Association between Psychological Stress and Glaucoma: Korea National Health and Nutritional Examination Survey 2008–2012

ABSTRACT

PURPOSE: To evaluate the possible association between psychological stress and glaucoma, given that there are emerging issues and controversy regarding whether psychological stress is one of contributing factors of glaucoma development. METHODS: We used the medical records of 16,426 patients from the Korean National Health and Nutritional Examination Survey 2008–2011. Glaucoma was defined based on examinations including the intraocular pressure, optic disc, visual field, and retinal nerve fiber layer. Stress was evaluated using five questionnaires regarding sustained stress, depression, feelings of suicide, history of suicide attempt/s, and history of psychological counseling. We used univariable and multivariable logistic regression analyses after adjusting confounding factors for glaucoma. RESULTS: Univariable logistic regression analysis revealed no significant association between glaucoma and psychological stress (odds ratio [OR] = 0.84; confidence interval [CI] = 0.70–1.01), depression (OR = 1.22; CI = 0.97–1.55), suicide attempt/s (OR = 0.73, CI = 0.33–1.59), and psychological counseling (OR = 0.72, CI = 0.43–1.21). Using univariate analysis, only the feelings of suicide factor (OR = 1.28, CI = 1.02–1.60) was significantly associated with glaucoma. Using multivariable analysis after adjusting for confounding factors, no significant association was found in any psychological stress factor. CONCLUSIONS: There was no significant association between psychological stress and glaucoma. The results of this study indicated that the pathogenesis of glaucoma is more consistent with the pathogenesis of physiological causes such as age or hypertension, rather than indirect causes such as stress.