Diego Tebaldi de Queiroz Barbosa

Ethnic differences in trabecular meshwork height by optical coherence tomography.

IMPORTANCE Differences in ocular anatomy may contribute to ethnic differences in glaucoma risk. Because the trabecular meshwork (TM) plays an important role in aqueous outflow, its anatomy in relation to at-risk populations may provide insight into a potential contributor to elevated intraocular pressure and thus to probability of glaucoma development. OBJECTIVE To investigate whether differences exist in TM height between ethnic groups. DESIGN, SETTING, AND PARTICIPANTS This prospective study took place from January 1, 2012, to December 31, 2013. Adult patients who self-reported as being of white, Asian, Hispanic, or African American ethnicity were recruited from ophthalmology clinics at the University of California, San Francisco. The TM height was assessed using spectral-domain anterior segment optical coherence tomography. MAIN OUTCOMES AND MEASURES Trabecular meshwork height was measured from the scleral spur to the Schwalbe line. We hypothesized that ethnicities with a higher prevalence of glaucoma would tend to have shorter TM heights. RESULTS We collected data from 460 eyes of 291 participants after excluding 34 optical coherence tomographic scans owing to poor image quality. The final sample was 32.2% white, 45.1% Asian, 10.5% African American, and 12.1% Hispanic. There were 64.2% women, and the mean age was 68.1 years. The mean (SD) TM height among all eyes included in the study was 836 (131) μm. The mean (SD) TM height was characterized among white (851 [131] μm), Asian (843 [126] μm), Hispanic (822 [147] μm), and African American (771 [118] μm) persons. Ethnicity was not associated with TM height overall (P = .23, linear mixed regression model). However, the TM heights of African American participants (771 μm) were shorter than those of white (851 μm; adjusted difference 95% CI, -119.8 to -8.1; P = .02) and Asian (843 μm; adjusted difference 95% CI, -117.4 to -10.8; P = .02) participants. CONCLUSIONS AND RELEVANCE Although TM height is not associated with ethnicity overall, African American individuals have shorter TM heights compared with Asian and white persons. Trabecular meshwork size may play a role in ethnic differences of glaucoma risk and be a new risk factor to consider in primary open-angle glaucoma.

Age-related macular degeneration and protective effect of HMG Co-A reductase inhibitors (statins): results from the National Health and Nutrition Examination Survey 2005–2008

PurposeTo determine the association of hydroxymethylglutarylcoenzyme A (HMG Co-A) reductase inhibitor (statin) use with the prevalence of age-related macular degeneration (AMD).MethodsThis cross-sectional study included 5604 participants in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2008, ≥40 years of age, who were ascertained with regard to the diagnosis of AMD, the use of statins, and comorbidities and health-related behaviors such as smoking.ResultsThe mean age of participants denying or confirming a history of AMD was 68 (SEM 0.90) and 55 (SEM 0.36) years, respectively. Individuals 68 years of age or older who were classified as long-term users of statins had statistically significant less self-reported AMD (odds ratio (OR) 0.64, 95% confidence interval (CI) 0.49–0.84; P=0.002), after adjusting for potential confounding variables. No significant association was found between the prevalence of AMD and statin consumption among subjects between 40 and 67 years of age (OR 1.61, 95% CI 0.85–3.03; P=0.137).ConclusionsOur results suggest a possible beneficial effect of statin intake for the prevention of AMD in individuals 68 years of age or older.

Oral Contraceptive Use and Prevalence of Self-Reported Glaucoma or Ocular Hypertension in the United States

PURPOSE To investigate the association between oral contraceptive (OC) use and glaucoma prevalence in the United States. DESIGN Cross-sectional study. PARTICIPANTS A total of 3406 female participants, aged 40 years or older, from the 2005 to 2008 National Health and Nutrition Examination Survey, who reported a presence or absence of glaucoma or ocular hypertension completed both the vision and the reproductive health questionnaires and underwent eye examinations. METHODS Multivariate regression analysis was used to assess the correlation between OC use and self-reported glaucoma or ocular hypertension (n = 231 cases), controlling for potential confounders, including age, ethnicity, systemic comorbidities such as hypertension and stroke, ocular diseases such as cataract and diabetic retinopathy, and reproductive health factors, including age at menopause, age at menarche, history of hormone replacement therapy, and gynecological surgical history. MAIN OUTCOME MEASURES The outcome variable was self-reported glaucoma or ocular hypertension. RESULTS After adjusting for confounders, those with ≥3 years of OC use had greater odds (odds ratio, 1.94; 95% confidence interval, 1.22-3.07) of self-reported glaucoma or ocular hypertension. Other factors associated with higher glaucoma or ocular hypertension prevalence included older age, African American race, and later age at menarche. CONCLUSIONS Oral contraceptive use may be associated with increased risk of self-reported glaucoma or ocular hypertension.