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Prevalence of diabetes mellitus and hypertension among Indian glaucoma patients and evaluation of systemic therapy

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Abstract

To study the prevalence and systemic control and evaluate the adequacy of therapy of diabetes mellitus (DM) and hypertension (HT) in glaucoma patients visiting a tertiary care eye facility at a university hospital. Consecutive cases with primary open-angle glaucoma (POAG) or primary angle-closure glaucoma (PACG) attending the outpatient services were evaluated for the presence of DM and HT and any systemic/ocular medications being taken were recorded. Of 615 glaucoma cases evaluated, 281 (45.7 %) were POAG and 334 (54.3 %) were PACG. The mean age was 58.19 ± 10.8 years with males comprising 60.5 % of the study group. Two hundred and ninety-two (47.5 %) glaucoma patients had HT and 181 (29.4 %) had DM, including 97 (15.8 %) patients who had both. One hundred and thirty-three (47.3 %) patients with POAG and 159 (47.6 %) patients with PACG had HT. Ninety-seven (34.5 %) POAG patients and 84 (25.1 %) PACG patients were diabetics. One hundred and sixty-one (55.1 %) HT patients had blood pressure above control levels and 88 (48.6 %) diabetics had uncontrolled blood sugars. Twenty-eight (9.6 %) patients with HT were found to be taking combined systemic and topical β-blocker therapy. A large majority of adult glaucoma patients had concurrent systemic disease, which was not adequately controlled. Patients were using systemic medications with known interactions with ocular hypotensive medications. This study highlights the unmet need for better coordination between ophthalmologists and physicians to improve the overall health of glaucoma patients.

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References

  1. Quigley HA, Broman AT (2006) The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol 90:262–267

    Article  PubMed  CAS  Google Scholar 

  2. Salim S, Shields MB (2010) Glaucoma and systemic diseases. Surv Ophthalmol 55:64–77

    Article  PubMed  Google Scholar 

  3. Wise LA, Rosenberg L, Radin RG, Mattox C, Yang EB, Palmer JR, Seddon JM (2011) A prospective study of diabetes, lifestyle factors, and glaucoma among African–American women. Ann Epidemiol 21:430–439

    Article  PubMed  Google Scholar 

  4. Pasquale LR, Kang JH, Manson JE, Willett WC, Rosner BA, Hankinson SE (2006) Prospective study of type 2 diabetes mellitus and risk of primary open-angle glaucoma in women. Ophthalmology 113:1081–1086

    Article  PubMed  Google Scholar 

  5. Mitchell P, Lee AJ, Rochtchina E, Wang JJ (2004) Open-angle glaucoma and systemic hypertension: the Blue Mountains Eye Study. J Glaucoma 13:319–326

    Article  PubMed  Google Scholar 

  6. Chopra V, Varma R, Francis BA, Wu J, Torres M, Azen SP, Los Angeles Latino Eye Study Group (2008) Type 2 diabetes mellitus and the risk of open-angle glaucoma the Los Angeles Latino Eye Study. Ophthalmology 115:227–232

    Google Scholar 

  7. Fechtner RD (1999) Beta blockers. In: Netland PA, Allen RC (eds) Glaucoma medical therapy: principles and management. AAO, San Francisco, pp 25–45

    Google Scholar 

  8. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ (2003) Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 42:1206–1252

    Article  PubMed  CAS  Google Scholar 

  9. American Diabetes Association (2011) Standards of medical care in diabetes—2011. Diabetes Care 34:S11–S61

    Article  Google Scholar 

  10. Lin HC, Chien CW, Hu CC, Ho JD (2010) Comparison of comorbid conditions between open-angle glaucoma patients and a control cohort: a case–control study. Ophthalmology 117:2088–2095

    Article  PubMed  Google Scholar 

  11. Tielsch JM, Katz J, Sommer A, Quigley HA, Javitt JC (1995) Hypertension, perfusion pressure, and primary open-angle glaucoma. A population-based assessment. Arch Ophthalmol 113:216–221

    Article  PubMed  CAS  Google Scholar 

  12. Bonomi L, Marchini G, Marraffa M, Bernardi P, Morbio R, Varotto A (2000) Vascular risk factors for primary open angle glaucoma: the Egna–Neumarkt Study. Ophthalmology 107:1287–1293

    Article  PubMed  CAS  Google Scholar 

  13. Tielsch JM, Katz J, Quigley HA, Javitt JC, Sommer A (1995) Diabetes, intraocular pressure, primary open angle glaucoma in the Baltimore Eye Survey. Ophthalmology 102:48–53

    PubMed  CAS  Google Scholar 

  14. Wang N, Peng Z, Fan B, Liu Y, Dong X, Liang X, Luan J (2002) Case control study on the risk factors of primary open angle glaucoma in China. Zhonghua Liu Xing Bing Xue Za Zhi 23:293–296

    PubMed  CAS  Google Scholar 

  15. Memarzadeh F, Ying-Lai M, Chung J, Azen SP, Varma R, Los Angeles Latino Eye Study Group (2010) Blood pressure, perfusion pressure, and open-angle glaucoma: the Los Angeles Latino Eye Study. Invest Ophthalmol Vis Sci 51:2872–2877

    Google Scholar 

  16. Langman MJ, Lancashire RJ, Cheng KK, Stewart PM (2005) Systemic hypertension and glaucoma: mechanisms in common and co-occurrence. Br J Ophthalmol 89:960–963

    Article  PubMed  CAS  Google Scholar 

  17. Klein BE, Klein R, Knudtson MD (2005) Intraocular pressure and systemic blood pressure: longitudinal perspective: the Beaver Dam Eye Study. Br J Ophthalmol 89:284–287

    Article  PubMed  CAS  Google Scholar 

  18. Dobree JH (1956) Calibre changes in retinal vessels occurring in raised ocular tension; circulatory compensation in chronic glaucoma. Br J Ophthalmol 1956(40):1–13

    Article  Google Scholar 

  19. He Zheng, Algis J, James A, Bang V (2011) The role of blood pressure in glaucoma. Clin Exp Optom 94:133–149

    Article  PubMed  Google Scholar 

  20. Gerber SL, Cantor LB (2000) Systemic side effects and interactions of glaucoma medications. In: Albert DM, Jakobiec FA (eds) Principle and practice of ophthalmology, 2nd edn. WB Saunders, Philadelphia, pp 2916–2930

    Google Scholar 

  21. Kitazawa Y, Shirai H, Go FJ (1989) The effect of calcium antagonist on visual field in low-tension glaucoma. Graefes Arch Clin Exp Ophthalmol 227:408–412

    Article  PubMed  CAS  Google Scholar 

  22. Ritch R (2000) Neuroprotection: is it already applicable to glaucoma therapy? Curr Opin Ophthalmol 11:78–84

    Article  PubMed  CAS  Google Scholar 

  23. Müskens RP, de Voogd S, Wolfs RC, Witteman JC, Hofman A, de Jong PT, Stricker BH, Jansonius NM (2007) Systemic antihypertensive medication and incident open-angle glaucoma. Ophthalmology 114:2221–2226

    Article  PubMed  Google Scholar 

  24. Netland PA (1999) Systemic drugs and intraocular pressure. In: Netland PA, Allen RC (eds) Glaucoma medical therapy: principles and management. AAO, San Francisco, pp 149–161

    Google Scholar 

  25. Novack GD (2006) Ophthalmic beta blockers since timolol. Surv Ophthalmol 51:179–212

    Article  Google Scholar 

  26. Allen RC (1999) Carbonic anhydrase inhibitors. In: Netland PA, Allen RC (eds) Glaucoma medical therapy: principles and management. AAO, San Francisco, pp 99–111

    Google Scholar 

  27. Constad WH, Fiore P, Samson C, Cinotti AA (1988) Use of an angiotensin converting enzyme inhibitor in ocular hypertension and primary open angle glaucoma. Am J Ophthalmol 105:674–677

    PubMed  CAS  Google Scholar 

  28. Hirooka K, Baba T, Fujimara T, Shiraga F (2006) Prevention of visual field defect progression with angiotensin-converting enzyme inhibitor in eyes with normal-tension glaucoma. Am J Ophthalmol 142:523–525

    Article  PubMed  CAS  Google Scholar 

  29. Gordon MO, Beiser JA, Brandt JD, Heuer DK, Higginbotham EJ, Johnson CA, Keltner JL, Miller JP, Parrish RK II, Wilson MR, Kass MA (2002) The Ocular Hypertension Treatment Study: baseline factors that predict the onset of primary open-angle glaucoma. Arch Ophthalmol 120:714–720

    Article  PubMed  Google Scholar 

  30. Klein BE, Klein R, Jensen SC (1994) Open-angle glaucoma and older-onset diabetes. The Beaver Dam Eye Study. Ophthalmology 101:1173–1177

    PubMed  CAS  Google Scholar 

  31. Mitchell P, Smith W, Chey T, Healey PR (1997) Open-angle glaucoma and diabetes: the Blue Mountains eye study, Australia. Ophthalmology 104:712–718

    Article  PubMed  CAS  Google Scholar 

  32. Velde TM, Kaiser FE (1983) Ophthalmic timolol treatment causing altered hypoglycemic response in a diabetic patient. Arch Intern Med 143:1627–1628

    Article  PubMed  CAS  Google Scholar 

  33. Gerber SL, Cantor LB (1990) Systemic drug interactions with topical glaucoma medications. Surv Ophthalmol 35:205–218

    Article  PubMed  CAS  Google Scholar 

  34. Gottfredsdottir MS, Allingham R, Shields MB (1997) Physicians’ guide to interactions between glaucoma and systemic medications. J Glaucoma 6:377–383

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India

    Abhishek Dave, Reetika Sharma, Raghav Gupta & Tanuj Dada

  2. Gimbel Eye Centre, Calgary, AB, Canada

    Shveta Jindal Bali

  3. Regional Institute of Ophthalmology, Post Graduate Institute of Medical Sciences, Rohtak, 124001, India

    Aruj K. Khurana

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  1. Abhishek Dave
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  2. Shveta Jindal Bali
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Correspondence to Tanuj Dada.

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Dave, A., Bali, S.J., Sharma, R. et al. Prevalence of diabetes mellitus and hypertension among Indian glaucoma patients and evaluation of systemic therapy. Int Ophthalmol 33, 527–532 (2013). https://doi.org/10.1007/s10792-013-9737-3

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  • DOI: https://doi.org/10.1007/s10792-013-9737-3

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