Alcohol use ups risk of open-angle glaucoma

Alcohol consumption appears to increase the likelihood of developing open-angle glaucoma (OAG), suggests a recent study.

However, the investigators advise caution in interpreting the results due to the weakness and heterogeneity of the underlying evidence base, the small absolute effect size, and the borderline statistical significance.

Two independent reviewers screened and assessed the quality of articles (as of 14 May 2021) from the databases of PubMed, Embase, and Scopus. All case-control, cross-sectional, and cohort studies reporting a quantitative effect estimate and 95 percent confidence interval (CI) for the association between alcohol use and either intraocular pressure (IOP) or OAG were eligible for analysis.

The investigators qualitatively summarized the evidence for the associations with both IOP and OAG and pooled effect estimates using random effects meta-analysis. They also appraised and discussed studies that did not meet the formal inclusion criteria for systematic review but had pertinent results. The GRADE framework was used to evaluate the certainty of evidence.

Thirty-four studies met the eligibility criteria. Ten studies showed evidence of the association of habitual alcohol use with higher IOP and prevalence of ocular hypertension (IOP >21 mm Hg), but the absolute effect sizes were small.

Eleven of 26 studies (n=173,058 participants) that examined the association with OAG were eligible for meta-analysis. Pooled effect estimates demonstrated a positive correlation between any use of alcohol and OAG (1.18, 95 percent CI, 1.02‒1.36; p=0.03; I², 40.5 percent), with similar estimates for both prevalent and incident OAG.

Of note, the overall GRADE certainty of evidence was very low.

“Nonetheless, these findings may be clinically relevant, and future research should focus on improving the quality of evidence,” the investigators said.