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The association between skin autofluorescence and mean deviation in patients with open-angle glaucoma
  1. Noriko Himori1,
  2. Hiroshi Kunikata1,2,
  3. Ryo Kawasaki3,
  4. Yukihiro Shiga1,
  5. Kazuko Omodaka1,4,
  6. Hidetoshi Takahashi1,5,
  7. Toshio Miyata6,
  8. Toru Nakazawa1,2,4,7
  1. 1Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
  2. 2Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Sendai, Japan
  3. 3Department of Public Health, Yamagata University Graduate School of Medicine, Yamagata, Japan
  4. 4Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Sendai, Japan
  5. 5Division of Ophthalmology, Department of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
  6. 6Department of Molecular Medicine and Therapy, Tohoku University Graduate School of Medicine, Sendai, Japan
  7. 7Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
  1. Correspondence to Professor Toru Nakazawa, Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi 980-8574, Japan; ntoru{at}


Background It has been suggested that local and systemic oxidative stress levels are causal risk factors for glaucoma.

Aim To evaluate the effect of age on the role of systemic oxidative stress in open-angle glaucoma (OAG).

Methods This study included 502 eyes of 251 Japanese patients with OAG. Systemic oxidative stress was assessed with skin autofluorescence (SAF), an indicator of advanced glycogen end products. We selected the youngest and oldest patients by quartile (≤58 and ≥74 years old, respectively) and determined the univariate correlation between SAF and mean deviation (MD) of the visual field in both eyes of each group. We also investigated the association between SAF and glaucoma in the youngest group with a logistic regression analysis.

Results The younger subjects with OAG with high SAF had significantly lower better-eye MD than the younger subjects with normal SAF (p<0.01), but the older subjects had similar better-eye MD regardless of SAF level. Furthermore, SAF was negatively correlated with MD in the youngest subjects (better eye: r=−0.35, p<0.01, worse eye: r=−0.28, p=0.02), but not in the older subjects. Finally, mixed-effects regression analysis showed that SAF contributed to the MD in the younger patients with OAG (p=0.01).

Conclusions We found that the relationship between systemic oxidative stress and visual field loss was strongest in relatively young patients with OAG, suggesting that the potential benefit of antioxidant therapies to combat systemic oxidative stress might be dependent on the age of the patient.

  • Biochemistry
  • Field of vision
  • Glaucoma
  • Apotosis

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  • Contributors NH: contributed to the analysis and interpretation of the data; drafted the work. HK: made substantial contributors to the conception and design of the work. RK: contributed to the analysis. YS, KO, HT and TM: contributed to revising the manuscript critically for important intellectual content. TN: contributed to the conception and design of the work and revised it critically for important intellectual content.

  • Funding This work was supported by a JSPS KAKEN grant-in-aid for young scientists (NH, 26861434 and 16K20299), JST grant from JSPS KAKENHI grants-in-aid for scientific research (B) (TN, 26293372) and for exploratory research (TN, 26670751) and by the JST Center for Revitalisation Promotion.

  • Competing interests None declared.

  • Ethics approval Approved by the ethics committee of the Tohoku University School of Medicine.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.