Early Hypertension, Type 2 Diabetes Tied to Earlier Glaucoma Onset

An earlier age of diagnosis of hypertension (HTN) and type 2 diabetes (DM2) is associated with earlier onset of primary-open angle glaucoma (POAG), according to study findings published in Clinical Ophthalmology.  

Researchers sought to determine the influence of HTN, DM2, migraine and obstructive sleep apnea (OSA) on the development of POAG. They collected data for 389 eligible patients (mean age: 71.39 years, 57.3% women, 42.7% men) with PAOG through medical records review and phone surveys. The patient mean age at POAG diagnosis was 58.58 years, and the patients mean ages at HTN and DM2 diagnoses were 52.95 years and 55.32 years, respectively. 

The team evaluated data collectively using stepwise multiple regression analysis to determine the relative contribution to age at POAG diagnosis. They used the following groups, according to age at diagnosis: HTN for those with or without DM2 (model 1), HTN for those with DM2 (model 2), DM2 for those with or without HTN (model 3), and DM2 for those with HTN (model 4). 

Model 1 found that age at HTN diagnosis was associated with age at POAG diagnosis (β=0.14; 95% CI, 0.01–0.26, P =.04). Model 2 found that age at HTN diagnosis was not associated with age at POAG diagnosis (P >.05). Model 3 found that age at DM2 diagnosis was associated with age at POAG diagnosis (β = 0.37; 95% CI 0.16–0.58, P =.001). Model 4 found that age at DM2 diagnosis was associated with age at POAG diagnosis (β=0.40; 95% CI 0.00–0.15, P =.003).

In model 3, Asian race/ethnicity was associated with early onset of POAG (β=-6.44; 95% CI -12.34-0.54, P =.033). OSA and migraine did not influence the development of POAG, the researchers note. 

“In our sample, an earlier age of diagnosis of DM2 and HTN was associated with an earlier POAG diagnosis,” according to the researchers. “Patients with early-onset DM2 or HTN may benefit from earlier POAG screening, especially if they have other significant risk factors.”

Study limitations included its cross-sectional design, limited sample size, uncertainty due to patients confirming their date of their disease diagnosis, no assessment of initial intraocular pressure, no analysis of the association between POAG and type 1 diabetes or the role of insulin, and all patients in the study belonged to 1 physician.  

Reference

Wooliscroft J, Akram R, Zuberi H, et al. Predictors of early onset glaucoma. Clin Ophthalmol. Published online June 10, 2022. doi:10.2147/OPTH.S360719