Glaucoma Diagnosis, Visual Field Progression Associated With Body Mass Index

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.
Researchers investigated associations between body mass index and glaucoma progression in 3 cohorts.
Body mass index may affect glaucomatous changes.

A lower body mass index (BMI) is associated with faster visual field progression, a greater likelihood of glaucoma diagnosis, and greater vertical cup-disc ratio (VCDR), according to a study published in the American Journal of Ophthalmology.

Researchers conducted an analysis using data from 3 studies: the Progression Risk Of Glaucoma: RElevant SNPs with Significant Association (PROGRESSA) study (n=355; 55.5% women; mean age, 65.0±9.1 years), the Canadian Longitudinal Study of Aging ([CLSA]; n=23,226; 50.5% women; mean age, 56.9±7.9 years), and UK Biobank cohorts (n=56,572; 54.0% women; mean age, 62.1±9.8 years). Association between BMI and glaucoma progression and prevalence were examined in the 3 cohorts.

In the PROGRESSA cohort, stratified by eyes with stable (n=629), slow (n=40), and fast (n=24) visual field progression, fast progressors had lower BMI compared with stable progressors (25.21±4.37 vs 27.7±5.24; P =.017).

In the UK Biobank cohort, a lower BMI was associated with a greater risk of glaucoma diagnosis (OR, 0.94; 95% CI, 0.91-0.98; P =.002) and positively associated with intraocular pressure (IOP) in a subset of participants with available ICD-10 data (n=13,290). Glaucoma risk was associated with smoking (OR, 0.81; P =.014), lower BMI (OR, 0.90; P =.011), highest IOP (OR, 1.03; P <.001), age (OR, 1.05; P <.001), household income (OR, 1.09; P =.005), gender (OR, 1.15; P =.036), and diabetes (OR, 1.32; P =.029).

VCDR was negatively correlated with BMI (β, -0.062; P <.001) and smoking (β, -0.076; P <.001) and positively correlated with highest IOP (β, 0.028; P <.001), age (β, 0.07; P <.001), gender (β, 0.096; P <.001), and diabetes (β, 0.149; P <.001).

Among the CLSA cohort, changes in VCDR were associated with baseline VCDR (β, -0.046; P <.001), BMI (β, -0.007; P =.023), age (β, 0.002; P <.001), and highest IOP (β, 0.006; P <.001).

Researchers cannot confirm the etiology of the associations between BMI and glaucoma and state, “It is difficult to discern from this study whether higher BMI is protective in glaucoma, or if a lower BMI is pathological, or whether these findings are attributed to an alternative confounding factor.”

Study limitations include a retrospective nature in 1 of the studies and an overrepresentation of individuals of European descent.

This article originally appeared on Optometry Advisor


Marshall H, Berry EC, Torres SD, et al. Association between body mass index and primary open-angle glaucoma in three cohorts. Am J Ophthalmol. Published online August 12, 2022. doi:10.1016/j.ajo.2022.08.006