Association between red blood cell distribution width and primary angle closure disease: A potential for disease prediction

Objectives: Primary angle closure glaucoma (PACG) is the most common cause of glaucomatous optic atrophy through multiple mechanisms such as oxidative stress, microangiopathy and inflammation in which underlying mechanisms are not fully understood. Red cell distribution is one of the key factors which is directly linked to such mechanisms. Materials and Methods: We performed a case–control study to describe the relation between red blood cell distribution width (RDW) and PACG. A total of 100 PACG patients (51 males and 49 females) were divided into mild, moderate and severe groups and 90 healthy controls (47 males and 43 females) were recruited during the study period. Detailed eye and physical examinations were performed for each subject. Results: Based on the laboratory results, the mean RDW was significantly higher ( P < 0.001) in the PACG group (14.49 ± 1.49) than in the control group (13.64 ± 1.57). Moreover, the mean RDW level was lower ( P < 0.05) in the mild PACG group than in the moderate and severe PACG groups. Pearson correlation analyses were performed to identify the associations between MD (mean deviation) and RDW (%). A significant positive correlation was found between the MD (db) and the RDW (r = 0.390, P < 0.001). After adjusting for the confounding factors, the logistic regression analyses indicated that the odds ratio for the PACG group was 1.440 ( P < 0.001, 95% confidence interval (1.174–1.767) when compared to the control group. In addition, an increased RDW was associated with the PACG severity, and this trend was also observed in the gender and age subgroups. Conclusion: Our study showed that an elevated RDW was associated with PACG and its severity. The use of an RDW assessment may provide an additional benefit in diagnosing PACG severity in each patient, allowing for effective preventive measures.