Objective: To establish the prevalence and risk factors of Primary Open Angle Glaucoma (POAG) among patients with Systemic Hypertension (SH) and Diabetes Mellitus (DM) in six cities of Colombia. Methods: A cross-sectional study among hypertensive and diabetic patients was conducted in Colombia. This study included 2067 subjects older than 50 years of age diagnosed with SH and/or DM. Participants underwent a complete ophthalmic examination including intraocular pressure (IOP) measurement by Goldmann tonometry and blood pressure measurement. The glaucoma diagnosis was confirmed by structural and functional evidence. Interviews and standardized questionnaires were used to evaluate participants’ lifestyle and other health conditions. Results: Among participants with DM/SH, 142 cases of POAG were confirmed for a prevalence of 5.6% [95% CI: 4.6 - 6.6], while 9.1% were glaucoma suspects [95% CI: 7.8% - 10.4%]. The majority of confirmed cases (77.5%) were undiagnosed. The prevalence of POAG was significantly higher with male gender, greater age, and diastolic blood pressure > 90 mmHg as risk factors. Conclusion: We found a high prevalence of POAG in patients with adequate SH and DM care in a novel Latino population. We also found great unawareness of the disease in this population. Our results have potentially enormous public health implications for Colombia and other Latino populations.
References
[1]
Quigley, H. and Broman, T. (2006) The Number of People with Glaucoma Worldwide in 2010 and 2020. British Journal of Ophthalmology, 90, 262-267. https://doi.org/10.1136/bjo.2005.081224
[2]
Klein, R., Klein, B.E., Linton, K.L. and De Mets, D.L. (1991) The Beaver Dam Eye Study: Visual Acuity. Ophthalmology, 98, 1310-1315. https://doi.org/10.1016/S0161-6420(91)32137-7
[3]
Tielsch, J.M., Sommer, A., Witt, K., Katz, J. and Royall, R.M. (1990) Blindness and Visual Impairment in an American Urban Population. The Baltimore Eye Survey. Archives of Ophthalmology (Chicago, Ill 1960), 108, 286-290. https://doi.org/10.1001/archopht.1990.01070040138048
[4]
Hyman, L., Wu, S.Y., Connell, A.M., et al. (2001) Prevalence and Causes of Visual Impairment in The Barbados Eye Study. Ophthalmology, 108, 1751-1756. https://doi.org/10.1016/S0161-6420(01)00590-5
[5]
Klaver, C.C., Wolfs, R.C., Vingerling, J.R., Hofman, A. and de Jong, P.T. (1998) Age-Specific Prevalence and Causes of Blindness and Visual Impairment in an Older Population: The Rotterdam Study. Archives of Ophthalmology (Chicago, Ill 1960), 116, 653-658. https://doi.org/10.1001/archopht.116.5.653
[6]
Mitchell, P., Smith, W., Chey, T. and Healey, P.R. (1997) Open-Angle Glaucoma and Diabetes. The Blue Mountains Eye Study, Australia. Ophthalmology, 104, 712-718. https://doi.org/10.1016/S0161-6420(97)30247-4
[7]
Wensor, M.D., McCarty, C.A., Stanislavsky, Y.L., Livingston, P.M. and Taylor, H.R. (1998) The Prevalence of Glaucoma in the Melbourne Visual Impairment Project. Ophthalmology, 105, 733-739. https://doi.org/10.1016/S0161-6420(98)94031-3
[8]
Munoz, B., West, S.K., Rubin, G.S., et al. (2000) Causes of Blindness and Visual Impairment in a Population of Older Americans: The Salisbury Eye Evaluation Study. Archives of Ophthalmology (Chicago, Ill 1960), 118, 819-825. https://doi.org/10.1001/archopht.118.6.819
[9]
Kreft, D., Doblhammer, G., Guthoff, R.F. and Frech, S. (2019) Prevalence, Incidence, and Risk Factors of Primary Open-Angle Glaucoma: A Cohort Study Based on Longitudinal Data from a German Public Health Insurance. BMC Public Health, 19, 851. https://doi.org/10.1186/s12889-019-6935-6
[10]
Varma, R., Francis, B.A., et al. (2004) Prevalence of Open-Angle Glaucoma and Ocular Hypertension in Latinos: The Los Angeles Latino Eye Study. Ophthalmology, 111, 1439-1448. https://doi.org/10.1016/j.ophtha.2004.01.025
[11]
Kim, K.E., Kim, M.J., Park, K.H., et al. (2016) Prevalence, Awareness, and Risk Factors of Primary Open-Angle Glaucoma: Korea National Health and Nutrition Examination Survey 2008-2011. Ophthalmology, 123, 532-541. https://doi.org/10.1016/j.ophtha.2015.11.004
[12]
Chopra, V., Varma, R., Francis, B.A., Wu, J., Torres, M. and Azen, S.P. (2008) Type 2 Diabetes Mellitus and the Risk of Open-Angle Glaucoma. The Los Angeles Latino Eye Study. Ophthalmology, 115, 227-233. https://doi.org/10.1016/j.ophtha.2007.04.049
[13]
Klein, B.E., Klein, R. and Jensen, S.C. (1994) Open-Angle Glaucoma and Older-Onset Diabetes. The Beaver Dam Eye Study. Ophthalmology, 101, 1173-1177. https://doi.org/10.1016/S0161-6420(94)31191-2
[14]
Dielemans, I., de Jong, P.T., Stolk, R., Vingerling, J.R., Grobbee, D.E. and Hofman, A. (1996) Primary Open-Angle Glaucoma, Intraocular Pressure, and Diabetes Mellitus in the General Elderly Population. The Rotterdam Study. Ophthalmology, 103, 1271-1275. https://doi.org/10.1016/S0161-6420(96)30511-3
[15]
Song, B.J., Aiello, L.P. and Pasquale, L.R. (2016) Presence and Risk Factors for Glaucoma in Patients with Diabetes. Current Diabetes Reports, 16, 124. https://doi.org/10.1007/s11892-016-0815-6
[16]
Zhao, Y.X. and Chen, X.W. (2017) Diabetes and Risk of Glaucoma: Systematic Review and a Meta-Analysis of Prospective Cohort Studies. International Journal of Ophthalmology, 10, 1430-1435.
[17]
Kahn, H.A. and Milton, R.C. (1980) Alternative Definitions of Open-Angle Glaucoma. Effect on Prevalence and Associations in the Framingham Eye Study. Archives of Ophthalmology (Chicago, Ill 1960), 98, 2172-2177. https://doi.org/10.1001/archopht.1980.01020041024003
[18]
Bankes, J.L. (1967) Ocular Tension and Diabetes Mellitus. British Journal of Ophthalmology, 51, 557-561. https://www.ncbi.nlm.nih.gov/pubmed/6035958 https://doi.org/10.1136/bjo.51.8.557
[19]
Tielsch, J.M., Katz, J., Quigley, H.A., Javitt, J.C. and Sommer, A. (1995) Diabetes, Intraocular Pressure, and Primary Open-Angle Glaucoma in the Baltimore Eye Survey. Ophthalmology, 102, 48-53. https://doi.org/10.1016/S0161-6420(95)31055-X
[20]
Bonomi, L., Marchini, G., Marraffa, M., Bernardi, P., Morbio, R. and Varotto, A. (2000) Vascular Risk Factors for Primary Open Angle Glaucoma: The Egna-Neumarkt Study. Ophthalmology, 107, 1287-1293. https://doi.org/10.1016/S0161-6420(00)00138-X
[21]
Memarzadeh, F., Chung, J., Azen, S.P., Varma, R., et al. (2010) Blood Pressure, Perfusion Pressure, and Open-Angle Glaucoma: The Los Angeles Latino Eye Study. Investigative Ophthalmology & Visual Science, 51, 2872-2877. https://doi.org/10.1167/iovs.08-2956
[22]
American Diabetes Association (2010) Diagnosis and Classification of Diabetes Mellitus. Diabetes Care, 33, S62-S69. https://doi.org/10.2337/dc10-S062
[23]
Mancia, G., Fagard, R., Narkiewicz, K., et al. (2013) ESH/ESC Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). European Heart Journal, 34, 2159-2219. https://doi.org/10.1093/eurheartj/eht151
[24]
Foster, P.J., Buhrmann, R., Quigley, H. and Johnson, G.J. (2002) The Definition and Classification of Glaucoma in Prevalence Surveys. British Journal of Ophthalmology, 86, 238-243. https://doi.org/10.1136/bjo.86.2.238
[25]
Quigley, H., West, S.K., Rodriguez, J., Munoz, B., Klein, R. and Snyder, R. (2001) The Prevalence of Glaucoma in a Population-Based Study of Hispanic Subjects: Proyecto VER. Archives of Ophthalmology, 119, 1819-1826. https://doi.org/10.1001/archopht.119.12.1819
[26]
Bautista, L.E., Vera-Cala, L.M., Villamil, L., Silva, S.M., Peña, I.M. and Luna, L.V. (2002) Factores de riesgo asociados con la prevalencia de hipertensión arterial en adultos de Bucaramanga, Colombia. Salud Pública de México, 44, 399-405. https://doi.org/10.1590/S0036-36342002000500003
[27]
Vargas-Uricoechea, H. and Casas-Figueroa, L.A. (2015) An Epidemiologic Analysis of Diabetes in Colombia. Annals of Global Health, 81, 742-753. https://doi.org/10.1016/j.aogh.2015.11.001
[28]
Costa, V.P., Spaeth, G.L., Smith, M., Uddoh, C., Cabral Vasconcellos, J.P. and Kara-José, N. (2006) Patient Education in Glaucoma: What Do Patients Know about Glaucoma? Arquivos Brasileiros de Oftalmologia, 69, 923-927. https://doi.org/10.1590/S0004-27492006000600024
[29]
Zhou, M., Wang, W., Huang, W. and Zhang, X. (2014) Diabetes Mellitus as a Risk Factor for Open-Angle Glaucoma: A Systematic Review and Meta-Analysis. PLoS ONE, 9, e102972. https://doi.org/10.1371/journal.pone.0102972
[30]
Yanagi, M., Kawasaki, R., Wang, J.J., Wong, T.Y., Crowston, J. and Kiuchi, Y. (2011) Vascular Risk Factors in Glaucoma: A Review. Clinical and Experimental Ophthalmology, 39, 252-258. https://doi.org/10.1111/j.1442-9071.2010.02455.x
[31]
Gerber, A.L., Harris, A., Siesky, B., et al. (2015) Vascular Dysfunction in Diabetes and Glaucoma. Journal of Glaucoma, 24, 474-479. https://doi.org/10.1097/IJG.0000000000000137
[32]
Sayin, N., Kara, N. and Pekel, G. (2015) Ocular Complications of Diabetes Mellitus. World Journal of Diabetes, 15, 562-566. https://doi.org/10.4239/wjd.v6.i1.92
[33]
Kanamori, A., Nakamura, M., Mukuno, H., Maeda, H. and Negi, A. (2004) Diabetes Has an Additive Effect on Neural Apoptosis in Rat Retina with Chronically Elevated Intraocular Pressure. Current Eye Research, 28, 47-54. https://doi.org/10.1076/ceyr.28.1.47.23487
[34]
Anderson, D.R. (1999) Introductory Comments on Blood Flow Autoregulation in the Optic Nerve Head and Vascular Risk Factors in Glaucoma. Survey of Ophthalmology, 43, S5-S9. https://doi.org/10.1016/S0039-6257(99)00046-6
