Increased stroke risk among patients with open-angle glaucoma: a 10-year follow-up cohort study

Rim, Tyler Hyungtaek; Lee, Sang Yeop; Bae, Hyoung Won; Kim, Sung Soo; Kim, Chan Yun

doi:10.1136/bjophthalmol-2017-310415

Cited by 29 publications

(30 citation statements)

References 24 publications

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“…Meta-regression also failed to distinguish the exact source of the heterogeneity. Several factors, such as different characteristics of the populations, different quality of the included studies, different methods used to ascertain outcomes and exposure, different sample 44 Age, sex Chen (2005) 9 Age, SBP, DBP, glucose Motsko (2008) 54 Age, sex Lin (2010) 8 Age, gender, monthly income, and level of urbanization of the community in which the patient resided Lin (2010) 45 Age, sex Imai (2010) 42 Age, maximum temperature, increased abdominal circumference, elevated fasting glucose level, BP Ishikawa (2011) 52 Age, sex, DBP, IOP, and ocular perfusion pressure Newman-Casey (2011) 7 Age, sex, race, education level, household net worth, region of residence at the time of enrollment in the medical plan, cataract, pseudophakia or aphakia, macular degeneration, diabetic retinopathy, systemic hypotension, sleep apnea, and migraine headache Lee (2012) 46 Age, sex, SBP Lin (2012) 33 Age, sex, BMI, waist, SBP, DBP, fasting sugar, and postprandial sugar Kim (2014) 34 Age, sex, impaired glucose tolerance, hypertension, and baseline IOP Aptel (2014) 47 Age, sex, BMI, hypertension, and thyroid dysfunction Kim (2014) 43 Age, sex Chung (2014) 53 Age, sex Kim (2014) 55 Age, sex, myopia, fasting blood glucose Chen (2014) 48 Age, sex, hypertension, diabetes, CAD, and obstructive sleep apnea Sahinoglu-Keskek (2014) 41 Age Fujiwara (2015) 49 Age, sex, SBP, diabetes, cholesterol, HDLcholesterol, BMI, waist circumference, smoking habits, alcohol intake, and regular exercise Shim (2015) 32 Age, sex Chen (2016) 50 Age, sex Chen (2016) 51 Age, gender, and comorbidities of diabetes, hypertension, and CAD Ko (2016) 35 Age, gender, ethnicity, education, insurance, diabetes duration, BMI, hypertension, obstructive sleep apnea, and current smoker Kim (2016) 36 Age, sex, IOP, household income, exercise, education level, smoking status, alcohol consumption, and BMI Yokomichi (2016) 10 Age, sex, SBP, DBP, fasting plasma glucose Rim (2017) 37 Age, sex, hypertension, DM, chronic renal failure, atrial fibrillation, residence, income Lee (2017) 38 Age, sex, hypertension, DM, congestive heart failure, ischemic heart disease, atrial fibrillat...…”

Section: Discussionmentioning

confidence: 99%

Hyperlipidemia, Blood Lipid Level, and the Risk of Glaucoma: A Meta-Analysis

Wang

Bao

2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. Previous studies reported that hyperlipidemia and blood lipid levels were associated with glaucoma, ocular hypertension (OHT), and intraocular pressure (IOP). However, studies aimed at investigating this association have yielded conflicting results. Therefore, to shed light on these inconclusive findings, we performed multiple distinct meta-analyses to clarify the association of hyperlipidemia and blood lipid levels with glaucoma, OHT, and IOP. METHODS. A systematic literature search from Embase, Web of Science, and PubMed was performed to identify relevant studies. To assess the association between hyperlipidemia and glaucoma, we used the pooled odds ratio (OR) with 95% confidence interval (CI). When we assessed the association between blood lipid levels and IOP levels, the pooled mean difference in IOP associated with a 10 mg/dL increase in the blood lipid level was estimated. The pooled difference in IOP was also estimated between patients with and without hyperlipidemia. All the papers that assessed the correlation between hyperlipidemia and glaucoma, between blood lipid levels and IOP levels, and between hyperlipidemia and IOP were included in this meta-analysis. RESULTS. We detected a marked association between hyperlipidemia and glaucoma (OR ¼ 1.37; 95% CI ¼ 1.16-1.61), with significant heterogeneity among studies. However, hyperlipidemia was not significantly associated with glaucoma in our analysis of only crosssectional studies, studies that reported only on hypercholesterolemia patients, studies that were conducted only in North America and Europe, or studies in which normal-tension glaucoma (NTG) patients were included only in the subgroup analyses. The pooled results showed that an increase of 10 mg/dL in blood triglyceride levels would increase the IOP by 0.016 mm Hg (95% CI ¼ 0.009-0.024), with evident heterogeneity between studies (P < 0.001; I 2 ¼ 92.0%). The pooled results showed that the blood total cholesterol and lowdensity lipoprotein-cholesterol (LDL-c) level both had a significant association with IOP. When compared to the patients with nonhyperlipidemia, those with hyperlipidemia had a significantly higher IOP of 0.51 mm Hg (95% CI ¼ 0.18-0.83) (P ¼ 0.001 for heterogeneity; I 2 ¼ 81.6%). CONCLUSIONS. The evidence suggests that hyperlipidemia is significantly associated with an increased risk of glaucoma and that hyperlipidemia and the increased blood lipid levels are associated with increased IOP.

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Section: Discussionmentioning

confidence: 99%

Hyperlipidemia, Blood Lipid Level, and the Risk of Glaucoma: A Meta-Analysis

Wang

Bao

2019

Invest. Ophthalmol. Vis. Sci.

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“…Development of OAG was defined as satisfying the following three criteria, as assessed by an ophthalmologist: (i) being diagnosed with ‘primary open‐angle glaucoma’ (KCD code H401, corresponding to ICD‐9 code 365.11); (ii) undergoing a visual field test more than once and (iii) being prescribed an antiglaucoma medication on the day of diagnosis (Rim, Lee, Bae, et al. ; Rim, Lee, Kim, et al. ).…”

Section: Methodsmentioning

confidence: 99%

Increased risk of open‐angle glaucoma among patients with diabetes mellitus: a 10‐year follow‐up nationwide cohort study

Rim

Lee

Bae

et al. 2018

Acta Ophthalmologica

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“…The association between glaucoma and neurologic disease has been investigated in several previous studies by evaluating pathogenic mechanisms like neurotoxicity caused by amyloid-beta, Tau protein, autophagy downregulation, dopamine depletion, and alteration of the hemodynamics of a cerebral artery with white matter lesions 17 . Several experts have suggested a correlation between glaucoma and stroke 18 – 21 . Alzheimer’s disease 22 – 24 and Parkinson’s disease 25 – 27 are representative neurologic disorders that are reportedly associated with glaucoma.…”

Section: Discussionmentioning

confidence: 99%

Association between glaucoma surgery and all-cause and cause-specific mortality among elderly patients with glaucoma: a nationwide population-based cohort study

Lee

et al. 2021

Sci Rep

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This population-based, retrospective cohort study aimed to evaluate the association between glaucoma surgery and all-cause and cause-specific mortality among Korean elderly patients with glaucoma. A total of 16210 elderly patients (aged ≥ 60 years) diagnosed with glaucoma between 2003 and 2012 were included, and their insurance data were analyzed. The participants were categorized into a glaucoma surgery cohort (n = 487), which included individuals who had diagnostic codes for open angle glaucoma (OAG) or angle closure glaucoma (ACG) and codes for glaucoma surgery, and a glaucoma diagnosis cohort (n = 15,723), which included patients who had codes for OAG and ACG but not for glaucoma surgery. Sociodemographic factors, Charlson Comorbidity Index score, and ocular comorbidities were included as covariates. Cox regression models were used to assess the association between glaucoma surgery and mortality. The incidence of all-cause mortality was 34.76/1,000 person-years and 27.88/1,000 person-years in the glaucoma surgery and diagnosis groups, respectively. The adjusted hazard ratio (HR) for all-cause mortality associated with glaucoma surgery was 1.31 (95% confidence interval [CI], 1.05–1.62, P = 0.014). The adjusted HR for mortality due to a neurologic cause was significant (HR = 2.66, 95% CI 1.18–6.00, P = 0.018). The adjusted HRs for mortality due to cancer (HR = 2.03, 95% CI 1.07–3.83, P = 0.029) and accident or trauma (HR = 4.00, 95% CI 1.55–10.34, P = 0.004) associated with glaucoma surgery for ACG were significant as well. Glaucoma surgery was associated with an increase of mortality in elderly patients with glaucoma. In particular, the risk of mortality associated with glaucoma surgery due to neurologic causes was significant.

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Increased stroke risk among patients with open-angle glaucoma: a 10-year follow-up cohort study

Abstract: Patients who were diagnosed with OAG were more likely to experience subsequent stroke than comparison group without OAG, and the risk was greater for older adults and males.

Cited by 29 publications

References 24 publications

Hyperlipidemia, Blood Lipid Level, and the Risk of Glaucoma: A Meta-Analysis

Hyperlipidemia, Blood Lipid Level, and the Risk of Glaucoma: A Meta-Analysis

Increased risk of open‐angle glaucoma among patients with diabetes mellitus: a 10‐year follow‐up nationwide cohort study

Association between glaucoma surgery and all-cause and cause-specific mortality among elderly patients with glaucoma: a nationwide population-based cohort study

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