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  • Alcohol Consumption Raises Risk of Exfoliation Glaucoma

    By Lynda Seminara
    Selected by Russell N. Van Gelder, MD, PhD
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    Journal Highlights

    Ophthalmology, February 2023

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    Studies of the relationship between alcohol and exfoliation glaucoma are limited by their small size and inconsis­tent findings. Hanyuda et al. set out to address the knowledge gap and deter­mine if alcohol consumption affects the risk of confirmed or suspected exfolia­tion glaucoma (XFG/XFGS). They found that both short- and long-term consumption of alcohol raised the risk of exfoliation glaucoma.

    This prospective longitu­dinal study included nearly 200,000 people who had participated in the Nurses’ Health Study (1980-2018), the Health Professionals Follow-Up Study (1986-2018), and the Nurses’ Health Study II (1991-2019). All had completed follow-up questionnaires biennially; data were collected on diet, lifestyle, and disease outcomes, including glaucoma. At each two-year observation interval, only the participants who were at least 40 years old, free of glaucoma, and had avail­able data for eye exams and diet were permitted to contribute person-time to later periods of the study. Cumula­tive averages were determined for total alcohol intake (primary exposure) and intake of specific beverages (beer, wine, and liquor) at intervals of two to four years. The main outcome measure was incident XFG/XFGS, confirmed by medical records. Per-eye Cox propor­tional hazards models, accounting for inter-eye correlations, were applied to estimate multivariate-adjusted relative risks (MVRRs) and 95% CIs.

    During the 6,877,823 eye-years of follow-up, 705 eyes of 507 patients were found to have XFG/XFGS, and high levels of total alcohol consumption significantly boosted an individual’s risk. The MVRR for XFG/XFGS status for cumulatively averaged alcohol con­sumption of ≥15 g/day (vs. nondrink­ing) was 1.55 (95% CI, 1.17-2.07; p = .02 for trend). Both short- and long-term alcohol intake significantly raised the risk of XFG/XFGS. The strongest associations with cumulatively aver­aged alcohol intake were within the four years preceding documentation of XFG/XFGS (MVRR ≥15 g/day vs. nondrinking; relative risk, 1.65; 95% CI, 1.25-2.18; p = .002 for trend).

    The type of alcoholic beverage also affected XFG/XFGS risk. Relative to participants who abstained from alco­hol, risk was elevated for those with weekly intake of at least 3.6 beverages of beer (MVRR, 1.26; 95% CI, 0.89-1.77), wine (MVRR, 1.30; (95% CI, 1.00-1.68), or liquor (MVRR, 1.46; 95% CI, 1.15-1.85). There was no apparent link between XFG/XFGS status and age, residential latitude, or intake of folate or vitamin A.

    Although the underlying mechanism between alcohol consumption and exfoliation glaucoma remains unclear, the researchers speculated that folate deficiency may play a role, as suggested by previous smaller investigations.

    The original article can be found here.