{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T13:10:54Z","timestamp":1781010654367,"version":"3.54.1"},"reference-count":47,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T00:00:00Z","timestamp":1604620800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Purpose<\/jats:title>\n<jats:p>To elucidate glaucoma-related fundus abnormalities in patients with primary aldosteronism (PA).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>The study compared 272 eyes from 137 PA patients and 352 eyes from 177 control subjects selected randomly from 1173 participants of a public glaucoma screening. The presence of glaucomatous optic disc appearance (rim thinning and cup enlargement) and retinal nerve fiber layer defects (RNFLDs) was determined independently from fundus photographs. The results were compared between the PA and control groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>There were 9 patients (6.6%) with glaucomatous optic disc abnormalities in the PA group and 10 cases (5.6%) identified in the control group (p = 0.92). RNFLDs were detected more frequently in the PA group (55 eyes, 20.2%) than in the control group (26 eyes, 7.4%; p&lt;0.001). The two types of RNFLDs were classified as either having their central ends at the disc margin (D) or away from the disc margin and around the retinal vessels (V). Type D and V RNFLDs were detected in 35 (12.9%) and 26 (9.6%) eyes in the PA group and in 25 (7.1%) and 4 (1.1%) eyes in the control group, respectively. Both types of RNFLDs were more frequent in the PA group than in the control group (Type D and V, p = 0.03, &lt;0.001, respectively).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Although the prevalence of glaucomatous optic disc appearance did not differ between the two groups, RNFLDs were more frequent in PA patients than in the control group. Moreover, RNFLDs with their central ends located around retinal vessels were characteristic of PA patients.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0242090","type":"journal-article","created":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T18:33:08Z","timestamp":1604687588000},"page":"e0242090","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["The association of primary aldosteronism with glaucoma-related fundus abnormalities"],"prefix":"10.1371","volume":"15","author":[{"given":"Yoshimi","family":"Ohshima","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9566-4587","authenticated-orcid":true,"given":"Tomomi","family":"Higashide","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimikazu","family":"Sakaguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Sasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachiko","family":"Udagawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinji","family":"Ohkubo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Yoneda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhisa","family":"Sugiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2020,11,6]]},"reference":[{"key":"pone.0242090.ref001","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s11154-011-9161-9","article-title":"Primary aldosteronism: A Japanese perspective","volume":"12","author":"F Satoh","year":"2011","journal-title":"Rev Endocr Metab Disord"},{"key":"pone.0242090.ref002","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1136\/jcp.2007.053264","article-title":"Primary aldosteronism and aldosterone-associated hypertension","volume":"61","author":"B Rayner","year":"2008","journal-title":"J Clin Pathol"},{"key":"pone.0242090.ref003","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1210\/jc.2015-4061","article-title":"The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline","volume":"101","author":"JW Funder","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"pone.0242090.ref004","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1038\/hr.2014.20","article-title":"The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2014)","volume":"37","author":"K Shimamoto","year":"2014","journal-title":"Hypertens Res"},{"key":"pone.0242090.ref005","doi-asserted-by":"crossref","first-page":"2226","DOI":"10.1253\/circj.CJ-13-0847","article-title":"Epidemiology of hypertension in Japan: where are we now?","volume":"77","author":"K Miura","year":"2013","journal-title":"Circ J"},{"key":"pone.0242090.ref006","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1038\/jhh.2011.37","article-title":"How does hypertension affect your eyes?","volume":"26","author":"M Bhargava","year":"2012","journal-title":"J Hum Hypertens"},{"key":"pone.0242090.ref007","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1111\/ceo.12905","article-title":"Hypertensive eye disease: a review.","volume":"45","author":"S Fraser-Bell","year":"2017","journal-title":"Clin Exp Ophthalmol"},{"key":"pone.0242090.ref008","doi-asserted-by":"crossref","first-page":"2033","DOI":"10.1007\/s00417-016-3417-8","article-title":"Central serous chorioretinopathy in primary hyperaldosteronism","volume":"254","author":"EH van Dijk","year":"2016","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"pone.0242090.ref009","doi-asserted-by":"crossref","first-page":"e711","DOI":"10.1038\/cddis.2013.240","article-title":"Aldosterone: a mediator of retinal ganglion cell death and the potential role in the pathogenesis in normal-tension glaucoma","volume":"4","author":"E Nitta","year":"2013","journal-title":"Cell Death Dis"},{"key":"pone.0242090.ref010","first-page":"1641","article-title":"The prevalence of primary open-angle glaucoma in Japanese: the Tajimi Study","volume":"111","author":"A Iwase","year":"2004","journal-title":"Ophthalmology"},{"key":"pone.0242090.ref011","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1016\/j.ophtha.2005.05.012","article-title":"The Tajimi Study report 2: prevalence of primary angle closure and secondary glaucoma in a Japanese population","volume":"112","author":"T Yamamoto","year":"2005","journal-title":"Ophthalmology"},{"key":"pone.0242090.ref012","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1016\/j.survophthal.2013.04.007","article-title":"Imaging of the optic nerve and retinal nerve fiber layer: an essential part of glaucoma diagnosis and monitoring","volume":"59","author":"J Kotowski","year":"2014","journal-title":"Surv Ophthalmol"},{"key":"pone.0242090.ref013","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1136\/bjo.56.8.577","article-title":"Fundoscopic appearance of a nerve-fibre-bundle defect","volume":"56","author":"WF Hoyt","year":"1972","journal-title":"Br J Ophthalmol"},{"key":"pone.0242090.ref014","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/S0039-6257(98)00049-6","article-title":"Ophthalmoscopic evaluation of the optic nerve head","volume":"43","author":"JB Jonas","year":"1999","journal-title":"Surv Ophthalmol"},{"key":"pone.0242090.ref015","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1001\/archopht.119.6.813","article-title":"Clinical factors associated with progression of glaucomatous optic disc damage in treated patients","volume":"119","author":"G Tezel","year":"2001","journal-title":"Arch Ophthalmol"},{"key":"pone.0242090.ref016","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1097\/00061198-199906000-00012","article-title":"Vascular dysregulation: a principal risk factor for glaucomatous damage?","volume":"8","author":"J Flammer","year":"1999","journal-title":"J Glaucoma"},{"key":"pone.0242090.ref017","doi-asserted-by":"crossref","first-page":"204","DOI":"10.4103\/2008-322X.183914","article-title":"Update on Normal Tension Glaucoma","volume":"11","author":"J Mallick","year":"2016","journal-title":"J Ophthalmic Vis Res"},{"key":"pone.0242090.ref018","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1097\/IJG.0b013e31804a5e97","article-title":"A pilot study to detect glaucoma with confocal scanning laser ophthalmoscopy compared with nonmydriatic stereoscopic photography in a community health screening","volume":"16","author":"S Ohkubo","year":"2007","journal-title":"J Glaucoma"},{"key":"pone.0242090.ref019","first-page":"814","article-title":"Fundoscopy of nerve fiber layer defects in glaucoma","volume":"12","author":"WF Hoyt","year":"1973","journal-title":"Invest Ophthalmol"},{"key":"pone.0242090.ref020","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1136\/bjo.86.2.238","article-title":"The definition and classification of glaucoma in prevalence surveys","volume":"86","author":"PJ Foster","year":"2002","journal-title":"Br J Ophthalmol"},{"key":"pone.0242090.ref021","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/S0039-6257(96)80065-8","article-title":"Evaluation of the retinal nerve fiber layer","volume":"40","author":"JB Jonas","year":"1996","journal-title":"Surv Ophthalmol"},{"key":"pone.0242090.ref022","doi-asserted-by":"crossref","first-page":"1646","DOI":"10.1136\/bjo.2005.072546","article-title":"Hypertensive retinopathy revisited: some answers, more questions","volume":"89","author":"A Grosso","year":"2005","journal-title":"Br J Ophthalmol"},{"key":"pone.0242090.ref023","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1007\/s10384-018-0595-4","article-title":"Gene expression changes in the retina after systemic administration of aldosterone","volume":"62","author":"A Ono","year":"2018","journal-title":"Jpn J Ophthalmol"},{"key":"pone.0242090.ref024","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1136\/bjo.78.4.285","article-title":"Localised wedge shaped defects of the retinal nerve fibre layer in glaucoma","volume":"78","author":"JB Jonas","year":"1994","journal-title":"Br J Ophthalmol"},{"key":"pone.0242090.ref025","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1007\/BF00184280","article-title":"Localized retinal nerve fiber layer defects in nonglaucomatous optic nerve atrophy","volume":"232","author":"JB Jonas","year":"1994","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"pone.0242090.ref026","doi-asserted-by":"crossref","first-page":"e0186032","DOI":"10.1371\/journal.pone.0186032","article-title":"Prevalence of retinal nerve fiber layer defects: The Korea National Health and Nutrition Examination Survey 2008\u20132012","volume":"12","author":"KI Na","year":"2017","journal-title":"PLoS One"},{"key":"pone.0242090.ref027","doi-asserted-by":"crossref","first-page":"5118","DOI":"10.1167\/iovs.15-16682","article-title":"Ten-Year Incidence of Retinal Nerve Fiber Layer Defects: The Beijing Eye Study 2001\/2011","volume":"56","author":"R Jie","year":"2015","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"pone.0242090.ref028","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/S0002-9394(00)00387-1","article-title":"Appearance of the optic disk and retinal nerve fiber layer in atherosclerosis and arterial hypertension: an experimental study in rhesus monkeys","volume":"130","author":"SS Hayreh","year":"2000","journal-title":"Am J Ophthalmol"},{"key":"pone.0242090.ref029","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1093\/ajh\/hps081","article-title":"Localized retinal nerve fiber layer defects and arterial hypertension","volume":"26","author":"L Xu","year":"2013","journal-title":"Am J Hypertens"},{"key":"pone.0242090.ref030","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/j.ajo.2012.03.028","article-title":"Visual field characteristics in normal-tension glaucoma patients with autonomic dysfunction and abnormal peripheral microcirculation","volume":"154","author":"HY Park","year":"2012","journal-title":"Am J Ophthalmol"},{"key":"pone.0242090.ref031","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1016\/j.ajo.2012.05.025","article-title":"Comparison of the progression rates of the superior, inferior, and both hemifield defects in normal-tension glaucoma patients","volume":"154","author":"H-K Cho","year":"2012","journal-title":"Am J Ophthalmol"},{"key":"pone.0242090.ref032","doi-asserted-by":"crossref","first-page":"2337","DOI":"10.1016\/j.ophtha.2010.04.002","article-title":"Retinal nerve fiber layer imaging with spectral-domain optical coherence tomography: pattern of RNFL defects in glaucoma","volume":"117","author":"CKS Leung","year":"2010","journal-title":"Ophthalmology"},{"key":"pone.0242090.ref033","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.1038\/eye.2012.204","article-title":"Characteristics of patients with a localized retinal nerve fiber layer defect and normal optic disc appearance","volume":"26","author":"J Lee","year":"2012","journal-title":"Eye (Lond)."},{"key":"pone.0242090.ref034","doi-asserted-by":"crossref","first-page":"4008","DOI":"10.1167\/iovs.16-19525","article-title":"Characteristics of Retinal Nerve Fiber Layer Defect in Nonglaucomatous Eyes With Type II Diabetes","volume":"57","author":"SJ Jeon","year":"2016","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"pone.0242090.ref035","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1007\/BF00184006","article-title":"Diabetes in primary open-angle glaucoma patients with inferior visual field defects","volume":"232","author":"JH Zeiter","year":"1994","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"pone.0242090.ref036","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1007\/s10384-004-0072-0","article-title":"Visual field damage in normal-tension glaucoma patients with or without ischemic changes in cerebral magnetic resonance imaging","volume":"48","author":"J Suzuki","year":"2004","journal-title":"Jpn J Ophthalmol"},{"issue":"7","key":"pone.0242090.ref037","doi-asserted-by":"crossref","first-page":"2650","DOI":"10.1167\/iovs.19-27230","article-title":"Sectoral Differences in the Association of Optic Nerve Head Blood Flow and Glaucomatous Visual Field Defect Severity and Progression","volume":"60","author":"N Kiyota","year":"2019","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"pone.0242090.ref038","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1055\/s-0043-122887","article-title":"Primary Aldosteronism and Obstructive Sleep Apnea: Is This A Bidirectional Relationship?","volume":"49","author":"A Prejbisz","year":"2017","journal-title":"Horm Metab Res"},{"key":"pone.0242090.ref039","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1007\/s10384-010-0830-0","article-title":"Localized retinal nerve fiber layer defects associated with cotton wool spots","volume":"54","author":"JW Koh","year":"2010","journal-title":"Jpn J Ophthalmol"},{"key":"pone.0242090.ref040","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/BF00172255","article-title":"Topographic changes in the optic disc in eyes with cotton-wool spots and primary open-angle glaucoma","volume":"229","author":"E Chihara","year":"1991","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"pone.0242090.ref041","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1097\/00041327-200112000-00010","article-title":"Nerve fiber bundle visual field defect resulting from a giant peripapillary cotton-wool spot","volume":"21","author":"E Chaum","year":"2001","journal-title":"J Neuroophthalmol"},{"key":"pone.0242090.ref042","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1159\/000309999","article-title":"Cotton-wool spots (inner retinal ischemic spots) in malignant arterial hypertension","volume":"198","author":"SS Hayreh","year":"1989","journal-title":"Ophthalmologica"},{"key":"pone.0242090.ref043","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1001\/archophthalmol.2011.1567","article-title":"Cotton-wool spot and optical coherence tomography of a retinal nerve fiber layer defect","volume":"130","author":"L Zhang","year":"2012","journal-title":"Arch Ophthalmol"},{"key":"pone.0242090.ref044","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1080\/08820530701420058","article-title":"Progressive localized retinal nerve fiber layer loss following a retinal cotton wool spot","volume":"22","author":"LM Alencar","year":"2007","journal-title":"Semin Ophthalmol"},{"key":"pone.0242090.ref045","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1136\/bjo.2004.058347","article-title":"Why cotton wool spots should not be regarded as retinal nerve fibre layer infarcts","volume":"89","author":"D McLeod","year":"2005","journal-title":"Br J Ophthalmol"},{"key":"pone.0242090.ref046","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1210\/jc.2008-2116","article-title":"Cardiovascular and cerebrovascular comorbidities of hypokalemic and normokalemic primary aldosteronism: results of the German Conn\u2019s Registry","volume":"94","author":"E Born-Frontsberg","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"key":"pone.0242090.ref047","doi-asserted-by":"crossref","DOI":"10.1177\/1470320318795001","article-title":"Elevated plasma aldosterone levels are associated with a reduction in retinal ganglion cell survival","volume":"19","author":"Y Takasago","year":"2018","journal-title":"J Renin Angiotensin Aldosterone Syst"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0242090","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T18:33:22Z","timestamp":1604687602000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0242090"}},"subtitle":[],"editor":[{"given":"Sanjoy","family":"Bhattacharya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2020,11,6]]},"references-count":47,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,11,6]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0242090","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,6]]}}}