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The Association Between Glaucoma and Immunoglobulin E Antibody Response to Indoor Allergens

  • Victoria L. Tseng
    Affiliations
    Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California

    Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California
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  • Gina Y. Lee
    Affiliations
    Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California
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  • Yahya Shaikh
    Affiliations
    Department of Preventive Medicine, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
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  • Fei Yu
    Affiliations
    Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California

    Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, California
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  • Anne L. Coleman
    Correspondence
    Inquiries to Anne L. Coleman, Fran and Ray Stark Professor of Ophthalmology, Stein Eye Institute, David Geffen School of Medicine, UCLA, 100 Stein Plaza, 2-118, Los Angeles, CA 90095
    Affiliations
    Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California

    Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California
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Published:February 20, 2015DOI:https://doi.org/10.1016/j.ajo.2015.02.007

      Purpose

      To evaluate the association between sensitization to indoor allergens and glaucoma in participants of the National Health and Nutrition Examination Survey (NHANES).

      Design

      Retrospective cross-sectional study.

      Methods

      This study examined the association between serum immunoglobulin E (IgE) levels for a panel of common indoor allergens and glaucoma for 2005–2006 NHANES participants. The exposures of interest were serum IgE levels to a panel of common indoor allergens. The outcome of interest was a clinical diagnosis of glaucoma based on the Rotterdam criteria. Logistic regression modeling was performed to assess the association between each type of IgE and glaucoma, while controlling for age, ethnicity, and steroid use. All estimates were weighted based on the multistage NHANES sampling design.

      Results

      Among a weighted total of 83 308 318 participants, the overall prevalence of glaucoma was 3.2% (95% confidence interval [CI]: 2.8%, 3.6%). The majority of patients were non-Hispanic white (n = 10 547 654; 77.1%). The American dust mite antigen had the highest proportion of participants with positive IgE values (n = 12 093 038; 14.5%). In the full model including all allergen-specific IgE subtypes as predictors, there were statistically significant associations between IgE subtypes and glaucoma for the cockroach (odds ratio [OR] = 2.78; 95% CI = 1.34, 5.76), cat (OR = 3.42; 95% CI = 1.10, 10.67), and dog (OR = 0.24; 95% CI = 0.06, 0.96) antigens.

      Conclusions

      In NHANES, participants with glaucoma had significantly higher odds of sensitization to the cockroach and cat allergens compared to those without glaucoma. These findings indicate the need for further research to elucidate the role of chronic indoor allergen exposure in the development of glaucomatous optic neuropathy.
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      Biography

      Victoria L. Tseng, MD, is an ophthalmology resident and epidemiology PhD candidate in the Specialty Training and Advanced Research (EyeSTAR) program at the Stein Eye Institute and Fielding School of Public Health of the University of California, Los Angeles. Her research interests include cataract surgery outcomes, novel risk factors for glaucoma, and the intersection of public health and ophthalmology.

      Linked Article

      • The Association Between Glaucoma and Immunoglobulin E Antibody Response to Indoor Allergens
        American Journal of OphthalmologyVol. 160Issue 3
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          I was interested to see Tseng and associates’ report in the May issue of the Journal.1 I remain curious as to why there is no mention of the most obvious confounding variable to the results of their work: namely, eye-rubbing. Eye-rubbing has been implicated as a cause of optic neuropathy that can imitate (if not duplicate) the mechanism for glaucoma.2 As rubbing one’s eyes is a common sequela of allergic inflammation, the relationship appears to be a significant issue that could explain the authors’ published findings.
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