title: Association between mitral valve prolapse and open-angle glaucoma.
abstract: OBJECTIVE
  Proteoglycans and glycosoaminoglycans play many roles in connective tissue formation, their accumulation in myxomatous tissues may influence the associated mechanical behaviour of the mitral valve, as well as the extracellular matrix of the eye. Open-angle glaucoma (OAG) and mitral valve prolapse (MVP) may share similar phathophysiology. We hypothesised that MVP increased the risk of developing glaucoma.
  
  
  METHODS
  The research was a retrospective cohort study using a longitudinal health insurance database from the National Health Insurance programme. The database was a randomly sampled population of 1,073,891 followed for 13 years from 1996 to 2008. There were 21,677 subjects with MVP, and 86,708 subjects without MVP were propensity score matched and served as a comparison group. Cox proportional hazards analysis was performed and adjusted for several comorbidities to evaluate the adjusted HR for OAG in the MVP group.
  
  
  RESULTS
  The incidence rate of OAG in patients in the non-MVP and MVP groups were 10.17 and 16.05 per 10,000 person-years, respectively. The adjusted HR for OAG in the MVP group was 1.88 (95% CI 1.58 to 2.23). A significantly elevated risk of OAG in patients with MVP was also identified in the four stratified age groups. The cumulative incidence of OAG was assessed by Kaplan-Meier analysis. The analysis revealed that the MVP group had a higher incidence of OAG than the comparison group during the follow-up period (p < 0.001).
  
  
  CONCLUSIONS
  This population-based study demonstrated that pre-existing MVP is a significant predictor for the development of OAG, after adjusting for possible confounding factors.
authors.affiliation: Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan Division of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Shuo Ju
authors.initials: SJ
authors.lastname: Chiang
authors.affiliation: Department of Clinical Laboratory, Tokyo University Hospital, Tokyo, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Daimon
authors.affiliation: Department of Pharmacy, Taipei Medical University Hospital, Taipei, Taiwan School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.
authors.forename: Li Hsuan
authors.initials: LH
authors.lastname: Wang
authors.affiliation: Chang Gung Memorial Hospital, Keelung, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Ming-Jui
authors.initials: MJ
authors.lastname: Hung
authors.affiliation: Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan Division of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Nen Chung
authors.initials: NC
authors.lastname: Chang
authors.affiliation: Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan Department of Laboratory Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Hsiu Chen
authors.initials: HC
authors.lastname: Lin
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D008945:Mitral Valve Prolapse / Q000150:complications* / Q000503:physiopathology; D011379:Prognosis; D057216:Propensity Score; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D017678:Sex Distribution; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult