Open-angle glaucoma and systemic thyroid disease in an older population: The Blue Mountains Eye Study

Abstract

Purpose To assess whether thyroid disease is independently associated with open-angle glaucoma (OAG), using history of thyroid disease and current thyroxine use. Methods The Blue Mountains Eye Study examined 3654 persons, aged 49-97 years. Interviewers collected self-reported history of diagnosis and treatment for thyroid disease. Eye examinations included applanation tonometry, stereoscopic optic disc photography and automated perimetry. OAG was diagnosed from the presence of matching typical glaucomatous field changes and optic disc cupping, independent of intraocular pressure. Associations between thyroid disease (history and treatment) and OAG were assessed in a multivariate model. Results Of 324 participants (8.9%) reporting history of thyroid disease, 147 (4.0%) were currently using thyroxine. Although we could not accurately categorize the thyroid disorder for all cases, current use of thyroxine suggests a prior hypothyroid state. All thyroid disease subgroups affected women more frequently than men, P ¼ 0.001. OAG was diagnosed in 108 subjects (3.0%) and was more frequent in those reporting past thyroid disease (4.6 vs 2.8%). This relationship was not statistically significant after adjusting for potential confounders, multivariate odds ratio (OR) 1.6; 95% confidence interval (95% CI) 0.9-2.9. OAG was significantly more frequent, however, in subjects reporting current thyroxine use (6.8 vs 2.8%), multivariate OR 2.1; 95% CI 1.0-4.4, or history of thyroid surgery (6.5 vs 2.8%), multivariate OR 2.5; 95% CI 1.0-6.2.Conclusions This population-based study suggests that thyroid disease, indicated by current thyroxine use or past thyroid surgery, could be independently related to OAG.

Risk factors for primary open-angle glaucoma in South Korea: the Namil study

“…A history of thyroid disease was a risk factor for the overall POAG and NTG. This is consistent with a finding of the Blue Mountains study, which showed an association between thyroid disease and POAG [13]. The cited work also found more lower than high-tension glaucoma patients among POAG patients with thyroid disease.…”

“…Elevated intraocular pressure (IOP), older age [5,6] and African ancestry [2] have been shown to be strongly associated with POAG. A number of other risk factors, including myopia [6,7], a family history of POAG [8,9], a thinner central cornea [9,10], smoking [11] and a history of thyroid disease [12,13], are suggested to be risk factors. However, the studies are not consistent in their findings.…”

Risk Factors and Open-angle Glaucoma: Classification and Application

“…The Blue Mountains prevalence survey found that those with OAG were about twice as likely to be receiving thyroxine treatment or to have had past thyroidectomy. 64 A large database survey found that newly coded OAG patients have 1.4 times the general risk for hypothyroidism. 65 …”

The effect of orbital decompression surgery on refraction and intraocular pressure in patients with thyroid orbitopathy

“…Most reports, however, have not found a significant association between thyroid dysfunction and POAG (Table 2). 2,[23][24][25][26][27] No patients were excluded from this audit because of a diagnosis of POAG, nor were any patients treated on ocular anti-hypertensive treatments prior to decompression surgery.…”