Editors Selection (IGR: 11-2) | International Glaucoma Review #304

Editors Selection IGR 11-2

Clinical glaucoma: Diabetes mellitus

Comment by David Friedman on:

15044 Is diabetes mellitus a risk factor for open-angle glaucoma? The Rotterdam Study, de Voogd S; Ikram MK; Wolfs RC et al., Ophthalmology, 2006; 113: 1827-1831

De Voogd et al. (1209) report that diabetes at baseline was not associated with the development of primary open angle glaucoma (OAG) in a population-based study conducted in the Netherlands (the Rotterdam Study). A total of 3,837 of 5,399 living eligible subjects participated in the study (71% response rate), and participants and non-participants were similar with regards to baseline vertical cup:disc ratio, intraocular pressure (IOP), IOP-lowering therapy, and 'possible' OAG status. A total of 87 cases of incident OAG occurred over 6.5 years of follow-up, and the unadjusted relative risk for incident OAG was 0.82 for those with diabetes, while the adjusted relative risk was 0.65 (95% CI = 0.25 - 1.64). The authors conclude that diabetes at baseline is not associated with incident POAG, but in fact, in the adjusted analysis the authors reported a 35% lower likelihood of POAG in persons with diabetes at baseline. The small number of incident cases precludes a proper assessment of this risk, and the 95% confidence interval is wide.

The findings of this study are therefore consistent with no difference in incidence rates between those with diabetes and those without, but the study was underpowered to answer the question of risk.

One approach to overcome this limitation is to pool data from multiple studies on glaucoma incidence to identify characteristics that are associated with incident glaucoma.

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Issue 11-2

Table of Contents Editor's Selection