Background It has been suggested that local and systemic oxidative stress levels are causal risk factors for glaucoma. Aim To evaluate the effect of age on the role of systemic oxidative stress in open-angle glaucoma (OAG). Methods This study included 502 eyes of 251 Japanese patients with OAG. Systemic oxidative stress was assessed with skin autofluorescence (SAF), an indicator of advanced glycogen end products. We selected the youngest and oldest patients by quartile (≤58 and ≥74 years old, respectively) and determined the univariate correlation between SAF and mean deviation (MD) of the visual field in both eyes of each group. We also investigated the association between SAF and glaucoma in the youngest group with a logistic regression analysis. Results The younger subjects with OAG with high SAF had significantly lower better-eye MD than the younger subjects with normal SAF (p<0.01), but the older subjects had similar better-eye MD regardless of SAF level. Furthermore, SAF was negatively correlated with MD in the youngest subjects (better eye: r=â '0.35, p<0.01, worse eye: r=â '0.28, p=0.02), but not in the older subjects. Finally, mixed-effects regression analysis showed that SAF contributed to the MD in the younger patients with OAG (p=0.01). Conclusions We found that the relationship between systemic oxidative stress and visual field loss was strongest in relatively young patients with OAG, suggesting that the potential benefit of antioxidant therapies to combat systemic oxidative stress might be dependent on the age of the patient.
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