1. Morio Ueno3, Shigeru Kinoshita6, and Chie Sotozono3
Influence of Geographical Climate Conditions On the Background of Japanese Normal-Tension Glaucoma Patients
Chikako Sannohe1, Yoko Ikeda2,3, Kazuhiko Mori3, Kengo Yoshii5, Satsuki Tsuzaki2, Asami Nara1,
Morio Ueno3, Shigeru Kinoshita6, and Chie Sotozono3 
1Sannnohe Eye Clinic, Aomori, Japan, 2Oike-Ikeda Eye Clinic, Kyoto, Japan,
3Department of Ophthalmology, 4Department of Genomic Medical Sciences, 5Department of Medical Statistics,
and 6Department of Frontier Medical Sciences and Technology for Ophthalmology,
Kyoto Prefectural University of Medicine, Kyoto, Japan.
P-FS-152
Introduction
Results (2) : Logistic Regression Analysis
Due to the geography of Japan, i.e., the long land mass from north to south, there is a large climate variation; i.e., the northern latitude region is colder than the southern region.
These regional temperature differences may produce environmental effects on the background of normal-tension glaucoma (NTG) patients in Japan.
In the island of Honshu, Japan, Aomori Prefecture is located at the northern most region, while Kyoto Prefecture is located at the western central region, and there is a big difference in the yearly mean temperature between these two cities, for example in 2016, degrees centigrade Celsius in Aomori and 17.1 degrees in Kyoto.
Aomori Pref.
Latitude 40º North
Kyoto Pref.
Latitude 35º North
2016 average temperature
Purpose
Logistic regression analysis showed significant differences among the following 5 factors between the AJ and KJ Group: age [odds ratio (OR): 0.95, p<0.001], baseline IOP (OR: 1.27, p<0.001), AL (OR: 0.79, p<0.001), BMI (OR: 1.15, p<0.001), and heart disease (OR: 10.62, p<0.001).
The purpose of this study was to investigate the differences between the backgrounds of Japanese NTG patients followed-up in two distinct climate regions.
Subjects and Methods
Summary and Discussion
This study involved 554 NTG patients (204 males and 350 females; mean age: 59.0±13.3 years) who underwent baseline intraocular pressure (IOP) examinations and self- questionnaires on systemic disease, family history of glaucoma, body mass index (BMI; i.e., calculated by patient weight and height), and axial length (AL) at the Sannohe Eye Clinic, Aomori, Japan (AJ Group: 311 patients; 125 males, 186 females; 57.2±12.9 years) and the Oike-Ikeda Eye Clinic, Kyoto, Japan (KJ Group: 243 patients; 79 males, 164 females; 61.3±13.3 years) from January 2010 to December 2016.
All factors, i.e., patient sex, age at initial visit, baseline IOP, family history of glaucoma, AL, BMI, and systemic disease (i.e., diabetes, heart disease, hyperlipidemia, and hypertension), were evaluated using logistic regression analysis between the AJ Group and the KJ Group.
For the factors of AL and baseline IOP, the eye with the higher IOP was selected, and if the IOP was the same bilaterally, the right-eye data was selected for both factors.
The findings of this present study revealed that untreated IOP, BMI, and cardiac morbidity rate are significantly higher in Aomori than in Kyoto as the background factors of normal tension glaucoma patients.
To the best of our knowledge, this is the first report to show that there are significant regional differences in the background of normal tension glaucoma patients in Japan.
In addition to the climate differences, It is well known that Aomori has a very high prevalence of myocardial infarction deaths in Japan1) , and also subjects in Aomori have the shortest lifespan compared with all other regions in Japan, thought to be related to the high sodium intake and high smoking rate of the Aomori 2-3), and therefore, these facts might be involved in the normal tension glaucoma patients.
Study limitations of this study are 1) clinic-based, not population-based, 2) not age- or gender-matched, 3) no direct background data from healthy subjects other than NTG patients of each region, and therefore, future study is needed to elucidate regional differences of NTG backgrounds.
Results (1) : Background of the Subjects
Ischemic Heart Disease
(number of cases
by prefecture)
Aomori
Kyoto
Conclusions
Significant differences were found in the background of NTG patients between the Aomori and the Kyoto subjects.
The Aomori Group patients were younger, yet the baseline IOP, BMI, and rate of heart disease were higher than those in the Kyoto Group patients.
References
Commercial Relationships: None to report
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