PMID- 38215989
OWN - NLM
STAT- Publisher
LR  - 20240228
IS  - 1549-4713 (Electronic)
IS  - 0161-6420 (Linking)
DP  - 2024 Jan 10
TI  - Association of Primary Open-Angle Glaucoma with Diabetic Retinopathy among 
      Patients with Type 1 and Type 2 Diabetes: A Large Global Database Study.
LID - S0161-6420(24)00052-6 [pii]
LID - 10.1016/j.ophtha.2024.01.016 [doi]
AB  - PURPOSE: To assess the correlation between primary open-angle glaucoma (POAG) and 
      the risk of developing diabetic retinopathy (DR) in patients with type 1 diabetes 
      mellitus (T1DM) and type 2 diabetes mellitus (T2DM). DESIGN: A retrospective 
      cohort study leveraging the global patient database of TriNetX Research Network. 
      PARTICIPANTS: The study included 44 359 patients with diabetes mellitus (DM) with 
      POAG and 4 393 300 patients with DM without any glaucoma >/= 18 years of age. 
      Propensity score matching harmonized the cohorts to 39 680 patients each, 
      covering diagnoses from January 1, 2005, to January 1, 2023. METHODS: We analyzed 
      data using specific International Classification of Diseases, 10(th) Revision 
      (ICD-10) codes for DM and glaucoma. We matched the cohorts using propensity score 
      matching, adjusting for age, sex, race/ethnicity, blood markers, relevant medical 
      history, and ophthalmic service use. MAIN OUTCOME MEASURES: The primary outcome 
      was the first-time occurrence of DR, including nonproliferative DR (NPDR) and 
      proliferative DR (PDR), in patients with DM with and without glaucoma at 1-, 5-, 
      and 10-year intervals from their individual index dates. RESULTS: At 10 years, 
      patients with T1DM with POAG exhibited a heightened risk for any DR (adjusted 
      risk ratios [RRs], 4.12; 95% confidence interval [CI], 3.05-5.57, P < 0.0001) and 
      PDR (RR, 7.02; 95% CI, 3.62-13.61, P < 0.0001). Patients with T2DM and POAG also 
      faced an increased 10-year risk for any DR (RR, 2.47; 95% CI, 2.28-2.68, P < 
      0.0001) and PDR (RR, 3.82; 95% CI, 3.09-4.70, P < 0.0001). The combined 
      association of POAG on DR risk in those with T1DM and T2DM at 10 years was found 
      to be significantly higher among patients with POAG (5.45%) compared with those 
      without glaucoma (2.12%) (adjusted hazard ratio [aHR], 2.33; 95% CI, 2.14-2.53). 
      The cumulative incidence of DR was significantly higher in the POAG group 
      compared with nonglaucoma counterparts after a decade (log-rank P < 0.001). 
      CONCLUSIONS: Our findings underscore a substantial association between POAG and 
      DR development in both T1DM and T2DM patients, emphasizing the need for vigilant 
      screening and comprehensive management in glaucomatous patients with DM to 
      mitigate the risk of DR. Future research should delve into elucidating the causal 
      mechanisms driving these observed associations. FINANCIAL DISCLOSURE(S): The 
      author(s) have no proprietary or commercial interest in any materials discussed 
      in this article.
CI  - Copyright (c) 2024 American Academy of Ophthalmology. Published by Elsevier Inc. 
      All rights reserved.
FAU - Chauhan, Muhammad Z
AU  - Chauhan MZ
AD  - Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical 
      Sciences, Little Rock, Arkansas.
FAU - Elhusseiny, Abdelrahman M
AU  - Elhusseiny AM
AD  - Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical 
      Sciences, Little Rock, Arkansas.
FAU - Kishor, Krishna S
AU  - Kishor KS
AD  - Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami 
      Miller School of Medicine, Palm Beach Gardens, Florida.
FAU - Sanvicente, Carina T
AU  - Sanvicente CT
AD  - Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical 
      Sciences, Little Rock, Arkansas.
FAU - Ali, Arsalan A
AU  - Ali AA
AD  - Anne Burnett Marion School of Medicine, Fort Worth, Texas.
FAU - Sallam, Ahmed B
AU  - Sallam AB
AD  - Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical 
      Sciences, Little Rock, Arkansas.
FAU - Bhattacharya, Sanjoy K
AU  - Bhattacharya SK
AD  - Miami Integrative Metabolomics Research Center, Bascom Palmer Eye Institute, 
      University of Miami, Miami, Florida.
FAU - Uwaydat, Sami H
AU  - Uwaydat SH
AD  - Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical 
      Sciences, Little Rock, Arkansas. Electronic address: SHUwaydat@uams.edu.
LA  - eng
PT  - Journal Article
DEP - 20240110
PL  - United States
TA  - Ophthalmology
JT  - Ophthalmology
JID - 7802443
SB  - IM
OTO - NOTNLM
OT  - Diabetic retinopathy
OT  - Glaucoma
OT  - Propensity score matching
OT  - T1DM
OT  - T2DM
EDAT- 2024/01/13 00:42
MHDA- 2024/01/13 00:42
CRDT- 2024/01/12 19:31
PHST- 2023/08/12 00:00 [received]
PHST- 2023/12/30 00:00 [revised]
PHST- 2024/01/05 00:00 [accepted]
PHST- 2024/01/13 00:42 [pubmed]
PHST- 2024/01/13 00:42 [medline]
PHST- 2024/01/12 19:31 [entrez]
AID - S0161-6420(24)00052-6 [pii]
AID - 10.1016/j.ophtha.2024.01.016 [doi]
PST - aheadofprint
SO  - Ophthalmology. 2024 Jan 10:S0161-6420(24)00052-6. doi: 
      10.1016/j.ophtha.2024.01.016.