Prevalence of normal-tension glaucoma in patients with primary aldosteronism: Prevalence of NTG in patients with primary aldosteronism

Kazuyuki Hirooka; Tomomi Higashide; Kimikazu Sakaguchi; Sachiko Udagawa; Kazuhisa Sugiyama; Kenji Oki; Mitsuhiro Kometani; Takashi Yoneda; Kensaku Fukunaga; Tomoyuki Akita; Taro Baba; Yoshiaki Kiuchi

doi:10.1016/j.ajo.2024.09.014

Prevalence of normal-tension glaucoma in patients with primary aldosteronism: Prevalence of NTG in patients with primary aldosteronism

Am J Ophthalmol. 2024 Sep 14:S0002-9394(24)00434-3. doi: 10.1016/j.ajo.2024.09.014. Online ahead of print.

Authors

Affiliations

¹ Department of Ophthalmology and Visual Science, Infectious Diseases Control and Prevention, Hiroshima University, Hiroshima, Japan. Electronic address: khirooka9@gmail.com.
² Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
³ Department of Molecular and Internal Medicine, Infectious Diseases Control and Prevention, Hiroshima University, Hiroshima, Japan.
⁴ Department of Health Promotion and Medicine of the Future, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
⁵ Department of Endocrinology and Metabolism, Kagawa University, Kagawa, Japan.
⁶ Department of Epidemiology, Infectious Diseases Control and Prevention, Hiroshima University, Hiroshima, Japan.
⁷ Department of Ophthalmology and Visual Science, Infectious Diseases Control and Prevention, Hiroshima University, Hiroshima, Japan.

PMID: 39284484
DOI: 10.1016/j.ajo.2024.09.014

Abstract

Purpose: To investigate patients with primary aldosteronism (PA) and the prevalence of normal-tension glaucoma (NTG).

Design: Cross-sectional study.

Methods: Newly diagnosed PA patients were evaluated in this cross-sectional study, with ophthalmic examinations such as intraocular pressure (IOP) measurements by a Goldmann applanation tonometer, central corneal thickness (CCT), slit-lamp biomicroscopic examination, gonioscopy, ophthalmoscopy, fundus photography, visual field test with a Humphrey Field Analyzer 24-2 SITA Standard program, and optical coherence tomography (OCT) of the peripapillary retinal nerve fiber layer (RNFL), performed in each of the subjects. Optic disc appearance, perimetric results, OCT results, and other ocular findings were all used for determining the glaucoma diagnosis. The primary outcome was shown the prevalence of NTG in patients with PA.

Results: NTG prevalence in the 212 PA patients was 11.8% (95% confidence interval [CI], 4.7%-20.7%). As compared to the hypertensive patients without PA, the hypertensive patients with PA exhibited a significantly increased NTG prevalence (odds ratio; 4.019, 95% CI, 1.223-13.205; P = .022). Increased NTG prevalence was associated with age, ranging from 8.8% (95% CI, 2.1%-15.6%) for those aged 40 to 49 years, to 37.5% (95% CI, 13.8%-61.2%) for those aged 70 years and older. In 72 hypertensive patients without PA, who were used as the controls, NTG prevalence was 5.2%, with a 95% CI ranging from 0.5% to 14.4%.

Conclusions: There was an 11.8% prevalence of NTG in PA patients, with these patients at an elevated risk of NTG, which was not mediated by blood pressure.

Keywords: aldosterone; hypertension; normal tension glaucoma; primary aldosteronism.