To determine the prevalence of selected comorbidities in patients with open-angle glaucoma (OAG) and whether these comorbidities are more prevalent among individuals with OAG than those without OAG.
A retrospective, nationwide, case-control study using an administrative database.
The study group comprised 76,673 OAG patients. The comparison group comprised 230,019 subjects matched to the study cohort.
Data were collected retrospectively from the Taiwan National Health Insurance Research Database. The study cohort comprised all patients with a diagnosis of OAG (International Classification of Diseases, 9th Revision, Clinical Modification codes 365.1-365.11) in 2005 (n = 76,673). The comparison cohort comprised randomly selected patients (3 for every 1 OAG patient; n = 230,019) matched with the study group in terms of age, gender, urbanization level, and monthly income. In total, 31 medical comorbidities were selected based mainly on the Elixhauser Comorbidity Index. Separate conditional logistic regression analyses were used to estimate the adjusted odds ratio for each of the medical comorbidities between patients with and without OAG.
The prevalences of selected comorbidities.
More than half (50.5%) of the OAG patients had hypertension, and more than 30% had hyperlipidemia or diabetes (30.5% and 30.2%, respectively). The prevalences of 28 of 31 comorbidities were significantly higher for OAG patients than subjects without glaucoma after adjusting for age, gender, urbanization level, and monthly income. The adjusted odds ratio was more than 1.50 for hypertension, hyperlipidemia, systemic lupus erythematosus, diabetes, hypothyroidism, fluid and electrolyte disorders, depression, and psychosis. Among the studied comorbidities, the prevalence difference of the OAG group minus the control group was 3% or higher for hypertension, hyperlipidemia, stroke, diabetes, liver disease, and peptic ulcer.
Open-angle glaucoma patients are significantly more likely to have comorbidities, many of which can be life threatening or can affect the quality of life appreciably.
The author(s) have no proprietary or commercial interest in any materials discussedin this article
"Various types of epileptic seizures are common in persons with SLE . Persons with open-angle glaucoma appear to have elevated rates of hypertension, diabetes mellitus, and SLE . This paper is suggesting elevated NE signaling is an etiological factor in the autoimmune disorder, SLE. "
[Show abstract][Hide abstract] ABSTRACT: The neurotransmitter norepinephrine (NE) participates in a broad range of physiological functions, both in the brain and in the periphery, where it is a principal output molecule of the sympathetic nervous system. NE receptors are present in nearly all, if not all, organs of the body, which may allow this molecule to play a role in a variety of disease processes. This paper examines the hypothesis elevated NE signaling, through genetics and/or environmental factors, is an etiological factor in a variety of diseases outside of the brain, including age-related macular degeneration, systemic lupus erythematosus, atrial fibrillation, and metabolic syndrome. Lines of evidence presented to assess the hypothesis include: (1) studies of noradrenergic drugs modulating the four diseases; (2) association of these diseases with bipolar disorder, hypertension, and obesity, where the latter three conditions may involve elevated NE signaling; and (3) association with psychological stress, since NE is released in response to stress. Many of the studies cited tend to support the hypothesis, or are at least consistent with it. If the hypothesis is correct, perhaps a large number of individuals would benefit from chronically taking drugs that systemically diminish noradrenergic signaling, thereby helping prevent or treat a wide variety of diseases.
Medical Hypotheses 02/2013; 80(5). DOI:10.1016/j.mehy.2013.01.018 · 1.07 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Open-angle glaucoma (OAG) is associated with systemic metabolic and cardiovascular disorders, and both share common risk factors with erectile dysfunction (ED). However, few studies have investigated the association of ED with OAG. This study aimed to estimate the association of ED with prior OAG by using a nationwide, population-based data with a retrospective case-control cohort design in Taiwan.
Age-matched case-control study.
We identified 4605 patients with ED as the cases and randomly selected 23 025 subjects as the controls (5 controls to 1 case).
We used conditional logistic regression analysis to estimate the odds ratio and 95% confidence interval of having previously been diagnosed with OAG according to the presence/absence of ED after adjusting for patient's monthly income, geographical location, hypertension, diabetes, coronary heart disease, hyperlipidemia, obesity, and alcohol abuse.
We identified OAG cases not only based on an International Classification of Diseases, Ninth Revision, Clinical Modification code, but also by the prescription of topical antiglaucoma medication.
In total, prior OAG was found among 137 subjects (0.5 %); 53 individuals (1.1% of the ED patients) from the cases and 84 individuals (0.4% of patients without ED) from the controls. Conditional logistic regression analysis demonstrated that, after adjusting for potential confounders, patients with ED were more likely to have prior OAG than controls (odds ratio, 2.85; 95% confidence interval, 2.10-4.07).
This study identifies a novel association between ED and prior OAG.
[Show abstract][Hide abstract] ABSTRACT: To assess the risk factors for anxiety and depression in patients with glaucoma.
Anxiety and depression in 408 patients with glaucoma were evaluated using the hospital anxiety and depression scale (HADS) questionnaire, which consists of two subscales, representing HADS-anxiety (HADS-A) and HADS-depression (HADS-D). To identify the risk factors for anxiety and depression, the stepwise and multiple linear regression analyses were carried out with the HADS-A and HADS-D subscores as dependent variables and demographic and clinical features as independent variables.
A stepwise linear regression analysis revealed the significantly related factors to be age for HADS-A (β=-0.046, p=0.0007) and HADS-D (β=0.035, p=0.011) and the mean deviation of the Humphrey Visual Field Analyzer 30-2 (HFA30-2) in the better eye for HADS-D (β=-0.095, p=0.0026). Based on multiple linear regression analyses, significant relationships were confirmed between age and the HADS-A subscore (β=-0.046, p=0.0008). Significant relationships were also confirmed between age (β=0.037, p=0.0077) or the mean deviation of HFA30-2 in the better eye (β=-0.094, p=0.0036) and the HADS-D subscore.
A younger age was thus found to be a risk factor for anxiety, while an older age and increasing glaucoma severity were risk factors for depression in patients with glaucoma.
The British journal of ophthalmology 02/2012; 96(6):821-5. DOI:10.1136/bjophthalmol-2011-300910 · 2.98 Impact Factor
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