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Editors Selection IGR 16-4
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.
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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