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BackgroundPrimary open-angle glaucoma (POAG) is a leading cause of blindness. High intraocular pressure (IOP) has been shown to be a key risk factor for POAG. Topical application of angiotensin 1-converting enzyme (ACE) inhibitors has been shown to lower IOP, and angiotensin-induced increase in vascular tone has been implicated as a pathogenetic mechanism in glaucomatous cupping and damage to the optic nerve. The objective of this study was to investigate the association between the deletion polymorphism in the ACE gene and ocular signs of POAG.MethodsBaseline data from the Rotterdam Study was used. The ACE genotype was determined in 6,462 subjects. We used univariate and multiple variable statistical techniques to examine associations between ACE genotype and each of ocular hypertension, glaucomatous optic neuropathy, glaucomatous visual field defects and POAG diagnosis.ResultsWe found no consistent evidence between ACE genotype and ocular signs of POAG. We did, however, find evidence of an association between ACE genotype and optic disc area, subjects homozygous for the deletion allele tending to have fractionally smaller optic disc areas than those with a single deletion allele subjects, who in turn tended to have fractionally smaller optic discs than those with no deletion alleles (P=0.01).ConclusionsThe data provided little evidence of any association between ocular signs of POAG and the deletion polymorphism of ACE. There was, however, evidence that ACE may be associated with optic disc size-this was an unexpected finding.

Original publication




Journal article


Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie

Publication Date





294 - 299


Moorfields Eye Hospital, City Road, London, EC1V 2PD, UK.


Optic Disk, Humans, Optic Nerve Diseases, Ocular Hypertension, Glaucoma, Open-Angle, Peptidyl-Dipeptidase A, Angiotensin-Converting Enzyme Inhibitors, Polymerase Chain Reaction, Gene Deletion, Blood Pressure, Intraocular Pressure, Genotype, Polymorphism, Genetic, Aged, Middle Aged, Female, Male