title: Nutritional, lifestyle and environmental factors in ocular hypertension and primary open-angle glaucoma: an exploratory case-control study.
abstract: OBJECTIVE
  To evaluate known and potential risk factors, including nutritional, lifestyle and environmental factors, differentiating patients with high-tension primary open-angle glaucoma (POAG) from control subjects with ocular hypertension (OHT).
  
  
  METHODS
  In 2006-2007, 111 French ophthalmologists prospectively enrolled 339 cases of POAG and 339 age-matched controls with OHT. After a clinical examination with assessment of ocular risk factors, the ophthalmologist filled, during face-to-face interview, a detailed questionnaire developed by nutritionists and epidemiologist on lifestyle and environmental risk factors, including socio-demographic variables, dietary habits related to omega-3 fatty acids intake, smoking and alcohol drinking and professional exposure to pesticides and other chemicals. Associations of POAG with risk factors were estimated using conditional logistic regression, with adjustment for age, gender and duration of disease.
  
  
  RESULTS
  In the final multivariate model, by comparison with OHT, POAG was significantly associated with more frequent use of pesticides during the professional life [OR = 2.65, 95% confidence interval (CI): 1.04-6.78, p = 0.04] and with low consumption of fatty fish (OR = 2.14, 95% CI: 1.10-4.17, p = 0.02) and walnuts (OR = 2.02, 95% CI: 1.18-3.47, p = 0.01). POAG was also associated with higher frequency of heavy smoking (40 pack-years or more, OR = 3.93, 95% CI: 1.12-13.80, p = 0.03) but not with moderate (20-40 pack-years) and light smoking (<20 pack-years).
  
  
  CONCLUSIONS
  These exploratory observations suggest a protective effect of omega-3 fatty acids and a deleterious effect of heavy smoking and professional exposure to pesticides in POAG. This will need to be confirmed in future studies.
authors.affiliation: Hôpital du Val de Grâce, Service d'ophtalmologie, Paris, France. pr_renard@yahoo.fr
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Renard
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Rouland
authors.forename: Alain
authors.initials: A
authors.lastname: Bron
authors.forename: Eric
authors.initials: E
authors.lastname: Sellem
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Nordmann
authors.forename: Christophe
authors.initials: C
authors.lastname: Baudouin
authors.forename: Philippe
authors.initials: P
authors.lastname: Denis
authors.forename: Max
authors.initials: M
authors.lastname: Villain
authors.forename: Gilles
authors.initials: G
authors.lastname: Chaine
authors.forename: Joseph
authors.initials: J
authors.lastname: Colin
authors.forename: Gérard
authors.initials: G
authors.lastname: de Pouvourville
authors.forename: Sybille
authors.initials: S
authors.lastname: Pinchinat
authors.forename: Nicholas
authors.initials: N
authors.lastname: Moore
authors.forename: Madina
authors.initials: M
authors.lastname: Estephan
authors.forename: Cécile
authors.initials: C
authors.lastname: Delcourt
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology; D016022:Case-Control Studies; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage; D004781:Environmental Exposure; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage; D005247:Feeding Behavior; D005260:Female; D005602:France / Q000453:epidemiology; D005902:Glaucoma, Open-Angle / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007429:Intraocular Pressure; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009747:Nutritional Physiological Phenomena; D009798:Ocular Hypertension / Q000453:epidemiology* / Q000209:etiology; D010575:Pesticides / Q000009:adverse effects*; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires
chemical_list: D004042:Dietary Fats, Unsaturated; D015525:Fatty Acids, Omega-3; D010575:Pesticides