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Original article
Association between mitral valve prolapse and open-angle glaucoma
  1. Shuo Ju Chiang1,2,
  2. Masao Daimon3,
  3. Li Hsuan Wang4,5,
  4. Ming-Jui Hung6,
  5. Nen Chung Chang1,2,
  6. Hsiu Chen Lin7,8
  1. 1Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
  2. 2Division of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
  3. 3Department of Clinical Laboratory, Tokyo University Hospital, Tokyo, Japan
  4. 4Department of Pharmacy, Taipei Medical University Hospital, Taipei, Taiwan
  5. 5School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
  6. 6Chang Gung Memorial Hospital, Keelung, Chang Gung University College of Medicine, Taoyuan, Taiwan
  7. 7Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
  8. 8Department of Laboratory Medicine, Taipei Medical University Hospital, Taipei, Taiwan
  1. Correspondence to Dr Hsiu Chen Lin, Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, No. 250, Wu-Hsing Street, Taipei 11031, Taiwan; jane2{at}tmu.edu.tw

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.

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