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A Pilot Study to Evaluate the Oral Microbiome and Dental Health in Primary Open-Angle Glaucoma

Polla, Daniel MD; Astafurov, Konstantin MD, PhD; Hawy, Eman MD; Hyman, Leslie PhD; Hou, Wei PhD; Danias, John MD, PhD

doi: 10.1097/IJG.0000000000000465
Original Studies

Purpose: To evaluate possible associations between primary open-angle glaucoma (POAG), dental health, and the oral microbiome.

Methods: Case-control study was conducted at SUNY Downstate. Adult subjects (40 to 87 y) were recruited as POAG cases (n=119) and controls without glaucoma (n=78) based on visual field and optic nerve criteria. Overall 74.6% were African Americans (AA). Information on medical history and oral health was collected and ophthalmologic examinations were performed. Mouthwash specimens (28 AA cases and 17 controls) were analyzed for bacterial DNA amounts. Analyses were limited to AAs as the predominant racial group. Outcome measures included number of natural teeth, self-reported periodontal health parameters, and amounts and prevalence of oral bacterial species. Logistic regression was used to evaluate associated factors and potential interactions.

Results: Cases and controls had similar age (mean: 62.2 and 60.9 y, respectively, P>0.48), and frequency of hypertension, diabetes, but cases had a higher proportion of men (P<0.04). On average (±SD), cases had fewer natural teeth than controls [18.0 (±11.1) vs. 20.7 (±9.4)]. Having more natural teeth was inversely associated with POAG, in multivariable analyses, at older ages [eg, odds ratio (95% confidence interval) at age 55: 1.0 (0.95-1.06), P=0.98 vs. at age 85: 0.87 (0.79-0.96), P=0.007]. Amounts of Streptococci were higher in cases than controls (P<0.03) in samples from the subset of subjects analyzed.

Conclusions: The number of teeth (an oral health indicator) and alterations in the amounts of oral bacteria may be associated with glaucoma pathology. Further investigation of the association between dental health and glaucoma is warranted.

Supplemental Digital Content is available in the text.

Departments of *Ophthalmology

Cell Biology, SUNY Downstate Medical Center, Brooklyn, NY

Department of Epidemiology, Stony Brook University, Stony Brook, NY

D.P. and K. A. contributed equally.

Funding/Support: R01 EY015224, Unrestricted challenge grant to the Department of Ophthalmology SUNY Downstate, Empire Clinical Research Investigator Program (ECRIP) fellowship, SUNY Eye Institute pilot grant. The sponsors and funding organizations had no role in the design or conduct of this research.

Financial Disclosures: No financial disclosures.

Disclosure: The authors declare no conflict of interest.

Reprints: Konstantin Astafurov, MD, PhD, SUNY Downstate Medical Center, 450 Clarkson Ave., BSB 2-23, Brooklyn, NY 11203 (e-mail:

Received January 31, 2016

Accepted May 12, 2016

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.