Danish Nationwide Data Reveal a Link between Diabetes Mellitus, Diabetic Retinopathy, and Glaucoma

Horwitz, Anna; Petrovski, Beáta Éva; Torp‐Pedersen, Christian; Kolko, Miriam

doi:10.1155/2016/2684674

Cited by 17 publications

(25 citation statements)

References 31 publications

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“…Similar results was noted in a large study conducted on Danish patients. 12 Researchers could explore the mechanism that retinopathy, a recognised microvascular complication of diabetes, could increase the risk of glaucoma in this cohort of patient.…”

Section: Family History and Retinopathy Findingsmentioning

confidence: 99%

Open-angle glaucoma in diabetic patients’ prevalence and risk factors: a cross-sectional study in Sudan

Salih

Hamed

2020

Int J Res Med Sci

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Background: Diabetic patients are at increased risk of glaucoma compared to the general population. Risk factors for glaucoma that is specific to diabetic patients include increased IOP, retinopathy and neovascular changes and years since diagnosis of diabetes. This cross-sectional study aims to report on the prevalence of glaucoma in diabetic patients in community diabetes centre in Sudan and examine associations with previously reported risk factors.Methods: A cross-sectional study was carried out in Omdurman specialised diabetic healthcare centre in Sudan. A total of 300 patients consented to participation. All patients filled in a survey for both demographics and diabetic disease history then had an assessment for glaucoma by an ophthalmologist. The assessment included examination of the anterior segment, optic nerve assessment and fundus examination using a stereoscopic slit lamp, intraocular pressure (IOP) measurement using tonometry, peripheral anterior chamber configuration and depth assessments using gonioscopy and central visual field assessment using perimetry.Results: Prevalence of open-angle glaucoma diagnosis was 2.8% among diabetic patients who were included in this study. Family history for glaucoma was significantly associated with increased risk of open-angle glaucoma (OR 5.67, 95% CI 1.74-18.45). Retinopathy was also associated with an increased risk of developing the condition (OR 3.1, 95% CI 1.11-8.51). Gender, years since diabetes diagnosis and medications did not have significant associations.Conclusions: Patients with diabetes are at increased risk of developing open-angle glaucoma, but the prevalence among the diabetic population attending community diabetes centre in Sudan remains low. Among different clinical determinants, diabetic retinopathy and genetic determinants may explain the increased risk in the diabetic population.

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Section: Family History and Retinopathy Findingsmentioning

confidence: 99%

Open-angle glaucoma in diabetic patients’ prevalence and risk factors: a cross-sectional study in Sudan

Salih

Hamed

2020

Int J Res Med Sci

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“…Likewise, while we account for individual-specific fixed effects that could potentially affect the risk of glaucoma, 38 future research could also include time-varying covariates.…”

Section: Limitationsmentioning

confidence: 99%

Antihypertensive Medication Postpones the Onset of Glaucoma

et al. 2017

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G laucoma is the second most common irreversible cause of blindness worldwide.1 It is becoming increasingly important in the context of an aging world population.1,2 It possesses a considerable challenge to public health because blindness and visual impairment is costly and have a huge impact on life quality. 3 Raised intraocular pressure (IOP) remains the only successful treatable factor to reduce the progression of glaucoma. Yet, glaucoma is multifactorial, and the understanding of the pathology is incomplete. More than 2 decades ago, the first study to suggest that blood pressure (BP) should be considered in glaucoma treatment was published. 4 Since then, the impact of BP on glaucoma has received greater attention as more evidence has mounted. [5][6][7] Despite the increasing evidence of an association between BP and glaucoma, the exact relationship is complex. In this matter, epidemiological and case-control studies have shown diverse results, and some studies have presented evidence of a correlation between high BP and glaucoma, [5][6][7][8][9][10][11] whereas other studies have linked glaucoma and low-tension glaucoma with low BP.12-17 The controversies have been discussed and related to the complexity of BP not only influencing IOP and ocular perfusion pressure, but also increasing the risk of compromised peripheral vascular capacity and a dysfunctional autoregulation. 5,[17][18][19] Recognized high BP is treated with many different antihypertensive medications, and growing evidence acknowledges that such treatment is associated with glaucoma. [20][21][22] In this matter, antihypertensive medication may conflict with ocular perfusion and autoregulation. 20,23 Although studies have shown a correlation between antihypertensive treatment and glaucoma, these studies have mostly been trials in small numbers of patients with minimal follow-up periods. 1,14,24 Moreover, to the best of our knowledge, no previous study has benefited from a complete data sample from an entire population norimportantly-estimated the causal effect of antihypertensive treatment on the risk of developing glaucoma.The main outcome in our study is the treatment for glaucoma. We hypothesized, before embarking on the empirical analysis, that treatment with antihypertensive medication could have an ambiguous effect on the development Abstract-The aim was to investigate the impact of antihypertensive medication on the onset of glaucoma. Data from the complete Danish population between 40 and 95 years of age were used in the period from 1996 to 2012, covering >2.6 million individuals. The National Danish Registry of Medicinal Products Statistics was used to identify all claimed prescriptions for glaucoma medication and antihypertensive drugs. We first investigated basic correlations in the data and found that patients treated with antihypertensive medication, at any time during the study period, had a significantly higher overall relative risk (RR) of glaucoma, even when controlling for age and sex (with a RR of 1.31 and P<0.0001). Furthermor...

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“…Despite the lack of autonomic innervation in the intraocular vascular system [ 44 ], it is likely that the systemic effects of adrenaline and noradrenaline play a role in the pathogenesis of glaucoma indirectly, if not directly [ 45 – 47 ]. In this context, Fitzgerald reports that systemic stress may lead to increased IOP [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

“…In this context, Fitzgerald reports that systemic stress may lead to increased IOP [ 45 ]. In line with such systemic affection on retinal neurodegeneration, Horwitz et al found that antiadrenergic antihypertensive drugs have a protective effect on the development of glaucoma [ 46 , 47 ], which hypothetically may be explained by increased ocular perfusion. Thus, systemic levels of catecholamines may indirectly affect oxygen and energy supply to the inner retina and thereby play a role in the pathogenesis of glaucomatous neurodegeneration.…”

Section: Discussionmentioning

confidence: 99%

Enhanced Physiological Stress Response in Patients with Normal Tension Glaucoma during Hypoxia

Dalgaard

Vibæk

Vohra

et al. 2021

Journal of Ophthalmology

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Purpose. To investigate whether patients with normal tension glaucoma (NTG) show an enhanced stress response to reduced oxygen supply compared to age-matched healthy controls, measured by serum adrenaline and endothelin-1 (ET-1) levels and changes in distal finger temperature. Methods. A thorough clinical characterization of patients with NTG and age-matched controls was performed prior to inclusion in the study. Twelve patients with NTG and eleven healthy controls met the inclusion criteria and were enrolled in the study. All subjects underwent a two-day investigation. Participants were randomly exposed to either hypoxia or normoxia during the first visit. Hypoxia or normoxia was induced for two hours through a tightly fitting face mask. In addition, the peripheral circulation was assessed with a thermographic camera. Blood samples were obtained before, during, and after hypoxia or normoxia to evaluate systemic stress molecules such as catecholamines and ET-1 levels. Results. In patients with NTG, reduced oxygen supply induced an increase in peripheral blood adrenaline ( p < 0.05) and a decrease during recovery ( p < 0.01). A difference in distal finger temperature was shown in patients with NTG under hypoxia compared to normoxia (exposure: p < 0.05; recovery: p < 0.05). Hypoxia induced an increase in peripheral blood ET-1 levels in both groups (NTG: p < 0.01; controls: p < 0.05). Conclusion. Patients with NTG had an enhanced physiological stress response as a consequence of hypoxia compared with age-matched controls. Although more studies are needed, the present study supports the involvement of vascular risk factors in the pathophysiology of NTG.

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Danish Nationwide Data Reveal a Link between Diabetes Mellitus, Diabetic Retinopathy, and Glaucoma

Cited by 17 publications

References 31 publications

Open-angle glaucoma in diabetic patients’ prevalence and risk factors: a cross-sectional study in Sudan

Open-angle glaucoma in diabetic patients’ prevalence and risk factors: a cross-sectional study in Sudan

Antihypertensive Medication Postpones the Onset of Glaucoma

Enhanced Physiological Stress Response in Patients with Normal Tension Glaucoma during Hypoxia

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