Glaucoma Risk Reduced in Patients With Diabetes

Retinal scan testing for glaucoma. Woman with her head resting in a machine (left) being used by an ophthalmologist (right) to scan the retinas of her eyes and examine them for signs of glaucoma. The retina is the light-sensitive layer at the back of the eye responsible for vision. Glaucoma is a build-up of pressure inside the eye causing blurring and blindness. The technique in use here is optical coherence tomography (OCT) using a confocal scanning laser ophthalmoscope (SLO) device. This machine is from the Optovue company. The results of the scan are shown on the screens and in image C028/1548.
Investigators conduct a longitudinal population-based study into the role of diabetes in glaucoma pathogenesis.
Patients with type 2 diabetes are modestly less likely to develop open-angle glaucoma.

The risk of open-angle glaucoma (OAG) appears to be modestly decreased in individuals with diabetes mellitus (DM), according to findings published in Acta Ophthalmologica.

To investigate the relationship between DM and risk of OAG, researchers reviewed data from a population-based historic cohort comprising individuals aged 40 years and older who began DM treatment between 2001 and 2010 and a reference population matched for age, gender and hospital district. 

The researchers compared the incidence of OAG between individuals with DM and the matched control individuals. They identified new glaucoma cases based on medication reimbursement certificates and hospital billing records. They analyzed the incidence rate ratios (IRR) with regression models adjusted for age, sex, hospital district, socioeconomic status, systemic medications and chronic diseases. 

A total of 244,100 individuals met the study inclusion criteria. Of those, the researchers found that 1.1% developed OAG. The follow-up period for patients ranged from 2001 to 2017. When adjusted for confounding factors, the team found that DM was associated with a modestly reduced incidence of OAG (IRR, 0.92; 95% confidence interval, 0.85-0.99).

“As components of metabolic syndrome may have a compounding risk on developing OAG, it is plausible that a well-rounded diabetes treatment regimen can attenuate the risk of diseases with vascular pathophysiology, including glaucoma,” according to the researchers. “Such intermediary effects linked to DM could explain the lower OAG incidence associated with DM in our study as the impact of DM on OAG may vary by population and management of other vascular conditions.”

Limitations of the study included those inherent to the use of administrative medication data and inability to distinguish between primary open-angle, normal-tension and pseudoexfoliation glaucoma using register data.

This article originally appeared on Ophthalmology Advisor


Virtanen A, Haukka J, Loukovaara S, Harju M. Diabetes mellitus and risk of open-angle glaucoma-A population-based follow-up study Acta Ophthalmol. Published online August 23, 2022. doi:10.1111/aos.15240