Association between systemic conditions and the development of glaucoma in a longitudinal large-scale health examination cohort.

PURPOSE: This study aimed to investigate the effect of ocular and systemic factors, including a biomarker for inflammation, on the development of glaucoma. METHOD: We followed up 9333 subjects from a health checkup cohort for 8 years, during which intraocular pressure (IOP) measurements and color fundus photographing were conducted at least annually, and systemic examinations (including blood pressures and 21 blood examinations) were measured at baseline. Using these data, significant risk factors for the development of glaucoma during follow-up were identified using the Cox proportional hazards regression model. RESULT: The mean age and IOP of the 9333 subjects (6118 men) were 52.2 years and 12.6 mmHg, respectively. Glaucoma was developed in 444 subjects during the follow-up period. Older age, higher IOP, lower alcohol intake, and higher C-reactive protein (CRP) levels were the significant risk factors for developing glaucoma. The significant effect of high CRP levels on the development of glaucoma was observed in whole cohort (both in those aged < 60 and ≧ 60 years old). CONCLUSIONS: The current large-scale longitudinal study indicated that inflammation was a significant risk factor for developing glaucoma in addition to older age and higher IOP. Such a significant influence of inflammation on the development of glaucoma may support a possible vascular or atherosclerotic etiology for the disease.