Association between Normal-tension Glaucoma and Allergic Rhinitis in a Korean Population-based Study

Areum Jeong; Soon Cheol Cha

doi:10.3341/jkos.2018.59.10.960

Journal List > J Korean Ophthalmol Soc > v.59(10) > 1103099

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Jeong and Cha: Association between Normal-tension Glaucoma and Allergic Rhinitis in a Korean Population-based Study

Original Article

Journal of the Korean Ophthalmological Society 2018; 59(10): 960-967.

Published online: 17 October 2018

DOI: https://doi.org/10.3341/jkos.2018.59.10.960

Association between Normal-tension Glaucoma and Allergic Rhinitis in a Korean Population-based Study

Areum Jeong, MD, Soon Cheol Cha, MD, PhD

Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea.

Address reprint requests to Soon Cheol Cha, MD, PhD. Department of Ophthalmology, Yeungnam University Hospital, #170 Hyeonchung-ro, Nam-gu, Daegu 42415, Korea. Tel: 82-53-620-3442, Fax: 82-53-626-5936, sccha@ynu.ac.kr

Received 10 May 2018 Revised 4 July 2018 Accepted 28 September 2018

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to investigate the association between normal-tension glaucoma (NTG) and allergic rhinitis in a population-based setting using data from the Korea National Health and Nutrition Exam Survey (2010–2012).

Methods

The authors selected a total of 8,614 participants aged 40 years and older for this study. All participants completed an ophthalmic examination required for diagnosis of NTG based on the International Society for Geographical and Epidemiological Ophthalmology criteria. An interview regarding nasal symptoms was also performed. The included participants were classified into NTG (n = 604) and control (n = 8,010) groups. The authors compared the groups in terms of prevalence of allergic rhinitis and identified risk factors of NTG.

Results

In NTG patients, allergic rhinitis prevalence was 29.1% (176/604), which was significantly higher than that of the control group (25.0%, 2,000/8,010; p = 0.023). There were significant associations between NTG and allergic rhinitis (odds ratio [OR]= 1.34, 95% confidence interval [CI] = 1.12–1.62, p = 0.002), even after adjusting for potential confounders (age, sex, diabetes, hypertension, number, of family members, household income quartile, frequency of eating out, and smoking status). In particular, patients with NTG aged 60–69 years, those aged 70–79 years, and those who were male had significantly higher ORs for prior allergic rhinitis compared with control subjects (OR = 1.62, 95% CI = 1.16–2.26, p = 0.005; OR = 1.52, 95% CI = 1.06–2.18, p = 0.024; and OR = 1.42, 95% CI = 1.10–1.83, p = 0.007, respectively).

Conclusions

This study showed a significant association between NTG incidence and allergic rhinitis, especially in males and elderly patients (>60 years of age). These results suggested that allergic rhinitis may have a potential role in the development of NTG. Therefore, ophthalmologists and allergic rhinitis patients should remain vigilant to this potential risk factor.

Keywords: Allergic rhinitis, Korea National Health and Nutrition Exam Survey, Normal tension glaucoma

Figures and Tables

Figure 1

Study population (Korea National Health and Nutrition Examination Survey [KNHANES], 2010–2012). Confounding variables included age, sex, area of residence, marital status, family number, household income level, stress level, eating out frequency, smoking status, current alcohol use, and chronic disease (diabetes mellitus, hypertension). FDT = frequency doubling technology; AR = allergic rhinitis; ISGEO = International Society for Geographical and Epidemiological Ophthalmology; IOP = intraocular pressure; PAC = primary angle closure; NTG = normal tension glaucoma.

Table 1

Basic characteristics of included subjects in this study

Values are presented as mean ± SD or n (%) unless otherwise indicated.

NTG = normal tension glaucoma; mo = month; AR = allergic rhinitis.

^*Independent t-test; ^†Chi-square test.

Table 2

Prevalence rate, odds ratios (ORs), and 95% confidence intervals (CIs) for allergic rhinitis among subjects with normal tension glaucoma (NTG)

Model 1: adjustment for age, sex; Model 2: additional adjustment for diabetes mellitus, hypertension; Model 3: additional adjustment for family number, household income, eating-out frequency, and smoking.

AR = allergic rhinitis.

^*Multivariate logistic regression analysis.

Table 3

Prevalence rate, odds ratios (ORs), and 95% confidence intervals (CIs) for allergic rhinitis among subjects with normal tension glaucoma (NTG) by age group

Model 1: adjustment for sex; Model 2: additional adjustment for diabetes mellitus, hypertension; Model 3: additional adjustment for family number, household income, eating-out frequency, and smoking. p-values were determined by multivariate logistic regression analysis.

AR = allergic rhinitis.

^*p < 0.05; ^†p < 0.01.

Table 4

Prevalence rate, odds ratios (ORs), and 95% confidence intervals (CIs) for allergic rhinitis among subjects with normal tension glaucoma (NTG) by gender difference

Model 1: adjustment for age; Model 2: additional adjustment for diabetes mellitus, hypertension; Model 3: additional adjustment for family number, household income, eating-out frequency, and smoking. p-values were determined by multivariate logistic regression analysis.

AR = allergic rhinitis.

^*p < 0.05; ^†p < 0.01.

Notes

^{Conflicts of Interest} The authors have no conflicts to disclose.

References

1. Bonomi L, Marchini G, Marraffa M, et al. Prevalence of glaucoma and intraocular pressure distribution in a defined population. The Egna-Neumarkt Study. Ophthalmology. 1998; 105:209–215.

2. Levene RZ. Low tension glaucoma: a critical review and new material. Surv Ophthalmol. 1980; 24:621–664.

3. Resnikoff S, Pascolini D, Etya'ale D, et al. Global data on visual impairment in the year 2002. Bull World Health Organ. 2004; 82:844–851.

4. Kim YD, Park SC, Kim DH. Epidemiological analysis and study of social welfare of low vision patients. J Korean Ophthalmol Soc. 2007; 48:111–116.

5. Kim CS, Seong GH, Lee NH, et al. Prevalence of primary open-angle glaucoma in central South Korea the Namil study. Ophthalmology. 2011; 118:1024–1030.

6. Chung SD, Lin HC, Hung SH. Allergic rhinitis is associated with open-angle glaucoma: a population-based case-control study. Am J Rhinol Allergy. 2014; 28:e148–e151.

7. Bousquet J, Khaltaev N, Cruz AA, et al. Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy. 2008; 63:Suppl 86. 8–160.

8. Tseng VL, Lee GY, Shaikh Y, et al. The association between glaucoma and immunoglobulin E antibody response to indoor allergens. Am J Ophthalmol. 2015; 159:986–993.e1.

9. Kaiser HJ, Schoetzau A, Stumpfig D, Flammer J. Blood flow velocities of the extraocular vessels in patients with high tension and normal-tension primary open-angle glaucoma. Am J Ophthalmol. 1997; 123:320–327.

10. Shields MB. Normal-tension glaucoma: is it different from primary open-angle glaucoma? Current Opin Ophthalmol. 2008; 19:85–88.

11. Hayreh SS. The blood supply of the optic nerve head and the evaluation of it - myth and reality. Prog Retin Eye Res. 2001; 20:563–593.

12. McLeod SD, West SK, Quigley HA, Fozard JL. A longitudinal study of the relationship between intraocular and blood pressures. Invest Ophthalmol Vis Sci. 1990; 31:2361–2366.

13. Plange N, Remky A, Arend O. Colour Doppler imaging and fluorescein filling defects of the optic disc in normal tension glaucoma. Br J Ophthalmol. 2003; 87:731–736.

14. Grunwald JE, Piltz J, Hariprasad SM, DuPont J. Optic nerve and choroidal circulation in glaucoma. Invest Ophthalmol Vis Sci. 1998; 39:2329–2336.

15. Gherghel D, Orgül S, Gugleta K, et al. Relationship between ocular perfusion pressure and retrobulbar blood flow in patients with glaucoma with progressive damage. Am J Ophthalmol. 2000; 130:597–605.

16. Douglas RA. Normal-tension glaucoma (low-tension glaucoma). Indian J Ophthalmol. 2011; 59:Suppl1. S97.

17. Okumura Y, Yuki K, Tsubota K. Low diastolic blood pressure is associated with the progression of normal-tension glaucoma. Ophthalmologica. 2012; 228:36–41.

18. Joe SG, Choi J, Sung KR, et al. Twenty-four hour blood pressure pattern in patients with normal tension glaucoma in the habitual position. Korean J Ophthalmol. 2009; 23:32–39.

19. Pache M, Dubler B, Flammer J. Peripheral vasospasm and nocturnal blood pressure dipping--two distinct risk factors for glaucomatous damage. Eur J Ophthalmol. 2003; 13:260–265.

20. Kim YD, Han SB, Park KH, et al. Risk factors associated with optic disc haemorrhage in patients with normal tension glaucoma. Eye(Lond). 2010; 24:567–572.

21. Bilgin G. Normal-tension glaucoma and obstructive sleep apnea syndrome: a prospective study. BMC Ophthalmology. 2014; 14:27.

22. Seidman MD, Gurgel RK, Lin SY, et al. Clinical practice guideline: Allergic rhinitis. Otolaryngol Head Neck Surg. 2015; 152:1 Suppl. S1–S43.

23. de Groot H, Brand PL, Fokkens WF, Berger MY. Allergic rhinoconjunctivitis in children. BMJ. 2007; 335:985–988.

24. Ishman SL, Martin TJ, Hambrook DW, et al. Autonomic nervous system evaluation in allergic rhinitis. Otolaryngol Head Neck Surg. 2007; 136:51–56.

25. Emin O, Esra G, Ufuk E, et al. Autonomic dysfunction and clinical severity of disease in children with allergic rhinitis. Int J Pediatr Otorhinolaryngol. 2012; 76:1196–1200.

26. Matsune S, Kono M, Sun D, et al. Hypoxia in paranasal sinuses of patients with chronic sinusitis with or without the complication of nasal allergy. Acta Otolaryngol. 2003; 123:519–523.

27. Kaur C, Foulds WS, Ling EA. Hypoxia-ischemia and retinal ganglion cell damage. Clinical Ophthalmology. 2008; 2:879–889.

28. Becker B, Keates EU, Coleman SL. Gamma-globulin in the trabecular meshwork of glaucomatous eyes. Arch Opthalmol. 1962; 68:643–647.

29. Rhee CS, Wee JH, Ahn JC, et al. Prevalence, risk factors and comorbidities of allergic rhinitis in South Korea: The Fifth Korea National Health and Nutrition Examination Survey. Am J Rhinol Allergy. 2014; 28:e107–e114.

30. Nam JW, Gwak JI, An HJ, et al. Relationship between intraocular pressure and smoking, alcohol consumption in Korean adults. Korean Journal of Family Practice. 2017; 7:544–550.

31. Morgado PB, Chen HC, Patel V, et al. The acute effect of smoking on retinal blood flow in subjects with and without diabetes. Ophthalmology. 1994; 101:1220–1226.

32. Hara K. Effects of cigarette smoking on ocular circulation chronic effect on choroidal circulation. Nippon Ganka Gakkai Zasshi. 1991; 95:939–943.

TOOLS

Similar articles