This study found a 1.22 odds ratio of glaucoma development in regular drinkers. Photo: Stanislav Ivanitskiy/Unsplash.

While intraocular pressure (IOP) is a major risk factor, there is growing interest in understanding other genetic and environmental contributors in primary open-angle glaucoma (POAG), including alcohol consumption. Prior research into the alcohol-glaucoma relationship has yielded mixed results. Researchers at the University of California San Diego in La Jolla, CA, recently leveraged the expansive dataset of the National Institutes of Health All of Us Research Program to explore the relationship between alcohol consumption and glaucoma risk, specifically POAG, with a particular focus on diverse populations. The team determined that higher frequency of alcohol consumption was associated with increased risk of POAG; in particular, four or more drinks per week significantly were associated with higher glaucoma risk.

This retrospective cohort study, which was published in Journal of Glaucoma, used the diverse All of Us Research Program, a nationwide effort by the United States National Institutes of Health to recruit those historically underrepresented in biomedical research. Electronic health records and survey data from the All of Us program were analyzed. Of the 3,876 POAG patients, 52% were female, 50% were Caucasian, 30% were Black, 3% were Asian and 15% were Hispanic. A randomized one-to-four case/control ratio was used for POAG patients and randomly selected control patients. The POAG cohort was significantly older (median age 72.7 vs. 55.7).

Alcohol use of four or more drinks per week was significantly higher in the glaucoma cohort relative to controls (15% vs. 12%). On bivariate analysis, diagnosed alcohol misuse was associated with higher odds of POAG (odds ratio; OR: 1.20). In multivariable regression, more frequent alcohol use was associated with higher odds of glaucoma; alcohol use with a frequency of 4 or more drinks per week was significantly associated with increased odds of glaucoma (OR: 1.22). This dose-response relationship was also observed and more pronounced for female participants, where alcohol use frequency of monthly or less was already associated with increased odds of glaucoma (OR: 1.21).

Still, the mechanism by which alcohol can contribute to increased risk of glaucoma is unclear. Also, there is currently conflicting evidence regarding the association between alcohol consumption and IOP.

The researchers did note in their paper that “because these surveys are performed with the participants’ understanding that their data would be de-identified, the social desirability bias may have been weaker than for surveys done in a clinic setting, where participants may be concerned with their physicians’ judgment regarding their responses.”

“This study demonstrated that alcohol consumption may be a modifiable risk factor for glaucoma, with the susceptibility to glaucoma of alcohol consumers being influenced by a higher frequency of consumption,” they concluded. “In individuals with heavy alcohol consumption, it may be of particular importance to set up preventative and management strategies for glaucoma beyond IOP reduction.”