Hearing Evaluation in Patients with Exfoliative and Primary Open-Angle Glaucoma

• Published in: Otolaryngology-head and neck surgery 2011-07, Vol.145 (1), p.125-130
• Main Authors: Paliobei, Vassiliki P., Psillas, Georgios K., Mikropoulos, Dimitrios G., Haidich, Anna-Bettina, Constantinidis, Jannis, Konstas, Anastasios G. P.
• Format: Article
• Language: English
• Subjects: Aged; Audiometry, Pure-Tone; auditory brainstem responses; Auditory Pathways - physiopathology; Auditory Threshold - physiology; Brain Stem - physiopathology; Comorbidity; Cooperative Behavior; Cross-Sectional Studies; Evoked Potentials, Auditory, Brain Stem; Exfoliation Syndrome - diagnosis; Exfoliation Syndrome - epidemiology; Exfoliation Syndrome - physiopathology; Female; Glaucoma, Open-Angle - diagnosis; Glaucoma, Open-Angle - epidemiology; Glaucoma, Open-Angle - physiopathology; Hearing Loss, Sensorineural - diagnosis; Hearing Loss, Sensorineural - epidemiology; Hearing Loss, Sensorineural - physiopathology; Humans; Interdisciplinary Communication; ISO 7029; Male; Mass Screening; Middle Aged; Otoacoustic Emissions, Spontaneous; Patient Care Team; Prospective Studies; pure‐tone audiometry; retrocochlear; Retrocochlear Diseases - diagnosis; Retrocochlear Diseases - epidemiology; Retrocochlear Diseases - physiopathology
• ISSN: 0194-5998; 1097-6817
• DOI: 10.1177/0194599811401206

Objective. The aim of this prospective study was to audiologically evaluate consecutive glaucoma patients with or without exfoliation. Study Design. Prospective study. Setting. Glaucoma Unit and Audiology Department at a university hospital. Subjects and Methods. Consecutive subjects with exfoliative glaucoma (XFG) or primary open-angle glaucoma (POAG) aged between 50 and 70 years were enrolled. Auditory thresholds at 0.5, 1.0, 2.0, 4.0, and 8.0 Hz were measured bilaterally. Cochlear activity was assessed by recording distortion product otoacoustic emissions (DPOEs). Functional changes in the retrocochlear auditory pathway were evaluated by auditory brainstem responses (ABRs). Results. One hundred and ten patients with XFG and 85 patients with POAG who presented in a glaucoma clinic were investigated. The mean age of study patients was 66.2 ± 5.6 years; range, 50-70 years). The odds of pathologic ABR central transmission time (interpeak latencies I-III, III-V, and I-V and waves I, III, and V) were 4.34 times higher in patients with XFG than in patients with POAG (95% confidence interval [CI], 2.22-8.49; P < .001). This significant association remained after adjusting for sex and age (odds ratio [OR] 4.12; 95% CI, 2.07-8.22; P < .001). Furthermore, the odds of ABR remained significantly higher in patients with XFG than in patients with POAG (OR 4.36; 95% CI, 2.10-9.06; P < .001) after controlling for systemic diseases (arterial hypertension, coronary heart disease, high cholesterol, and stroke). Conclusion. In the first study to compare XFG and POAG monitoring of the peripheral and central auditory pathway, it has been documented that XFG patients show a greater prevalence of retrocochlear pathology.