The Relationship Between Carotid Artery Stenosis and the Development of Open-Angle Glaucoma: A Long-term Cohort Study in Taiwan.

IF 1.7 4区 医学 Q3 OPHTHALMOLOGY Ophthalmic epidemiology Pub Date : 2024-08-15 DOI:10.1080/09286586.2024.2371467
Wen-Yun Lin, Jin-Jhe Wang, Chauyin-Yin Chen, Chia-Yen Liu, Meng-Hung Lin, Yao-Hsu Yang, Chien-Hsiung Lai
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Abstract

Purposes: To determine the relationship between carotid artery stenosis (CAS) and the development of open-angle glaucoma (OAG) in the Taiwanese population.

Methods: This retrospective cohort study was conducted using Chang Gung Research Database. Cox-proportional hazards model was applied to calculate the hazard ratio for OAG between CAS and the control cohort.

Results: Among 19,590 CAS patients, 17,238 had mild CAS (<50%), 1,895 had moderate CAS (50-69%), and 457 had severe CAS (≥70%). The CAS cohort had a higher proportion of several comorbidities. After adjusting for comorbidities, no significant difference in OAG development was found between CAS and control cohorts. Matching for key comorbidities, no significant differences in OAG incidence were found between matched cohorts (P = .869). Subdividing the matched CAS cohort by stenosis severity: mild (<50%), moderate (50-69%), and severe (≥70%), a statistically significantly lower OAG risk was observed in patients with mild CAS stenosis (HR: 1.12, 95% CI = 1.03-1.21, = .006). Kaplan-Meier analysis revealed reduced OAG incidence in CAS patients who underwent surgical intervention, compared to the control cohort (P <.001). Subgroup analysis revealed that patients in the mild CAS stenosis group, those who underwent surgical intervention exhibited a reduced OAG risk (HR: 0.29, 95% CI = 0.15-0.58, = .001).

Conclusions: No statistically significant differences in OAG risk were observed between patients with CAS and the control cohort. The severity of CAS appears to influence OAG risk, with surgical intervention potentially offering protective effects, particularly in patients with mild CAS stenosis (<50%), suggesting that enhanced ocular perfusion post-surgery may act as a protective factor against OAG development.

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颈动脉狭窄与开角型青光眼发病的关系:台湾长期队列研究。
目的确定台湾人群中颈动脉狭窄(CAS)与开角型青光眼(OAG)发病之间的关系:这项回顾性队列研究利用长庚研究数据库进行。方法:这项回顾性队列研究利用长庚研究数据库进行,采用 Cox 比例危险模型计算 CAS 与对照队列之间发生开角型青光眼的危险比:结果:在 19,590 名 CAS 患者中,17,238 人患有轻度 CAS(P = .006)。Kaplan-Meier分析显示,与对照组相比,接受手术干预的CAS患者OAG发病率降低(P = .001):结论:CAS 患者与对照组之间的 OAG 风险无统计学差异。CAS的严重程度似乎会影响OAG风险,手术干预可能会起到保护作用,尤其是对轻度CAS狭窄的患者而言(P = .001)。
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来源期刊
Ophthalmic epidemiology
Ophthalmic epidemiology 医学-眼科学
CiteScore
3.70
自引率
5.60%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Ophthalmic Epidemiology is dedicated to the publication of original research into eye and vision health in the fields of epidemiology, public health and the prevention of blindness. Ophthalmic Epidemiology publishes editorials, original research reports, systematic reviews and meta-analysis articles, brief communications and letters to the editor on all subjects related to ophthalmic epidemiology. A broad range of topics is suitable, such as: evaluating the risk of ocular diseases, general and specific study designs, screening program implementation and evaluation, eye health care access, delivery and outcomes, therapeutic efficacy or effectiveness, disease prognosis and quality of life, cost-benefit analysis, biostatistical theory and risk factor analysis. We are looking to expand our engagement with reports of international interest, including those regarding problems affecting developing countries, although reports from all over the world potentially are suitable. Clinical case reports, small case series (not enough for a cohort analysis) articles and animal research reports are not appropriate for this journal.
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