The Development of Glaucoma after Surgery-Indicated Chronic Rhinosinusitis: A Population-Based Cohort Study

Abstract

This study investigates the development of glaucoma in subjects with surgery-indicated chronic rhinosinusitis (CRS) by the use of the National Health Insurance Research Database in Taiwan. Individuals that received the functional endoscopic sinus surgery (FESS) with a diagnostic code of CRS were regarded as surgery-indicated CRS and enrolled in the study group. Four non-CRS patients were age- and gender-matched to each patient in the study group. The exclusion criteria included legal blindness, ocular tumor, history of eyeball removal, and previous glaucoma. The outcome was regarded as the development of glaucoma, and conditional logistic regression was used for the statistical analysis, which involved multiple potential risk factors in the multivariate model. A total of 6506 patients with surgery-indicated CRS that received FESS and another 26,024 non-CRS individuals were enrolled after exclusion. The age and gender distributions were identical between the two groups due to matching. There were 108 and 294 glaucoma events in the study group and control group, respectively, during the follow-up period, and the study group had a significantly higher adjusted hazard ratio (1.291, 95% confidential interval: 1.031–1.615). The cumulative probability analysis also revealed a correlation between the occurrence of glaucoma and the CRS disease interval. In the subgroup analysis, the chance of developing open-angle glaucoma and normal-tension glaucoma was significantly higher in the study group than in the control group. In conclusion, the existence of surgery-indicated CRS is a significant risk factor for the development of glaucoma, which correlated with the disease interval.

Incidence Rates and Risk Ratios of Normal Tension Glaucoma in Patients with Chronic Rhinosinusitis: A Population-Based Longitudinal Follow-Up Study

“…Another study highlighted that surgery-associated CRS contributed to a significant risk ratio in both the open-angle glaucoma (adjusted HR = 2.244) and NTG (adjusted HR = 2.127) subgroups, but not in the angle-closure glaucoma subgroup. Consistently, the present investigation also demonstrated an increased risk ratio for incident NTG events in all CRS patients, with an adjusted HR of 1.41 over a 10-year follow-up period [19]. Moreover, several studies hypothesized that ostial obstruction in CRS could limit airflow, leading to hypoxia, which could contribute to retinal ischemia, a factor associated with glaucoma development [30][31][32].…”

“…Additionally, previous studies have shown that the respiratory distress condition is very closely correlated with increased intraocular pressure (IOP) [16,17]. Moreover, some cohort studies from Taiwan revealed a positive correlation between patients with CRS and the subsequent development of open-angle glaucoma [18,19].…”

Association of the nasopharyngeal carcinoma and the subsequent open glaucoma development: a nationwide cohort study

“…On the other side, compressive lesion might be risk factor for OAG development in which the ocular adnexal lymphoma as well as infantile hemangioma and associated OAG have been reported previously [24,25]. Chronic rhinosinusitis contributes to elevated incidence of subsequent glaucoma in a population-based study [26]. Regarding NPC, orbital invasion occurred in a large number of patients [14,27].…”

Risk Factors for Primary Angle-closure Glaucoma: A Systematic Review and Meta-analysis of 45 Studies

“…1. Appendix Table A4, available at http://links.lww.com/OPX/A658, shows the characteristics of the remaining 45 related studies 12–56 . Two of the 45 articles were conducted from the same cohort 44,45 .…”