PT  - JOURNAL ARTICLE
AU  - Zhi Wei Lim
AU  - Miao-Li Chee
AU  - Sahil Thakur
AU  - Xiaoling Fang
AU  - Zhi Da Soh
AU  - Shivani Majithia
AU  - Zhen Ling Teo
AU  - Charumathi Sabanayagam
AU  - Tien Yin Wong
AU  - Ching-Yu Cheng
AU  - Yih-Chung Tham
TI  - Albuminuria and Primary Open-Angle Glaucoma: the Singapore Chinese Eye Study (SCES)
AID  - 10.1136/bjophthalmol-2020-315920
DP  - 2020 Jul 15
TA  - British Journal of Ophthalmology
PG  - bjophthalmol-2020-315920
4099  - http://bjo.bmj.com/content/early/2020/07/15/bjophthalmol-2020-315920.short
4100  - http://bjo.bmj.com/content/early/2020/07/15/bjophthalmol-2020-315920.full
AB  - Aims To determine the association between albuminuria and primary open-angle glaucoma (POAG).Methods Participants of the Singapore Chinese Eye study were recruited and underwent standardised ocular and systemic examinations. Albuminuria was determined using urinary albumin-to-creatinine ratio (UACR, mg/g) based on random spot urinary albumin and creatinine measurements. POAG was defined using the International Society of Geographic and Epidemiological Ophthalmology classification. Multivariable logistic regression with generalised estimating equation model was used to evaluate the association between albuminuria and POAG, while accounting for correlation between eyes.Results A total of 3009 Chinese adults (5963 eyes), aged 40–80 years, were included in this study, of which, 52 subjects (75 eyes) had POAG. Higher UACR (per 50 mg/g increase) was independently associated with POAG (OR=1.04, 95% CI 1.01 to 1.07, p=0.003) following adjustment for age, gender, intraocular pressure, diabetes mellitus, hyperlipidaemia, hypertension, anti-hypertensive medication, history of cardiovascular disease, current smoking status, alcohol intake, body mass index and estimated glomerular filtration rate. Further stratification revealed that individuals with macroalbuminuria were 8.00 times likely to have POAG (95% CI 2.97 to 21.54, p<0.001), compared with those with normoalbuminuria. Microalbuminuria was not significantly associated with POAG (OR=0.49, 95% CI 0.19 to 1.29, p=0.150). The association between macroalbuminuria and POAG remained significant among individuals who were diabetic (OR=9.89, 95% CI 2.49 to 39.30, p=0.001) and hypertensive (OR=8.39, 95% CI 3.07 to 22.94, p<0.001).Conclusion In this population-based study of Chinese adults, albuminuria was independently associated with POAG. Our findings provide further understanding on the pathogenesis of POAG and may potentially help to better identify individuals at risk of POAG.