Perspectives on Glaucoma

OAG exhibits significantly higher rate of stroke development

Patients diagnosed with open-angle glaucoma are more likely to experience a stroke, and males are at greater risk than females, according to a retrospective study in the British Journal of Ophthalmology.

Researchers used the Korean National Health Insurance Service database and targeted 1,520 patients who underwent an initial diagnosis of open-angle glaucoma from January 2004 to December 2007 along with a comparison group of five matched controls per OAG patient, totaling 7,570 controls.

Patients with OAG were more likely to experience a subsequent stroke compared with the comparison group, according to the study. Hypertension, diabetes mellitus, chronic renal failure, atrial fibrillation and hyperlipidemia were more prevalent in the OAG group. Traditional risk factors such as increasing age and male gender were also associated with an increased risk of stroke.

A stroke occurred in 22.9 per 1,000 person-years for the OAG group and in 16.5 per 1,000 person-years for the comparison group, according to researchers. The predicative value of OAG for stroke was elevated in patients with hypertension compared to subjects without hypertension.

In other diseases such as diabetes mellitus, atrial fibrillation and hyperlipidemia, the effect sizes were similar to that of the entire cohort, regardless of the presence of OAG, according to researchers.

They also found that the higher risk of stroke after OAG was maintained after adjusting for sociodemographic factors and comorbidities.

Further, adults at least 65 years and males with OAG are more susceptible to stroke than adults younger than 65 years and females with OAG. – by Abigail Sutton

Disclosures: The researchers report no relevant financial disclosures.

Patients diagnosed with open-angle glaucoma are more likely to experience a stroke, and males are at greater risk than females, according to a retrospective study in the British Journal of Ophthalmology.

Researchers used the Korean National Health Insurance Service database and targeted 1,520 patients who underwent an initial diagnosis of open-angle glaucoma from January 2004 to December 2007 along with a comparison group of five matched controls per OAG patient, totaling 7,570 controls.

Patients with OAG were more likely to experience a subsequent stroke compared with the comparison group, according to the study. Hypertension, diabetes mellitus, chronic renal failure, atrial fibrillation and hyperlipidemia were more prevalent in the OAG group. Traditional risk factors such as increasing age and male gender were also associated with an increased risk of stroke.

A stroke occurred in 22.9 per 1,000 person-years for the OAG group and in 16.5 per 1,000 person-years for the comparison group, according to researchers. The predicative value of OAG for stroke was elevated in patients with hypertension compared to subjects without hypertension.

In other diseases such as diabetes mellitus, atrial fibrillation and hyperlipidemia, the effect sizes were similar to that of the entire cohort, regardless of the presence of OAG, according to researchers.

They also found that the higher risk of stroke after OAG was maintained after adjusting for sociodemographic factors and comorbidities.

Further, adults at least 65 years and males with OAG are more susceptible to stroke than adults younger than 65 years and females with OAG. – by Abigail Sutton

Disclosures: The researchers report no relevant financial disclosures.

    Perspective
    Scott Anthony, OD

    Scott Anthony

    Over the years it has become clear to me that glaucoma is indeed a multifactorial disease. In some cases, glaucoma seems to be tied to the patient’s general health, although the connection is never quite clear and ultimately the treatments remain the same – lowering intraocular pressure.

    In this study there is evidence that open-angle glaucoma is possibly linked to a higher risk of stroke. But, unfortunately, that’s where the insight stops.

    Glaucoma does a great job of hiding amongst various other systemic diseases that likely contribute to its formation or progression. I’ve read dozens of studies that hint at a connection between glaucoma and a specific medical risk factor, but none have shown an absolute connection.

    Unraveling the pathophysiology of glaucoma continues to be an elusive process. A breakthrough will likely not occur until a novel treatment surfaces that targets IOP-independent factors of this multifactorial disease. 

    • Scott Anthony, OD, FAAO
    • Cleveland VAMC
      Adjunct assistant professor of clinical optometry, staff optometrist

    Disclosures: Anthony reports no relevant financial disclosures.