The Prevalence Of Glaucoma In Physical Examination Population:Correlation Between Glaucoma And Peripheral Blood Biomarkers

Background: Glaucoma is a blinding eye disease with the second highest prevalence rate at present,which is widely popular around the world.The early clinical manifestations of glaucoma are very hidden,Early screening is very important for the prevention and control of glaucoma.In China,the epidemiological survey of glaucoma based on the health examination population has certain advantages,with lower screening costs and higher benefits.In addition,two issues have gradually attracted people’s attention.The first is whether there is a correlation between peripheral blood biomarkers and glaucoma,and the second is whether peripheral blood biomarkers can become a reference index for auxiliary diagnosis of glaucoma.Aim: To investigate the prevalence of glaucoma in the physical examination population and explore the correlation between glaucoma and peripheral blood biomarkers.Methods: Select 7948 subjects who volunteered for physical examination at the Health Management Center of Sichuan Provincial People’s Hospital from December 2020 to December 22,We conducted glaucoma screening for the subjects to investigate the epidemiological characteristics of glaucoma in this population,and collected the peripheral blood test indicators of their physical examination for correlation analysis.Through multivariate logistic regression analysis and propensity score matching(PSM),we corrected the influence of confounding factors.Result: The total prevalence of glaucoma in this population was 2.7%,and 46.9%of the patients were diagnosed with glaucoma for the first time.Among the suspected patients initially screened,235 were referred,101(42.98%)were finally diagnosed with glaucoma,while 824 refused to accept further examination or referral.The results of multivariate analysis showed that the risk of glaucoma was increased in men,the elderly,people with elevated intraocular pressure,people with a history of high myopia,people with elevated glycosylated hemoglobin,people with elevated platelet-to-lymphocyte ratio,and people with elevated direct bilirubin.Those with elevated eGFR and albumin had a lower risk of glaucoma.After controlling the confounding factors by the propensity score matching,It was found that elevated intraocular pressure was an independent risk factor for glaucoma,elevated lymphocyte-to-monocyte ratio and albumin reduced the risk of glaucoma(P<0.05).Glycosylated hemoglobin,eGFR,albumin,LMR and direct bilirubin have the ability to distinguish glaucoma,suspected glaucoma and normal population.Combined with the above peripheral blood biomarkers and intraocular pressure examination,the diagnostic efficacy is higher.Glycosylated hemoglobin and eGFR have certain diagnostic value in differentiating mild glaucoma from severe glaucoma.Conclusion: We cannot ignore the prevalence of glaucoma in the physical examination population.In addition to intraocular pressure,male,elderly,high myopia and some common peripheral blood biomarkers may be associated with glaucoma.Peripheral blood markers have shown some value in distinguishing glaucoma,suspected patients and normal population as well as the severity of the disease,and may become the focus of glaucoma auxiliary diagnosis and risk prediction in the future.