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Is kidney function associated with primary open-angle glaucoma? Findings from the Asian Eye Epidemiology Consortium
  1. Yih-Chung Tham1,2,
  2. Yijin Tao1,3,
  3. Liang Zhang1,
  4. Tyler Hyung Taek Rim1,4,
  5. Sahil Thakur1,
  6. Zhi Wei Lim1,5,
  7. Miao Li Chee1,
  8. Mukharram M Bikbov6,
  9. Gyulli M Kazakbaeva6,
  10. Ningli Wang7,
  11. Kai Cao7,
  12. Jie Hao7,
  13. Vinay Nangia8,
  14. Songhomitra Panda-Jonas9,
  15. Ya Xing Wang7,
  16. Ian Y Wong10,11,
  17. Jonathan Cheuk Hung Chan11,
  18. Qianli Meng12,
  19. Charumathi Sabanayagam1,2,
  20. Tien Y Wong1,2,13,
  21. Jost B Jonas9,
  22. Hua Zhong3,
  23. Ching-Yu Cheng1,2,13
  24. The Asian Eye Epidemiology Consortium (AEEC)
    1. 1Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
    2. 2Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
    3. 3Department of Ophthalmology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
    4. 4Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
    5. 5Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
    6. 6Ufa Eye Research Institute, Ufa, Bashkortostan, Russian Federation
    7. 7Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
    8. 8Suraj Eye Institute, Nagpur, Maharashtra, India
    9. 9Department of Ophthalmology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
    10. 10Department of Ophthalmology, Hong Kong Sanatorium and Hospital, Hong Kong SAR, China
    11. 11Department of Ophthalmology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
    12. 12Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China
    13. 13Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
    1. Correspondence to Dr Ching-Yu Cheng, Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore, Singapore; chingyu.cheng{at}


    Aim To comprehensively examine the association between kidney function and primary open angle glaucoma (POAG) in a large consortium of multiple Asian population-based studies.

    Methods 28 925 participants (57 340 eyes) from 9 population-based studies (from China, Hong Kong, India, Korea, Russia, Singapore) of the Asian Eye Epidemiology Consortium were included. Across all studies, POAG was defined based on the International Society of Geographical and Epidemiological Ophthalmology criteria. Estimated glomerular filtration rate (eGFR) was calculated from serum creatinine. Chronic kidney disease (CKD) was defined as eGFR<60 mL/min/1.73 m2. Eye-specific data were pooled from each study. Multivariable regression analysis with generalised estimating equation models was performed to evaluate the associations between kidney function with POAG and intraocular pressure (IOP).

    Results After adjusting for age, gender, study group, hypertension, diabetes, hyperlipidaemia, body mass index, smoking status and IOP, lower eGFR (per 10 mL/min/1.73 m2 decrease) was not significantly associated with POAG (OR=1.01; p=0.77). Presence of CKD was also not significantly associated with POAG (OR=1.01; p=0.739). Furthermore, lower eGFR and presence of CKD were not associated with IOP (all p≥0.12), However, in the subgroup of combined Korean and Chinese individuals, significant associations between lower eGFR (OR=1.09; 95% CI 1.00 to 1.18; p=0.048) and severe kidney function decline (<45 mL/min/1.73 m2; OR=2.57; 95% CI 1.34 to 4.93; p=0.004) with POAG, were observed.

    Conclusion In this large pooled-analysis of multiple Asian population-based studies, our findings suggest that the association between CKD and POAG may only be present in East Asians specifically but not in the overall Asian population. Further evaluation in Japanese population is warranted to confirm this observation.

    • epidemiology
    • glaucoma

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    • Y-CT and YT contributed equally as first authors.

    • JBJ, HZ and C-YC contributed equally as last authors.

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    • JBJ, HZ and C-YC are joint senior authors.

    • Collaborators The Asian Eye Epidemiology Consortium (AEEC): Bonnie Nga Kwan Choy, Ying Cui, Timur R. Gilmanshin, Se Woong Kang, Sarang Lambat, Yuanbo Liang, Shivani Majithia, Prabhat Nangia, Purna Nangia, Kyu Hyung Park, Ellina M. Rakhimova, Zhi Da Soh, Wenbin Wei, Jiangping Wen, Liang Xu, Marco Yu, Seung-Young Yu, Rinat M. Zainullin, Ye Zhang.

    • Contributors Y-CT, YT, THTR, MMB, GMK, NW, KC, JH, VN, SP-J, YXW, IYW, JCHC, QM, CS, TYW, JBJ, HZ and C-YC conceived and designed the study. Y-CT, YT, LZ, THTR and MLC analysed and interpreted the data. Y-CT, YT, LZ, THTR, ST, ZWL, JBJ, HZ and C-YC wrote the manuscript. All authors reviewed and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

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

    • Data availability statement No data are available.