Albuminuria Is Associated with Open-Angle Glaucoma in Nondiabetic Korean Subjects: A Cross-Sectional Study

Kim, Gyu Ah; Park, Se Hee; Ko, Jeong-Sik; Lee, Si Hyung; Bae, Hyoung Won; Seong, Gong Je; Kim, Chan Yun

doi:10.1371/journal.pone.0168682

Cited by 8 publications

(5 citation statements)

References 34 publications

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“…12 Another previous study also using the KNHANES 2011 to 2012 reported that albuminuria, even low-grade, was significantly associated with OAG in nondiabetic subjects. 26 These results are concordant with the main findings of our study that CRD increased the risk of following glaucoma development in the Korean population, although our study was a longitudinal study compared with the cross-sectional previous studies. Another populationbased study using the Taiwan Longitudinal Health Insurance Database 2000, they found that chronic renal failure (CRF) had a significantly higher prevalence of glaucoma and other eye diseases, including retinal disorders, uveitis, and cataract, compared with patients without CRF.…”

Section: Discussionsupporting

confidence: 93%

Association Between Chronic Renal Disease and the Risk of Glaucoma Development: A 12-year Nationwide Cohort Study

Cho

Han

Choi

et al. 2021

Invest. Ophthalmol. Vis. Sci.

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The purpose of this study was to present the results of our investigation into the risk of glaucoma development in patients with chronic renal disease (CRD). METHODS.The present retrospective cohort study used the Korean National Health Insurance Service data, which consisted of 1,025,340 random subjects who were tracked from 2002 to 2013. Newly diagnosed glaucoma and CRD were included on the basis of the Korean Classification of Disease codes. The CRD group consisted of patients who received an initial CRD diagnosis between January 2003 and December 2007 as an index period (n = 3640). The control group (n = 17,971) was selected using 1:5 propensity-score matching using social and demographic factors, along with the year of enrollment. Each group subject was followed until 2013. We used multivariate Cox proportional hazard regression analysis to compare the risk of glaucoma development between the two groups.RESULTS. Glaucoma consecutively developed in 4.3% in the CRD group and 2.8% in the control group (P < 0.0001). CRD increased the risk of glaucoma development (hazard ratio [HR] = 1.63, 95% confidence interval [CI] = 1.34-1.98] after adjusting for age, sex, comorbidities, residence, household income, and the year of enrollment. In multivariate Cox regression analysis, patients with comorbidity of hypertension, diabetes mellitus, or aged ≥ 50 years showed a significantly higher risk of glaucoma development (all P < 0.008). CONCLUSIONS.A significant association between CRD and following development of glaucoma was revealed after adjusting the potential confounding factors.

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Section: Discussionsupporting

confidence: 93%

Association Between Chronic Renal Disease and the Risk of Glaucoma Development: A 12-year Nationwide Cohort Study

Cho

Han

Choi

et al. 2021

Invest. Ophthalmol. Vis. Sci.

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“…Another interesting finding is that higher UACR was independently associated with increased GCC-FLV and GCC-GLV. Previous studies have documented that albuminuria was independently associated with POAG ( Kim et al, 2016 ), an ocular disease characterized by loss of the retinal ganglion cells in the retina ( Shin et al, 2018 ), suggesting that albuminuria might be associated with retinal ganglion cell loss. In this regard, albuminuria (as indicated by higher UACR) might be a potential biomarker suggestive of neuronal damage in the retina.…”

Section: Discussionmentioning

confidence: 99%

Retinal Neurovascular Impairment in Non-diabetic and Non-dialytic Chronic Kidney Disease Patients

Zeng

Chen

et al. 2021

Front. Neurosci.

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Background: Widespread neural and microvascular injuries are common in chronic kidney disease (CKD), increasing risks of neurovascular complications and mortality. Early detection of such changes helps assess the risks of neurovascular complications for CKD patients. As an extension of central nervous system, the retina provides a characteristic window to observe neurovascular alterations in CKD. This study aimed to determine the presence of retinal neurovascular impairment in different stages of CKD.Methods: One hundred fifteen non-diabetic and non-dialytic CKD patients of all stages and a control group of 35 healthy subjects were included. Retinal neural and microvascular parameters were obtained by optical coherence tomography angiography (OCTA) examination.Results: CKD 1–2 group (versus control group) had greater odds of having decreased retinal ganglion cell-inner plexiform layer thickness (GC-IPLt) (odds ratio [OR]: 0.92; 95% confidence interval [CI]: 0.86–0.98), increased ganglion cell complex-focal loss volume (GCC-FLV) (OR: 3.51; 95% CI: 1.27–9.67), and GCC-global loss volume (GCC-GLV) (OR: 2.48; 95% CI: 1.27–4.82). The presence of advanced stages of CKD (CKD 3–5 group versus CKD 1–2 group) had greater odds of having decreased retinal vessel density in superficial vascular plexus (SVP)-WholeImage (OR: 0.77, 95% CI: 0.63–0.92), SVP-ParaFovea (OR: 0.83, 95% CI: 0.71–0.97), SVP-ParaFovea (OR: 0.76, 95% CI: 0.63–0.91), deep vascular plexus (DVP)-WholeImage (OR: 0.89, 95% CI: 0.81–0.98), DVP-ParaFovea (OR: 0.88, 95% CI: 0.78–0.99), and DVP-PeriFovea (OR: 0.90, 95% CI: 0.83–0.98). Besides, stepwise multivariate linear regression among CKD patients showed that β2-microglobulin was negatively associated with GC-IPLt (β: –0.294; 95% CI: –0.469 ∼ –0.118), and parathyroid hormone was positively associated with increased GCC-FLV (β: 0.004; 95% CI: 0.002∼0.006) and GCC-GLV (β: 0.007; 95% CI: 0.004∼0.01). Urine protein to creatinine ratio was positively associated with increased GCC-FLV (β: 0.003; 95% CI: 0.001∼0.004) and GCC-GLV (β: 0.003; 95% CI: 0.001∼0.006).Conclusion: Retinal neuronal impairment is present in early stages of CKD (stages 1–2), and it is associated with accumulation of uremic toxins and higher UACR, while retinal microvascular hypoperfusion, which is associated with worse eGFR, was only observed in relatively advanced stages of CKD (stages 3–5). The results highlight the importance of monitoring retinal neurovascular impairment in different stages of CKD.

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“…CHO, cholesterol; CI, confidence interval; LDL-C, low density lipoprotein cholesterol; HDL-C, high density lipoprotein cholesterol; OR, odds ratio; POAG, primary open angle glaucoma; NS, non-significant; NTG, normal tension glaucoma. In ( 107 ) and ( 110 ), age was significantly different between controls and cases.…”

Section: Cholesterol Oxysterols and Glaucomamentioning

confidence: 86%

“… Results are given as mean ± SD (except for ( 110 ) mean ± SE) or OR, 95%CI. See references for details regarding specific statistical methods.…”

Section: Cholesterol Oxysterols and Glaucomamentioning

confidence: 99%

Cholesterol and oxysterols in retinal neuron-glia interactions: relevance for glaucoma

Masson,

Serrano,

Leger-Charnay

et al. 2024

Front. Ophthalmol.

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Cholesterol is an essential component of cellular membranes, crucial for maintaining their structural and functional integrity. It is especially important for nervous tissues, including the retina, which rely on high amounts of plasma membranes for the transmission of the nervous signal. While cholesterol is by far the most abundant sterol, the retina also contains cholesterol precursors and metabolites, especially oxysterols, which are bioactive molecules. Cholesterol lack or excess is deleterious and some oxysterols are known for their effect on neuron survival. Cholesterol homeostasis must therefore be maintained. Retinal glial cells, especially Müller cells, the principal glial cells of the vertebrate retina, provide mechanical, nutritional, and metabolic support for the neighboring neurons. Several pieces of evidence indicate that Müller cells are major actors of cholesterol homeostasis in the retina, as it is known for other glial cells in the brain. This process is based on a close cooperation with neurons, and sterols can be signaling molecules participating in glia-neuron interactions. While some implication of cholesterol in age-related macular degeneration is now recognized, based on epidemiological and laboratory data, evidence for its role in glaucoma is still scarce. The association between cholesterolemia and glaucoma is controversial, but experimental data suggest that sterols could take part in the pathological processes. It has been demonstrated that Müller glial cells are implicated in the development of glaucoma through an ambivalent reactive retinal gliosis process. The early steps contribute to maintaining retinal homeostasis and favor the survival of ganglion cells, which are targeted during glaucoma. If gliosis persists, dysregulation of the neuroprotective functions, cytotoxic effects of gliotic Müller cells and disruption of glia-neuron interactions lead to an acceleration of ganglion cell death. Sterols could play a role in the glial cell response to glaucomatous injury. This represents an understudied but attractive topic to better understand glaucoma and conceive novel preventive or curative strategies. The present review describes the current knowledge on i) sterol metabolism in retinal glial cells, ii) the potential role of cholesterol in glaucoma, and iii) the possible relationships between cholesterol and oxysterols, glial cells and glaucoma. Focus is put on glia-neuron interactions.

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Albuminuria Is Associated with Open-Angle Glaucoma in Nondiabetic Korean Subjects: A Cross-Sectional Study

Cited by 8 publications

References 34 publications

Association Between Chronic Renal Disease and the Risk of Glaucoma Development: A 12-year Nationwide Cohort Study

Association Between Chronic Renal Disease and the Risk of Glaucoma Development: A 12-year Nationwide Cohort Study

Retinal Neurovascular Impairment in Non-diabetic and Non-dialytic Chronic Kidney Disease Patients

Cholesterol and oxysterols in retinal neuron-glia interactions: relevance for glaucoma

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