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Childhood or adolescent abuse and primary open-angle glaucoma in a longitudinal cohort of women

Eye volume 39, pages 1975–1982 (2025)Cite this article

Subjects

Abstract

Objective

To examine associations of childhood/adolescence abuse with primary open-angle glaucoma (POAG) and POAG subtypes.

Methods

We included US female nurse participants from the Nurses’ Health Study II (1989–2019). Participants (n = 59,712) were ≥40 years old, reported follow-up eye exams, had no glaucoma, and had early-life adverse experience data. Self-reported childhood/adolescence abuse was assessed in 2001 with the Revised Conflict Tactics Scale (CTS) and the 2-item sexual maltreatment scale of the parent–child CTS. We evaluated associations by type (any, physical, sexual) and timing (childhood, adolescence). POAG cases (n = 255) were confirmed and subtyped with medical record review. Multivariable-adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

Results

Severe childhood/adolescent abuse was reported by 16.5%. There was no association between any childhood/adolescent abuse (HR 1.03; 95% CI: 0.79–1.35), physical abuse, abuse experienced during childhood only or adolescence only, and POAG risk. Compared to no sexual abuse history, any sexual abuse was modestly associated with POAG (HR 1.31; 95% CI: 1.01–1.69). Specifically, we observed adverse associations with sexual abuse for the POAG subtype with paracentral vs. peripheral VF loss (Pheterogeneity = 0.04). For paracentral POAG, we observed a 1.80-fold higher risk (95% CI: 1.14–2.85) with any sexual abuse history, a 2.38-fold higher risk (95% CI: 1.25–4.53) with a threat of/actual forced sexual activity, and a significant dose-response relationship with increasing severity of sexual abuse (Ptrend = 0.005; Ptrend_FDR corrected = 0.045).

Conclusions

While any childhood/adolescence abuse history was not associated with POAG, the modest adverse associations with early-life sexual abuse history warrant confirmation in future studies.

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Fig. 1
Fig. 2
Fig. 3: Adjusted hazard ratios for the association between sexual abuse during childhood or adolescence and any incident primary open-angle glaucoma subtype defined by visual field loss pattern among 59,172 women in the NHSII followed from 1989 to 2019.

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Data availability

Because of participant confidentiality and privacy concerns, data cannot be shared publicly and requests to access NHSII data must be submitted in writing. According to standard controlled access procedures, applications to use NHSII resources will be reviewed by our External Collaborations Committee to verify that the proposed use maintains the protection of the privacy of participants and the confidentiality of the data. Investigators wishing to use NHSII data are asked to submit a brief description of the proposed project (go to https://www.nurseshealthstudy.org/researchers (contact email: nhsaccess@channing.harvard.edu) for details.

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Funding

This work was supported by the National Institutes of Health U01 CA176726, R01EY036460 (LRP, JHK), R01EY032559 (LRP, JLW). LRP is also supported by The Glaucoma Foundation (NYC) and an unrestricted Challenge Grant from Research to Prevent Blindness (NYC). The funders had no role in the: design or conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.

Author information

Author notes

  1. These authors contributed equally: Megan Yu, Hannah H. Hwang.

Authors and Affiliations

  1. Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Megan Yu

  2. Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA

    Hannah H. Hwang & Janey L. Wiggs

  3. Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Andrea L. Roberts

  4. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Karestan C. Koenen

  5. Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Louis R. Pasquale

  6. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Jae H. Kang

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Contributions

Megan Yu—data analysis, draft of manuscript and proofreading. Hannah H. Hwang—draft of manuscript and proofreading. Andrea L. Roberts—proofreading. Karestan C Koenen—proofreading. Janey L. Wiggs—proofreading. Louis R. Pasquale—data collection, proofreading. Jae H. Kang—concept, overseeing each stage of work, data collection, data analysis, draft of manuscript, and proofreading.

Corresponding author

Correspondence to Jae H. Kang.

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Competing interests

All authors have declared no conflicts of interest. Unrelated to this work: JLW is a consultant for Allergan, Editas, Maze, Regenxbio, and Avellino. JLW also received research support from Aerpio Pharmaceuticals. LRP was a consultant for Twenty Twenty.

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Meeting Presentation: American Academy of Ophthalmology Annual Meeting, San Francisco, CA, 2023.

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Yu, M., Hwang, H.H., Roberts, A.L. et al. Childhood or adolescent abuse and primary open-angle glaucoma in a longitudinal cohort of women. Eye 39, 1975–1982 (2025). https://doi.org/10.1038/s41433-025-03785-3

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