Associations between the red blood cell distribution width and primary angle-closure glaucoma: a potential for disease prediction

  • Qiang Chen
  • Bin Zhao
  • Meng-ya Wang
  • Xue-yu Chen
  • Dong Li
  • Xin-quan Jiang
  • Jing-hui Tian
  • Yong-jun LiuEmail author


The red blood cell distribution width (RDW) is a simple and inexpensive laboratory parameter that can be linked to oxidative stress, inflammation and microvascular flow resistance. For this research, we performed a large-sample case-control study to describe the relationships between the RDW and primary angle-closure glaucoma (PACG). A total of 1191 PACG patients (422 males and 769 females), who were divided into mild, moderate and severe PACG groups, and 982 healthy controls (344 males and 638 females) were recruited between January 2008 and June 2018. Detailed eye and physical examinations were performed for each subject. Based on the laboratory results, the mean RDW was significantly higher (p < 0.001) in the PACG group (13.01 ± 0.82%) than in the control group (12.65 ± 0.53%). Moreover, the mean RDW level was lower (p < 0.05) in the mild PACG group than in the moderate and severe PACG groups. The Pearson correlation analyses showed significant positive correlations between the mean deviation and the RDW (r = 0.141, p < 0.001) and the intraocular pressure and the RDW (r = 0.085, p = 0.004). After adjusting for the confounding factors, the logistic regression analyses indicated that the odds ratio for the PACG group was 2.318 (p < 0.001, 95% confidence interval 1.997, 2.690) when compared to the control group. Additionally, an increased RDW was associated with the PACG severity, and this trend was also observed in the gender and age subgroups. In summary, the results of our study showed that an elevated RDW was associated with PACG and its severity. If future studies confirm this relationship, the use of an RDW assessment may help to predict the PACG severity in each patient in order to better customise effective prevention treatments.


Primary angle-closure glaucoma Red blood cell distribution width Patient stratification Recommendation Laboratory medicine Oxidative stress Inflammation Endothelial dysfunction Individualised patient profile Predictive preventive personalised medicine 


Authors’ contributions

Q C, B Z and YJ L designed the study; BZ, MY W and YJ L contributed to the patient recruitment and collected the data; XY C, D L, XQ J and JH T performed the statistical analysis; Q C wrote the manuscript. All authors read and approved the final manuscript.

Funding information

This work was supported by the National Natural Science Foundation of China (No. 31500148).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Consent for publication

Written informed consent for the use of any clinical data in research was obtained for all patients. All individuals were informed about the purposes of the study and have signed their consent for publishing the data.

Ethical approval

All the patient investigations conformed to the principles outlined in the Declaration of Helsinki, and the study was approved by the ethical committee of the Affiliated Hospital of Taishan Medical University and the ethical committee of the Taian City Central Hospital, Shandong, China. All the patients were informed about the purposes of the study and have signed their “consent of the patient.” This article does not contain any studies with animals performed by any of the authors.


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Copyright information

© European Association for Predictive, Preventive and Personalised Medicine (EPMA) 2019

Authors and Affiliations

  • Qiang Chen
    • 1
  • Bin Zhao
    • 2
  • Meng-ya Wang
    • 3
  • Xue-yu Chen
    • 1
  • Dong Li
    • 1
  • Xin-quan Jiang
    • 1
  • Jing-hui Tian
    • 1
  • Yong-jun Liu
    • 4
    Email author
  1. 1.School of public HealthTaishan Medical UniversityTai’anChina
  2. 2.Department of OphthalmologyAffiliated Hospital of Taishan Medical UniversityTai’anChina
  3. 3.Department of NursingFeicheng People’s HospitalFeichengChina
  4. 4.Department of OphthalmologyTaian City Central HospitalTai’anChina

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