akafo; Michele Ramsay; Kazuki Hashimoto; Yoichiro Kamatani; Masato Akiyama; Yukihide Momozawa; Paul J Foster; Peng T Khaw; James E Morgan; Nicholas G Strouthidis; Peter Kraft; Jae H Kang; Chi Pui Pang; Francesca Pasutto; Paul Mitchell; Andrew J Lotery; Aarno Palotie; Cornelia van Duijn; Jonathan L Haines; Chris Hammond; Louis R Pasquale; Caroline C W Klaver; Michael Hauser; Chiea Chuen Khor; David A Mackey; Michiaki Kubo; Ching-Yu Cheng; Jamie E Craig; Stuart MacGregor; Janey L Wiggs Journal: Nat Commun Date: 2021-02-24 Impact factor: 14.919