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Original Investigation |

Association Between Body Levels of Trace Metals and Glaucoma Prevalence

Shuai-Chun Lin, MD1,2; Kuldev Singh, MD3; Shan C. Lin, MD1
[+] Author Affiliations
1Department of Ophthalmology, University of California, San Francisco
2Department of Medicine, National Yang-Ming University, Taipei, Taiwan
3Department of Ophthalmology, Stanford University, Stanford, California
JAMA Ophthalmol. 2015;133(10):1144-1150. doi:10.1001/jamaophthalmol.2015.2438.
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Importance  Abnormal body levels of essential elements and exposure to toxic trace metals have been postulated to contribute to the pathogenesis of diseases affecting many organ systems, including the eye.

Objective  To investigate associations between body levels of trace metals and the prevalence of glaucoma in a cross-sectional population-based study.

Design, Setting, and Participants  Blood or urine metallic element levels and information pertaining to ocular disease were available for 2680 individuals 19 years and older participating in the fourth Korea National Health and Nutrition Examination Survey between January 1, 2008, and December 31, 2009, the second and the third years of the survey (2007-2009). Glaucoma diagnosis was based on criteria established by the International Society of Geographic and Epidemiologic Ophthalmology. Demographic, comorbidity, and health-related behavior information was obtained via interview. Multivariable logistic regression analyses were performed to determine associations between blood and urine trace element levels and the odds of glaucoma diagnosis. All analyses were performed between September 2014 and December 2014.

Main Outcome and Measure  The presence or absence of glaucoma.

Results  After adjustment for potential confounders, blood manganese level was negatively associated with the odds of glaucoma diagnosis (odds ratio [OR], 0.44; 95% CI, 0.21-0.92). Blood mercury level was positively associated with glaucoma prevalence (OR, 1.01; 95% CI, 1.00-1.03). No definitive association was identified between blood cadmium or lead levels or urine arsenic level and a diagnosis of glaucoma.

Conclusions and Relevance  These findings in a cross-sectional study of the South Korean population suggest that a lower blood manganese level and a higher blood mercury level are associated with greater odds of glaucoma. For more confidence that trace metals may have a role in the pathogenesis of glaucoma, prospective studies would need to confirm that the presence of such trace metals increases the chance of developing glaucoma.

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