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TOPLINE:

Long-term exposure to air pollutants was associated with an increased risk of developing primary open-angle glaucoma (POAG), with each SD increase in their average 10-year levels of pollution raising the risk by 40%-108%.

METHODOLOGY:

• Researchers analyzed the records of 590,338 individuals aged 20 years or older from a nationwide cohort in Taiwan who had never been diagnosed with glaucoma and had at least 10 years of data regarding their exposure to air pollution.
• The levels of seven air pollutants — including sulfur dioxide (SO2), carbon monoxide (CO), particulate matter < 10 µm in diameter (PM10), PM2.5, nitrogen oxides (NOX) — nitrogen monoxide (NO), and nitrogen dioxide (NO2) — were monitored, with the exposure data linked to the residential postal codes of the participants.
• The primary outcome was the incidence of POAG during the follow-up period from January 1, 2000, to December 31, 2013.

TAKEAWAY:

• During the follow-up period, 3158 participants (mean age, 42.7 years; 50.1% men) were diagnosed with POAG.
• An increase of 1 SD in the 10-year average levels of SO2, CO, NOX, NO, and NO2 was associated with a 40%, 108%, 84%, 63%, and 84% increased risk for POAG, respectively (P < .001 for all).
• Increased long-term exposure to PM10 and PM2.5 increased the risk of developing POAG by 56% and 94%, respectively (P < .001 for both).

IN PRACTICE:

“Our analysis showed that mean concentrations of PM10 (54.63 μg/m³), PM2.5 (32.72 μg/m³), and NO2 (18.14 ppb) exceeded the WHO’s recommended limits of 15 μg/m³ (annual average limit), 5 μg/m³ (annual average limit), and 13.30 ppb, respectively. This highlights that the individuals in our study were exposed to pollutant levels surpassing international safety standards, which may have contributed to the increased risk of POAG,” the researchers wrote.

“Our findings suggest that air pollution is a significant environmental risk factor for POAG and that different pollutants potentially contribute to systemic inflammation,” they added.

SOURCE:

This study was led by Shu-Han Chuang of Changhua Christian Hospital in Changhua and Chien-Liang Wu of Taipei Medical University in Taipei, both in Taiwan. It was published online on May 31, 2025, in the American Journal of Ophthalmology.

LIMITATIONS:

This study did not measure the quality of air breathed by people inside their homes or at their workplaces. The database lacked any information on smoking, even though smoking influences both air pollution levels and risk for glaucoma. It also limited the inclusion of factors such as genetic predisposition, severity of disease, clinical symptoms, laboratory data, and lifestyle.

DISCLOSURES:

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.