Association between Pretreatment Serum Uric Acid Levels and Progression of Newly Diagnosed Primary Angle-Closure Glaucoma: A Prospective Cohort Study

Abstract

Purpose. Increased evidence reveals that uric acid (UA) may have an important neuroprotective effect through its antioxidant properties. The aim of the present study was to investigate the relationship between pretreatment serum UA levels and the progression of newly diagnosed primary angle-closure glaucoma (PACG). Methods. This prospective observational cohort study included 64 patients with newly diagnosed PACG who were followed up for a mean period of 12.77 months (range: 3–28 months). All subjects underwent a complete ophthalmological examination during the baseline and final follow-up visits, together with the acquisition of blood samples for UA measurements. During the follow-up period, the progression of PACG was defined as a clinical diagnosis of medically uncontrolled intraocular pressure and a loss of visual field with a mean deviation of >1 dB/year. Univariable and multivariable Cox regression models were used to investigate the association between baseline serum UA levels and the progression of PACG. The cumulative probability of progression of glaucoma was analyzed using the Kaplan-Meier method. Results. During follow-up, 32 subjects were defined as progressive PACG, among whom baseline UA values were significantly higher in nonprogressing subjects than in progressing subjects (0.314±0.069 mmol/l versus [vs.] 0.258±0.069 mmol/l, respectively; P=0.002). Similar results were also observed in male and female subgroups (P<0.05). In a multivariable model, a decreased baseline serum UA level was associated with an increased risk for progressing PACG: both in male (hazard ratio [HR] 6.088 [95% confidence interval (CI) 1.163–31.8638]; P=0.032) and female subjects (HR 3.565 [95% CI 1.131–11.236]; P=0.030). Subjects with high UA levels demonstrated higher cumulative probabilities of nonprogressing PACG than those with low UA levels (male [16.67% vs. 80.00%; P=0.0084] and female [29.41% vs. 68.00%; P=0.0182]). Conclusion. An association between high baseline serum UA levels and a decreased risk for progressing PACG was found. This primary finding suggests that high serum UA levels may have a protective role against PACG and could slow disease progression.

Relationship between Oxidative Stress Biomarkers and Visual Field Progression in Patients with Primary Angle Closure Glaucoma

“…The previously described methods were used for the VF analysis as follows [ 13 ]. The Glaucoma Department of the Eye and ENT Hospital of Fudan University performed perimetry on the glaucoma subjects unless they were unable to see any light with both eyes open or suffered from an eye infection.…”

“…PACG was diagnosed by a glaucoma specialist. Previously described diagnostic criteria were used to diagnose PACG [13][14][15][16][17]. PACG was diagnosed based on narrow anterior chamber angles with glaucomatous optic neuropathy and corresponding VF loss.…”

Association Between Serum Lipid Levels and Patients With Primary Angle-Closure Glaucoma in China: A Cross Sectional, Case–Control Study

“…PACG was diagnosed by a glaucoma specialist. Previously described diagnostic criteria were used to diagnose PACG and previously described inclusion criteria were used to select patients ( 11 – 13 ). PACG was diagnosed based on narrow anterior chamber angles with glaucomatous optic neuropathy and corresponding VF loss.…”

Increased risk of glaucoma amongst new‐onset gout patients aged 20‐39 years: A nationwide population‐based cohort study in Taiwan

“…Previous studies have shown that high serum uric acid levels within the normal range may have a protective role against the primary angle-closure glaucoma (PACG). [24][25][26] In their cross-sectional and case-control studies, the uric acid levels are within normal range, and the PACG patient has lower uric acid levels whereas the non-PACG patient has high baseline serum uric acid levels. These studies propose that uric acid may have an important neuroprotective effect through its antioxidant properties.…”