title: A survey of preoperative blood tests in primary open-angle glaucoma patients versus cataract surgery patients.
abstract: OBJECTIVE
  To investigate biomarker differences in routine preoperative blood tests performed on primary open-angle glaucoma (POAG) case and control patients presenting for anterior segment eye surgery.
  
  
  METHODS
  POAG cases and age-related cataract surgery patients (controls) who underwent anterior segment surgery at Massachusetts Eye and Ear from January 2009 through March 2012 were identified by retrospective record review. Patients with diabetes mellitus, secondary glaucoma, and cataract due to trauma or steroid exposure were excluded. Data on demographic features, preoperative ophthalmological and medical diagnosis, blood pressure, anthropometric measures, basic metabolic panel, and complete blood count were extracted from the medical records. Univariate differences in lab values between POAG cases and controls were assessed using unpaired t tests. Multivariate logistic regression analysis was completed to determine the independent associations of biomarkers with POAG.
  
  
  RESULTS
  A total of 150 cases and 150 age-related controls were included. In multivariate analysis, higher AG was inversely associated with POAG (odds ratio [OR] = 0.90; 95% confidence interval [CI], 0.80-1.00), and higher Cl- level was positively associated with POAG (OR = 1.15; 95% CI, 1.02-1.29). The lower AG in POAG patients could be explained by higher IgG levels as the available data in post hoc analysis showed a nonsignificant trend toward higher IgG in cases compared to controls (17 vs 23; 1142 ± 284 mg/dl vs 1028 ± 291 mg/dl; P = 0.22). Furthermore, in multivariable analysis, a higher red blood cell count was also associated with POAG (OR = 1.91; 95% CI, 1.11-3.28).
  
  
  CONCLUSIONS
  Patients with POAG presenting for anterior segment surgery had a lower AG compared to age-related cataract surgery patients. The etiology of this reduced gap is unclear but the possible contribution of IgG warrants further exploration. The etiology of higher red blood cell counts in POAG cases is unknown and deserves further exploration.
authors.affiliation: Glaucoma Service, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts;
authors.forename: Laura P
authors.initials: LP
authors.lastname: Cohen
authors.affiliation: Glaucoma Service, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts;
authors.forename: Jessica
authors.initials: J
authors.lastname: Wong
authors.affiliation: Glaucoma Service, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts;
authors.forename: Aliya Z
authors.initials: AZ
authors.lastname: Jiwani
authors.affiliation: Comprehensive Ophthalmology Service, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts;
authors.forename: Scott H
authors.initials: SH
authors.lastname: Greenstein
authors.affiliation: Glaucoma Service, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts; ; Comprehensive Ophthalmology Service, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts;
authors.forename: Stacey C
authors.initials: SC
authors.lastname: Brauner
authors.affiliation: Comprehensive Ophthalmology Service, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts;
authors.forename: Sherleen C
authors.initials: SC
authors.lastname: Chen
authors.affiliation: Glaucoma Service, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts;
authors.forename: Angela V
authors.initials: AV
authors.lastname: Turalba
authors.affiliation: Glaucoma Service, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts;
authors.forename: Teresa C
authors.initials: TC
authors.lastname: Chen
authors.affiliation: Glaucoma Service, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts;
authors.forename: Lucy
authors.initials: L
authors.lastname: Shen
authors.affiliation: Glaucoma Service, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts;
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Rhee
authors.affiliation: Glaucoma Service, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts;
authors.forename: Janey L
authors.initials: JL
authors.lastname: Wiggs
authors.affiliation: Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Jae Hee
authors.initials: JH
authors.lastname: Kang
authors.affiliation: Glaucoma Service, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts;
authors.forename: Stephanie
authors.initials: S
authors.lastname: Loomis
authors.affiliation: Glaucoma Service, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts; ; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Louis R
authors.initials: LR
authors.lastname: Pasquale
mesh_terms: D000136:Acid-Base Equilibrium / Q000502:physiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002386:Cataract / Q000097:blood; D002387:Cataract Extraction; D005260:Female; D005902:Glaucoma, Open-Angle / Q000097:blood* / Q000601:surgery; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D057234:Preoperative Period; D012044:Regression Analysis; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D007074:Immunoglobulin G; D011188:Potassium
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