Direct and Indirect Associations Between Diabetes and Intraocular Pressure: The Singapore Epidemiology of Eye Diseases Study

Luo, Xiaorong; Tan, Nicholas; Chee, Miao-Li; Shi, Yuan; Tham, Yih‐Chung; Wong, Tien Yin; Wang, Jie Jin; Cheng, Ching‐Yu

doi:10.1167/iovs.17-23013

Cited by 25 publications

(19 citation statements)

References 40 publications

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“…38 Although diabetes was generally considered to be associated with higher IOP and thicker CCT, CCT contributed a small proportion of mediating effect to the total effect of diabetes on IOP. 10 It is considered that diabetes-related autonomic dysfunction and corneal stiffening caused by glycation-induced corneal collagen cross-links in diabetes may contribute to increase IOP. 45 Strengths of the current study include a population-based design, a large sample size, and the availability of multiple potential risk factors (systemic and ocular parameters) for IOP.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Thus it is of pragmatic significance to understand the distribution and risk factors of IOP for glaucoma prevention and prognosis. Many factors, such as age, [3][4][5][6] body mass index (BMI), 7 blood pressure (BP), 5,8 blood glucose, 9,10 central corneal thickness (CCT), 4 have been reported to associate with IOP, but their results were not entirely consistent in all studies, and the potential risk factors in their analysis were failed to account due to lack of data. Therefore, population-based studies with larger sample size and detailed information are needed to better understand these issues.…”

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confidence: 99%

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Intraocular Pressure in General and Diabetic Populations From Southern China: the Dongguan Eye Study

Cui

Yang

Zhang

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To investigate the distribution and risk factors for intraocular pressure (IOP) among general and diabetic populations in Southern China. METHODS. The study participants aged 40 years or older were enrolled from the Dongguan Eye Study, a population-based cross-sectional study from September 2011 to February 2012. Systemic and ophthalmic examinations were performed, and diabetes status was screened based on the American Diabetes Association diagnostic criteria (2010). IOP was measured by a noncontact tonometer per standardized protocol. Regression analyses were used to assess the association between potential risk factors and IOP. RESULTS. A total of 2112 subjects were included with a median age of 55 years. IOP for general population showed a near normal distribution with an average of 15.58 6 3.27 mm Hg. Multiple regression analyses revealed that higher IOP was significantly correlated with younger age, higher body mass index (BMI), shorter height, higher blood pressure (BP), higher fasting blood glucose (FBG), higher low-density lipoprotein cholesterol (LDL-C), lower high-density lipoprotein cholesterol (HDL-C), and thicker central corneal thickness (CCT). There was no association between diabetes status and IOP after adjusting for possible confounders. IOP for diabetic participants showed a right-skewed distribution. Risk factors for IOP elevation in diabetes included female, younger age, higher BP, higher LDL-C, lower HDL-C, and thicker CCT. CONCLUSIONS. The present study identifies risk factors for elevated IOP in general and diabetic populations. Younger age and lower HDL-C, as well as higher BP, LDL-C, and CCT were significant factors contributing to higher IOP, especially in the female diabetic population.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Intraocular Pressure in General and Diabetic Populations From Southern China: the Dongguan Eye Study

Cui

Yang

Zhang

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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“…Additionally, metabolic disturbances of the carbohydrate metabolism could play a role in glaucoma damage and pathogenesis [84]. Finally, diabetes is associated with an increased IOP, and this association is not through the influence of diabetes of central corneal thickness [85]. The aforementioned factors could highlight the importance of vascular risk factors in the pathogenesis of POAG.…”

Section: Diabetes Mellitusmentioning

confidence: 99%

Primary Open Angle Glaucoma and Vascular Risk Factors: A Review of Population Based Studies from 1990 to 2019

Grzybowski¹,

Och

Kanclerz

et al. 2020

JCM

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Glaucoma is one of the leading causes of blindness worldwide, and as the proportion of those over age 40 increases, so will the prevalence of glaucoma. The pathogenesis of primary open angle glaucoma (POAG) is unclear and multiple ocular risk factors have been proposed, including intraocular pressure, ocular perfusion pressure, ocular blood flow, myopia, central corneal thickness, and optic disc hemorrhages. The purpose of this review was to analyze the association between systemic vascular risk factors (including hypertension, diabetes, age, and migraine) and POAG, based on major epidemiological studies. Reports presenting the association between POAG and systemic vascular risk factors included a total of over 50,000 patients. Several epidemiological studies confirmed the importance of vascular risk factors, particularly hypertension and blood pressure dipping, in the pathogenesis and progression of glaucomatous optic neuropathy. We found that diabetes mellitus is associated with elevated intraocular pressure, but has no clear association with POAG. No significant correlation between migraine and POAG was found, however, the definition of migraine varied between studies.

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“…Overall, while CCT is increased in patients with diabetes based on several studies, [46][47][48] this corneal feature only partially mediated IOP variation in a study from Singapore. 6 While CCT is a static biophysical parameter, CH and CRF are dynamic biomechanical properties that are also affected by diabetes control. 49,50 Overall, accounting for CCT, CH and CRF may not completely explain how the diabetic process leads to increased IOP as measured by Goldman applanation tonometry.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Studies show that patients with diabetes have higher intraocular pressure (IOP) than patients without diabetes and that increased fasting blood sugar (FBS) is associated with higher IOP. [1][2][3][4][5][6] However, the link between diabetes and IOP is complex as diabetes alters corneal hysteresis (CH) and corneal resistance factor (CRF), possibly confounding the true correlation between diabetes and IOP. 7,8 The Ocular Response Analyzer (ORA) noncontact tonometer (NCT) generates both a Goldmann-correlated IOP (IOPg) and a cornea-compensated IOP (IOPcc), with the latter adjusting for corneal biomechanical properties.…”

Section: Introductionmentioning

confidence: 99%

Genetic Correlations Between Diabetes and Glaucoma: An Analysis of Continuous and Dichotomous Phenotypes

Laville

Kang

Cousins

et al. 2019

American Journal of Ophthalmology

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A genetic correlation is the proportion of phenotypic variance between traits that is shared on a genetic basis. Here we explore genetic correlations between diabetes-and glaucoma-related traits. Design: Cross-sectional study. Methods: We assembled genome-wide association study summary statistics from Europeanderived participants regarding diabetes-related traits like fasting blood sugar (FBS) and type 2 diabetes (T2D) and glaucoma-related traits (intraocular pressure (IOP), central corneal thickness (CCT), corneal hysteresis (CH), corneal resistance factor (CRF), cup-disc ratio (CDR), and primary open-angle glaucoma (POAG)). We included data from the National Eye Institute Glaucoma Human Genetics Collaboration Heritable Overall Operational Database, the UK Biobank and the International Glaucoma Genetics Consortium. We calculated genetic correlation (r g) between traits using linkage disequilibrium score regression. We also calculated genetic correlations between IOP, CCT and selected diabetes-related traits based on individual level phenotype data in two Northern European population-based samples using pedigree information and Sequential Oligogenic Linkage Analysis Routines (SOLAR). Results: Overall, there was little r g between diabetes-and glaucoma-related traits. Specifically, we found a non-significant negative correlation between T2D and POAG (r g =-0.14; p=0.16). Using SOLAR, the genetic correlations between measured IOP, CCT, FBS, fasting insulin and hemoglobin A1c, were null. In contrast, genetic correlations between IOP and POAG (r g ≥0.45; p≤3.0E-04) and between CDR and POAG were high (r g =0.57; p=2.8E-10). However, genetic correlations between corneal properties (CCT, CRF and CH) and POAG were low (r g range:-0.18-0.11) and non-significant (p≥0.07). Conclusion: These analyses suggest there is limited genetic correlation between diabetes-and glaucoma-related traits.

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Direct and Indirect Associations Between Diabetes and Intraocular Pressure: The Singapore Epidemiology of Eye Diseases Study

Cited by 25 publications

References 40 publications

Intraocular Pressure in General and Diabetic Populations From Southern China: the Dongguan Eye Study

Intraocular Pressure in General and Diabetic Populations From Southern China: the Dongguan Eye Study

Primary Open Angle Glaucoma and Vascular Risk Factors: A Review of Population Based Studies from 1990 to 2019

Genetic Correlations Between Diabetes and Glaucoma: An Analysis of Continuous and Dichotomous Phenotypes

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