Association between oxidative balance score and glaucoma in the National Health and Nutrition Examination Survey

Objective: To investigate the association between Oxidative Balance Score (OBS) and glaucoma risk. Methods: Using data from the National Health and Nutrition Examination Survey (2005-2008), we analyzed 2,615 participants aged ≥40 years. OBS was calculated from 15 antioxidant and 5 pro-oxidant components, including dietary nutrients and lifestyle factors. Glaucoma was identified through self-reported diagnosis and retinal imaging. Survey-weighted logistic regression and restricted cubic splines (RCS) were used to assess associations. Results: Higher OBS was associated with lower glaucoma risk (adjusted OR = 0.97, 95% CI: 0.94-1.00). Participants in the highest OBS quartile showed 51% lower odds of glaucoma compared to the lowest quartile (adjusted OR = 0.49, 95% CI: 0.27-0.90). The protective effect was more pronounced among middle-aged adults (40-60 years; OR = 0.90, 95% CI: 0.86-0.95) and males (OR = 0.93, 95% CI: 0.90-0.97). Conclusion: Higher OBS were associated with lower glaucoma prevalence, particularly among middle-aged adults and males, suggesting potential benefits of maintaining oxidative balance in glaucoma prevention.