Diabetes Patients with Glaucoma have heightened risk of developing Retinopathy

Danish Researchers found that when compared to non-diabetic controls, diabetic patients are at increased risk of developing Glaucoma or Ocular Hypertension within 5 years and the risk of developing Diabetic retinopathy shoots up in these patients. The study results were published in the Journal of Acta Ophthalmologica. 

Diabetes is a global metabolic disorder that increases mortality and morbidity due to its effect on several organ systems. Out of the various complications, Diabetic retinopathy (DR) occurs most frequently. Previous literature has shown that there is an escalated risk of glaucoma in diabetics but the exact association of developing DR in diabetics with Glaucoma or ocular hypertension (OHT) is not established. Hence researchers conducted a bidirectional 5 years prospective, registry-based cohort study based on the longitudinal data from more than 1.2 million people to investigate if DR, glaucoma and/or OHT are longitudinally linked. 

By extracting data from national registers like the Danish Registry of Diabetic Retinopathy, the Danish Civil Registration System, the Danish National Patient Register, and the Danish National Prescription Registry screening was done by practicing ophthalmologists or hospital departments, and results are reported to DiaBase. Based on the highest level in the two eyes, the DR level was defined. Glaucoma and/or OHT was defined by diagnostic codes (H40*) or at least three redeemed prescriptions of glaucoma medication (S01E*) within 1 year. 

Nearly 2,05,970 persons with diabetes and 10,03,170 age- and gender-matched non-diabetes controls were included in the study. The main exposures were the level-specific DR, glaucoma, and/or OHT, and hazard ratios (HRs) for 5 years of incident glaucoma and/or OHT and DR were the main outcomes. 

Results

• As per the multivariable-adjusted HR, diabetic patients were more likely to develop glaucoma and/or OHT by 11%, but this did not depend on the level of DR.
• Diabetics having glaucoma and/or OHT were more likely to develop DR within 5 years by 12 %. 

Thus, this national cohort study has shown that diabetic patients with glaucoma/OHT were more likely to develop retinopathy, but this screening program did not justify including glaucoma evaluation in the national Danish DR-screening program. 

Further reading: Sperling S, Stockholm L, et al Bidirectional 5-year risks of diabetic retinopathy, glaucoma and/or ocular hypertension: Results from a national screening programme. Acta Ophthalmologica, 00, 1– 8. DOI:  https://doi.org/10.1111/aos.15300