The Role of Hypertension and Type II Diabetes in Glaucoma Severity

BACKGROUND: Hypertension (HTN) and Type II Diabetes (DM) are risk factors associated with the development of primary open angle glaucoma (POAG), but the effects of these diseases on POAG severity are not well known. OBJECTIVE: To evaluate for differences in glaucoma severity for patients with (1) HTN alone, (2) DM alone, (3) both HTN and DM, and (4) neither HTN nor DM. METHODS: In this IRB approved retrospective chart review study, we selected a total of 767 patients with POAG or ocular hypertension (OHT) seen at UT Southwestern Aston eye clinic in Dallas, Texas. The inclusion criteria were patients who were > 18 years old, had open angles, and no evidence of secondary glaucoma or retinal/optic nerve pathologies. Variables collected included: visual acuity, intraocular pressure, central corneal thickness, visual fields, blood pressure, HgbA1c, demographic factors (age, race, gender), and optic coherence tomography angiography (OCTA) data such as mean macular vessel density (VD), peripapillary VD, peripapillary retinal nerve fiber layer (RNFL), and total ganglion cell complex (GCC). RESULTS/CONCLUSION: Out of a total of 1104 participants reviewed, we selected 767. Among the included patients, there were 149 (19.5%) subjects without POAG, 122 (15.9%) with OHT, 95 (12.4%) with mild POAG, 137 (17.9%) with moderate POAG, and 262 (34.2%) with severe POAG. Regarding the four comorbid disease groups of interest, there were 212 (27.6%) control patients with neither HTN nor DM, 318 (41.5%) with HTN alone, 47 (6.1%) with DM alone, and 190 (24.8%) with both HTN and DM. All comorbidity groups had more female than male, and the average age of the groups ranged from 66-72 years old. We did not find a significant difference in the distribution of glaucoma severity between those with HTN/DM and those without. OCTA analysis corroborated our findings.