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Alcohol, intraocular pressure and open-angle glaucoma: A systematic review and meta-analysis

Stuart, Kelsey V; Madjedi, Kian; Luben, Robert N; Chua, Sharon YL; Warwick, Alasdair N; Chia, Mark; Pasquale, Louis R; ... Modifiable Risk Factors for Glaucoma Collaboration, .; + view all (2022) Alcohol, intraocular pressure and open-angle glaucoma: A systematic review and meta-analysis. Ophthalmology 10.1016/j.ophtha.2022.01.023. (In press). Green open access

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Abstract

TOPIC: This systematic review and meta-analysis summarizes the existing evidence for the association of alcohol use with intraocular pressure (IOP) and open-angle glaucoma (OAG). CLINICAL RELEVANCE: Understanding and quantifying these associations may aid clinical guidelines or treatment strategies and shed light on disease pathogenesis. The role of alcohol, a modifiable factor, in determining IOP and OAG risk may also be of interest from an individual or public health perspective. METHODS: The study protocol was pre-registered in the Open Science Framework Registries (https://osf.io/z7yeg). Eligible articles (as of 14 May 2021) from three databases (PubMed, Embase, Scopus) were independently screened and quality assessed by two reviewers. All case-control, cross-sectional and cohort studies reporting a quantitative effect estimate and 95% confidence interval (CI) for the association between alcohol use and either IOP or OAG were included. The evidence for the associations with both IOP and OAG were qualitatively summarized. Effect estimates for the association with OAG were pooled using random effects meta-analysis. Studies not meeting formal inclusion criteria for systematic review, but with pertinent results, were also appraised and discussed. Certainty of evidence was assessed using the GRADE framework. RESULTS: Thirty four studies were included in the systematic review. Evidence from 10 studies reporting an association with IOP suggest that habitual alcohol use is associated with higher IOP and prevalence of ocular hypertension (IOP >21mmHg), although absolute effect sizes were small. Eleven of 26 studies, comprising 173 058 participants, that tested for an association with OAG met inclusion criteria for meta-analysis. Pooled effect estimates indicated a positive association between any use of alcohol and OAG (1.18; 95% CI, 1.02-1.36; p=0.03; I2=40.5%), with similar estimates for both prevalent and incident OAG. The overall GRADE certainty of evidence was very low. CONCLUSION: While this meta-analysis suggests a harmful association between alcohol use and OAG, our results should be interpreted cautiously given the weakness and heterogeneity of the underlying evidence base, the small absolute effect size and the borderline statistical significance. Nonetheless, these findings may be clinically relevant and future research should focus on improving the quality of evidence.

Type: Article
Title: Alcohol, intraocular pressure and open-angle glaucoma: A systematic review and meta-analysis
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.ophtha.2022.01.023
Publisher version: https://doi.org/10.1016/j.ophtha.2022.01.023
Language: English
Additional information: Copyright 2022 by the American Academy of Ophthalmology This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Keywords: Alcohol, intraocular pressure, meta-analysis, open-angle glaucoma, systematic review
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10143158
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