Residential Greenspace and Domestic Gardens, Genetic Predisposition, and Incident Glaucoma: A Prospective Cohort Study.

While greenness has been linked to enhanced physiological and psychological health, its association with glaucoma remains unexplored. This study aims to investigate the effect of residential greenspace and domestic gardens on incident glaucoma. 357, 920 participants from the UK Biobank were included. Land use coverage percentages of greenspace and domestic gardens within 300 and 1,000 m buffers of participants' residential locations were estimated using land use databases. Cox regression models were used to estimate the association between greenness exposures and incident glaucoma. Four-way decomposition models were used to explore potential mediators or moderators in the pathway. Gene-environment interaction effects were tested using multi-trait genetic polygenic risk score of glaucoma and Myocilin p.Gln368Ter genotype. During a median (IQR) follow-up of 13.5 (12.8, 14.1) years, 4, 046 glaucoma cases occurred. After full adjustment, the fourth quartile of greenspace was associated with 17.7% (HR = 0.823, 95%CI 0.723-0.937, p = 0.003) and 19% (HR = 0.810, 95%CI 0.708-0.927, p = 0.002) lower risk of incident glaucoma in 300 and 1000 m buffer. Domestic gardens showed a similar trend (4th quartile vs. 1st quartile: 300 m HR = 0.843, 95%CI 0.742-0.957, p = 0.008; 1,000 m HR = 0.827, 95%CI 0.727-0.941, p = 0.004), though restricted cubic spline analysis showed a nonlinear association in 300 m buffer. Greenspace in 300 m buffer was associated with lower cornea-compensated intraocular pressure. No significant mediating or interactive effects were identified for air pollution, recreational screen time, physical activities, or genetic predisposition. Residential greenspace and domestic gardens may be protective against glaucoma. Therefore, greenspace coverage should be incorporated into land use planning policies for public ocular health promotion.