Association between Daily Niacin Intake and Glaucoma: National Health and Nutrition Examination Survey.

BACKGROUND AND AIMS: To determine the relationship between dietary intake of niacin and glaucoma using the data from the 2005 to 2008 National Health and Nutrition Examination Survey (NHANES). METHODS: Subjects aged 40 years and older who participated in the dietary intake interview and vision health questionnaire of NHANES were included in the study. Glaucoma diagnosis by self-report was utilized. Additionally, glaucoma diagnosis by fundus imaging and International Society Geographical and Epidemiological Ophthalmology (ISGEO) criteria was used in subjects with available qualified retinal imaging. Survey logistic regression analyses were used to examine the association between daily niacin consumption and glaucoma. RESULTS: A total of 5768 participants were included in the study. There was a significant decrease in the crude odds of self-reported glaucoma in the third (OR 0.57, 95% Cl 0.43-0.76; p < 0.001) and fourth (OR 0.57, 95% Cl 0.37-0.90; p = 0.018) quartiles of daily niacin consumption, which equated to 21.01 to 28.22 mg/day and greater than 28.22 mg/day, respectively. A similar trend was found using fundus imaging of subjects with niacin intake in the third (OR 0.42, 95% Cl 0.25-0.72; p = 0.002) and fourth (OR 0.36, 95% Cl 0.20-0.67; p = 0.002) quartiles. After adjusting for covariates, the odds of glaucoma based on fundus imaging remained significantly lower for niacin intake in the third (OR 0.49, 95% Cl 0.28-0.87; p = 0.016) and fourth (OR 0.48, 95% Cl 0.26-0.89; p = 0.022) quartile levels. Using ISGEO criteria, there was no significant association between glaucoma and daily niacin consumption. CONCLUSIONS: Greater niacin intake may be associated with a lower chance of developing glaucoma.

Displacement between anterior chamber width obtained by swept-source anterior segment optical coherence tomography and white-to-white distance.

PURPOSE: To determine the relationship between the external limbal location, represented by white-to-white (WTW) distance, and the actual angle location, represented by spur-to-spur (STS) and angle-to-angle (ATA) distances. METHODS: 166 eyes from 166 participants were imaged using CASIA2 anterior chamber optical coherence tomography (AS-OCT) and LenStar LS 900 optical biometer. The horizontal ATA and STS were measured using the swept-source Fourier-domain AS-OCT (CASIA2). The horizontal WTW was automatically measured using LenStar. The displacement lengths (DL) between WTW-STS and WTW-ATA were calculated. Bland-Altman plots and intraclass correlation were performed. RESULTS: The study showed that WTW has a positive correlation with STS (ICC = 0.82, p<0.001) and ATA (ICC = 0.82, p<0.001). The Bland-Altman analysis demonstrated that the mean difference of WTW-STS is 0.10 mm (95% CI 0.06 to 0.14 mm) with limits of agreement of -0.42 to 0.63 mm between WTW and STS, and the mean difference of WTW-ATA is 0.10 mm (95% CI 0.06 to 0.15 mm) with limits of agreement of -0.48 to 0.64 mm between WTW and ATA. Linear regression with adjustment showed that a WTW value greater than 12.07 mm is associated with a greater DL (WTW-STS DL ß 0.18, p = 0.003; WTW-ATA DL ß 0.14, p = 0.03). CONCLUSIONS: Greater WTW was significantly associated with higher displacement of WTW from the two distances representing anterior chamber width. External limbal location may not accurately represent the actual angle location in eyes with larger WTW.

Recurrent Choroidal Detachment in Peritoneal Dialysis Patient With Hypervolemia and Dilutional Hypoalbuminemia.

The following presents a case of recurrent choroidal detachments (CD) correlated with changes in serum albumin levels and the patient's fluid status. A 71-year-old female patient presented with a 4-day history of blurry vision in her left eye. Pertinent medical history included end-stage renal disease treated with continuous ambulatory peritoneal dialysis. Previously, the patient's left eye was treated for primary angle-closure glaucoma by trabeculectomy. While this resulted in a low baseline intraocular pressure (IOP) of 2 to 7 mm Hg, the patient never developed any hypotony-related complications for the past 6 years. After examination, CD was diagnosed and treated with transscleral surgical drainage. The patient further developed 2 additional episodes of CD in the same eye. All episodes were also associated with bilateral pitting edema, weight gain, and hypoalbuminemia. Thus, the patient was recommended to take a protein supplement and limit her fluid intake. In addition, the dialysis treatment regimen was altered to achieve greater daily fluid removal. After 12 weeks, there was no recurrent episode of CD, and the patient was clinically stable with a final visual acuity of 20/30 and an IOP of 3 mm Hg. The serum albumin levels improved slightly, and there were no signs of hypervolemia. In this case of recurrent CD, a possible association between the development of CD, hypoalbuminemia, and hypervolemia in patients with end-stage renal disease is demonstrated. Clinicians should be aware that these systemic factors can be tied with recurrent CDs, especially among patients with a low baseline IOP.