Thursday, 28 November 2013

Glaucoma – The Risk Factors

Glaucoma is a medical condition of an eye disease as result of the damage of the nerve of eye’s optic over time. If left untreated, it can lead to permanently vision impair and blindness.
B. Risk Factors
1. In a Randomly selected subjects 60 years of age and older (n=2554) participated in the Thessaloniki Eye Study by the Aristotle University of Thessaloniki, indicated that(15)
In the study to assess the prevalence of primary angle-closure glaucoma (PACG)n in Northern Italy, showed that In multivariate analysis restricted to persons who participated in clinic visits and who had at least 1 phakic eye (n=2078)
a. Intraocular pressure (IOP)(odds ratio [OR], 1.21 per 1 mm Hg; P<.001),
b. PEX (OR, 2.81; P<.001),
c. History of coronary artery bypass or vascular surgery (OR, 1.95; P=.017), and
d. Moderate-to-high myopia (≥ -3 diopters; OR, 2.40; P=.009) were associated with higher odds for Open-angle glaucoma (OAG).
2. In analysis including all clinic visits (n=2261), age became significantly associated (OR, 1.05; P=.004). In multivariate analysis for primary open-angle glaucoma (POAG) (n=1840), associations were found for
a. Age (OR, 1.04 per year; P=.048), IOP (OR, 1.19 per 1 mm Hg; P<.001),
In recent decades the problem of low vision and blindness in elderly people became major and socially significant issue. The number of patients having age-related macular degeneration (AMD) in association with glaucoma grows all over the world that attaches medical and social value to this problem, according to study
b. History of coronary artery bypass or vascular surgery (OR, 2.09; P=.01), and
c. History of diabetes treated with insulin (OR, 3.05; P=.045).
In multivariate analysis for PEXG (n=238), the latter was associated with increased IOP (OR, 1.25 per 1 mm Hg; P<.001)(14).
3. Medical conditions and medication use
Certain medical conditions, such as diabetes, heart diseases, high blood pressure and hypothyroidism and medication used such as corticosteroid for a prolonged period of time are associated with increased risk of Glaucoma. In a case-crossover study design to investigate the association between recent exposure to antidepressant drugs and AACG, showed that recent exposure to antidepressant drugs is associated with an increased risk of AACG. Clinicians should remain vigilant for the development of this uncommon but potentially serious adverse event after initiating antidepressant therapy(14a).
4. Other risk factors
Other study indicated there are growing evidences suggested that other risk factors like age, gender, race, refractive error, heredity and systemic factors may play a role in glaucoma pathogenesis. Many studies found that high myopia has been associated with POAG, however, direct and convincing evidences are still lacking(16).
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Sources
(a) tp://www.glaucoma.org/glaucoma/types-of-glaucoma.php
(14) http://www.ncbi.nlm.nih.gov/pubmed/23367753
(14a) http://www.ncbi.nlm.nih.gov/pubmed/22544015
(15) http://www.ncbi.nlm.nih.gov/pubmed/21664597
(16) http://www.ncbi.nlm.nih.gov/pubmed/23275912

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