TY - JOUR
T1 - The Multifaceted Non-Genetic Risk Factors for Primary Open-Angle Glaucoma
T2 - An Overview of Systematic Reviews
AU - Rovelt, Jens
AU - Freiberg, Josefine
AU - Azuara-Blanco, Augusto
AU - Virgili, Gianni
AU - Kolko, Miriam
N1 - Copyright © 2024. Published by Elsevier Inc.
PY - 2025
Y1 - 2025
N2 - TOPIC: A synthesis of the current knowledge on risk factors for primary open-angle glaucoma (POAG).METHOD: We conducted a systematic search of PubMed, Embase, Web of Science, and the Cochrane Library to identify relevant systematic reviews (SR) published in English after 2012. The inclusion criteria focused on SRs investigating risk factors for POAG. We registered the study prospectively in the PROSPERO database (CRD42022351372) and used Covidence and the Risk Of Bias In Systematic reviews (ROBIS) tool to manage article selection and assess the risk of bias in the included SRs. Data was extracted independently by two authors.RESULTS: After removing duplicate SRs, we assessed 2,542 SRs. Of these, 2,396 were determined to be irrelevant, leaving 138 for a full text review. Following this, 78 were excluded with reasons, resulting in 57 SRs. Of these, 30 had a low risk of bias. In our bias assessment, SRs categorized as high risk of bias were characterized by 1) lack of sufficient detail in the bias assessment of the SR and 2) insufficient information or missing calculations of heterogeneity among the included studies. In our study, we identified 22 risk factors associated with POAG. The SRs covered a wide range of risk factors for POAG. Among these, the strongest associations with glaucoma, based on effect size, were observed in two SRs related to obstructive sleep apnea (OSA), with a pooled odds ratio (OR) of 3.66 (95% CI: 1.70-7.90) and an adjusted OR of 2.46 (95% CI: 1.32-4.59). Similarly, two SRs investigating Helicobacter pylori (H. pylori) infections showed significant associations, with pooled ORs of 2.08 (95% CI: 1.48-2.93) and 2.08 (95% CI: 1.42-3.04), respectively.CONCLUSION: This article summarizes the current knowledge on risk factors for POAG from published SRs. Our findings highlight the complexity of the disease and the nature of the factors that may affect various populations. Among the reported associations with low risk of bias, we found the highest effect estimates for OSA and H. pylori infections in relation to POAG. Our review helps advance understanding, guide future research and inform strategies for the prevention and treatment of POAG.
AB - TOPIC: A synthesis of the current knowledge on risk factors for primary open-angle glaucoma (POAG).METHOD: We conducted a systematic search of PubMed, Embase, Web of Science, and the Cochrane Library to identify relevant systematic reviews (SR) published in English after 2012. The inclusion criteria focused on SRs investigating risk factors for POAG. We registered the study prospectively in the PROSPERO database (CRD42022351372) and used Covidence and the Risk Of Bias In Systematic reviews (ROBIS) tool to manage article selection and assess the risk of bias in the included SRs. Data was extracted independently by two authors.RESULTS: After removing duplicate SRs, we assessed 2,542 SRs. Of these, 2,396 were determined to be irrelevant, leaving 138 for a full text review. Following this, 78 were excluded with reasons, resulting in 57 SRs. Of these, 30 had a low risk of bias. In our bias assessment, SRs categorized as high risk of bias were characterized by 1) lack of sufficient detail in the bias assessment of the SR and 2) insufficient information or missing calculations of heterogeneity among the included studies. In our study, we identified 22 risk factors associated with POAG. The SRs covered a wide range of risk factors for POAG. Among these, the strongest associations with glaucoma, based on effect size, were observed in two SRs related to obstructive sleep apnea (OSA), with a pooled odds ratio (OR) of 3.66 (95% CI: 1.70-7.90) and an adjusted OR of 2.46 (95% CI: 1.32-4.59). Similarly, two SRs investigating Helicobacter pylori (H. pylori) infections showed significant associations, with pooled ORs of 2.08 (95% CI: 1.48-2.93) and 2.08 (95% CI: 1.42-3.04), respectively.CONCLUSION: This article summarizes the current knowledge on risk factors for POAG from published SRs. Our findings highlight the complexity of the disease and the nature of the factors that may affect various populations. Among the reported associations with low risk of bias, we found the highest effect estimates for OSA and H. pylori infections in relation to POAG. Our review helps advance understanding, guide future research and inform strategies for the prevention and treatment of POAG.
U2 - 10.1016/j.ogla.2024.10.004
DO - 10.1016/j.ogla.2024.10.004
M3 - Review
C2 - 39419202
SN - 2589-4196
VL - 8
SP - 188
EP - 198
JO - Ophthalmology. Glaucoma
JF - Ophthalmology. Glaucoma
IS - 2
ER -