Increased risk of open-angle glaucoma following chronic rhinosinusitis: a population-based matched-cohort study

Abstract

Purpose Anatomically, the eyes and paranasal sinuses are neighboring structures and some studies have mentioned eye disease in conjunction with chronic rhinosinusitis (CRS). However, to the best of our knowledge, no prior research has investigated the risk of developing openangle glaucoma (OAG) among CRS patients. This study aims to provide an estimated risk of developing OAG among patients with CRS by using a population-based data set in Taiwan. Methods This retrospective cohort study used data sourced from the 'Longitudinal Health Insurance Database 2000'. A total of 15 642 CRS patients were included in the study cohort and 46 926 subjects were randomly extracted as a comparison cohort. A cox proportional-hazards regression analysis was performed to calculate the 5-year risk of subsequently developing OAG following a diagnosis of CRS between the study cohort and the comparison cohort. Results The incidence rate of developing OAG over the 5-year follow-up period was 5.45 (95% CI: 4.95-5.98) per 1000 person-years for the study cohort and 2.80 (95% CI: 2.60-3.03) per 1000 person-years for the comparison cohort. After censoring the cases that died over the 5-year period and adjusting for the factors of monthly income, geographic region, hypertension, diabetes, coronary heart disease, hyperlipidemia, and hypothyroidism the hazard ratio for developing OAG over the 5-year period for subjects with CRS to subjects without CRS was 1.73 (95% CI: 1.53-1.96). Conclusion We found that those subjects with CRS had a significantly higher risk of developing OAG over the 5-year follow-up period as compared with subjects without CRS.

Hypothyroidism as a risk factor for open angle glaucoma: A systematic review and meta-analysis

“…Among them, three studies were excluded because they did not provide sufficient data to calculate the OR[ 23 , 24 , 25 ]. Another three studies were omitted for various reasons: one only provided data about the association between hypothyroidism and chronic rhinosinusitis[ 26 ], one was not based on hypothyroidism but thyroid disease[ 27 ], and one only provided data about the association between hypothyroidism and obstructive sleep apnea[ 28 ]. Ultimately, 11 studies, including five case-control, two cohort or nested case-control, and four cross-sectional studies, met the inclusion criteria and were included in this meta-analysis [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 29 , 30 , 31 , 32 ].…”

The Development of Glaucoma after Surgery-Indicated Chronic Rhinosinusitis: A Population-Based Cohort Study

“…Regarding the relationship between CRS and glaucoma, delayed elevation in IOP was found in patients with CRS who received FESS [15]. Furthermore, in a previous population-based study conducted in Taiwan during a 5-year follow-up interval, CRS of all severities led to the development of OAG with a higher hazard ratio and correlated to the disease interval [16]. In the current study, surgery-indicated CRS contributed to a greater occurrence rate of all types of glaucoma, with a significant aHR and significant correlation of glaucoma development to the CRS disease period, which is similar to the previous research.…”

“…However, since the ICD-9 and ICD-10 codes would not be deleted from the medical record except in some extreme conditions such as misdiagnosis, the presence of one diagnosis for a year cannot represent a correlated disease course well. Compared to the previous study performed by Chung et al that only used diagnostic codes to evaluate the disease period [16], the prescription of CRS-related medications were considered in the current study to more accurately estimate the CRS disease interval. Systemic and local corticosteroids are commonly prescribed in patients with CRS [7], but the effects of corticosteroid were not examined in the previous study, which may account for the occurrence of glaucoma to some degree [16].…”

“…Changes in intraocular pressure (IOP) in patients with CRS who received FESS has also been demonstrated [14,15], in which significantly elevated IOP was found 6 weeks after the performance of FESS [15]. Additionally, another population-based study showed the development of open-angle glaucoma (OAG) after CRS in Taiwan [16]. However, the severity and duration of CRS in that study could not be evaluated since related surgical and medical management was not available in that study [16].…”

“…Additionally, another population-based study showed the development of open-angle glaucoma (OAG) after CRS in Taiwan [16]. However, the severity and duration of CRS in that study could not be evaluated since related surgical and medical management was not available in that study [16]. Moreover, whether the likelihood of angle-closure glaucoma (ACG) and normal-tension glaucoma (NTG) was elevated after CRS was not elucidated.…”