Original articleThe Association of Refractive Error with Glaucoma in a Multiethnic Population
Section snippets
Setting
Study participants were identified from the KPNC, a large nonprofit integrated healthcare delivery system with 3.5 million active members comprising approximately 30% of the population of Northern California. The KPNC membership has been shown to be representative of the general population with respect to demographic characteristics, including racial or ethnic diversity, with some underrepresentation at the extremes of income.19 Since 1995, KPNC has recorded diagnoses, prescriptions, and
Results
A total of 1 679 185 KPNC members were eligible for the study. Of those, 52% of the glaucoma cases (n = 69 939) and 36% of the controls (n = 536 761) had refractive errors measured at 35 years of age or older (Table 1). A history of cataract surgery was the most common reason for exclusion, and the proportion of cases that were excluded for this reason varied by glaucoma subtype, ranging from 32% for OHTN to 76% for PEX. After these exclusions, a total of 34 040 glaucoma cases (49%) and 403 398
Discussion
In this large, community-based cross-sectional study, we assessed the associations between refractive error and the prevalence of several subtypes of glaucoma. Although hyperopia was associated with PACG, myopia was associated with an increased prevalence of all forms of open-angle glaucoma. The magnitudes of the associations were strongest for those with the greatest refractive error. In general, associations were stronger in younger persons, whereas some associations were strongest in racial
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See editorial on page 7.
Supplemental material is available at www.aaojournal.org.
Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Supported by a research grant from the Kaiser Permanente Medical Care Plan, Northern California Region, Community Benefit program, Oakland, California.
Author Contributions:
Conception and design: Shen, Jorgenson
Analysis and interpretation: Shen, Melles, Metlapally, Barcellos, Schaefer, Risch, Herrinton, Wildsoet, Jorgenson
Data collection: Shen, Melles, Jorgenson
Obtained funding: Schaefer, Jorgenson
Overall responsibility: Shen, Melles, Metlapally, Barcellos, Schaefer, Risch, Herrinton, Wildsoet, Jorgenson