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Diabetes, fasting glucose, and the risk of glaucoma: a meta-analysis.
Ophthalmology 2015; 122(1):72-8O

Abstract

TOPIC

We performed a systematic review to summarize the association of diabetes and blood glucose levels with glaucoma, intraocular pressure (IOP), and ocular hypertension in the general population.

CLINICAL RELEVANCE

Diabetes has been proposed as a risk factor for glaucoma, but epidemiologic studies have been inconsistent, and the association is still controversial. Furthermore, no systematic reviews evaluated other metabolic abnormalities, such as the metabolic syndrome, with the risk of glaucoma.

METHODS

We identified the studies by searching the PubMed and EMBASE databases. We used inverse-variance weighted random-effects models to summarize relative risks across studies.

RESULTS

We identified 47 studies including 2 981 342 individuals from 16 countries. The quality of evidence generally was higher in the cohort compared with case-control or cross-sectional studies. The pooled relative risk for glaucoma comparing patients with diabetes with those without diabetes was 1.48 (95% confidence interval [CI], 1.29-1.71), with significant heterogeneity across studies (I(2) = 82.3%; P < 0.001). The risk of glaucoma increased by 5% (95% CI, 1%-9%) for each year since diabetes diagnosis. The pooled average difference in IOP comparing patients with diabetes with those without diabetes was 0.18 mmHg (95% CI, 0.09-0.27; I(2) = 73.2%), whereas the pooled average increase in IOP associated with an increase in 10 mg/dl in fasting glucose was 0.09 mmHg (95% CI, 0.05-0.12; I(2) = 34.8%).

CONCLUSIONS

Diabetes, diabetes duration, and fasting glucose levels were associated with a significantly increased risk of glaucoma, and diabetes and fasting glucose levels were associated with slightly higher IOP.

Authors+Show Affiliations

Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland; Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea; Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, School of Medicine, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.Saevit Eye Hospital, Goyang, Gyeonggi-do, Korea; Department of Epidemiology, Graduate School of Public Health, Seoul National University, Seoul, Korea. Electronic address: philip.mhkim@gmail.com.Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

25283061

Citation

Zhao, Di, et al. "Diabetes, Fasting Glucose, and the Risk of Glaucoma: a Meta-analysis." Ophthalmology, vol. 122, no. 1, 2015, pp. 72-8.
Zhao D, Cho J, Kim MH, et al. Diabetes, fasting glucose, and the risk of glaucoma: a meta-analysis. Ophthalmology. 2015;122(1):72-8.
Zhao, D., Cho, J., Kim, M. H., Friedman, D. S., & Guallar, E. (2015). Diabetes, fasting glucose, and the risk of glaucoma: a meta-analysis. Ophthalmology, 122(1), pp. 72-8. doi:10.1016/j.ophtha.2014.07.051.
Zhao D, et al. Diabetes, Fasting Glucose, and the Risk of Glaucoma: a Meta-analysis. Ophthalmology. 2015;122(1):72-8. PubMed PMID: 25283061.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diabetes, fasting glucose, and the risk of glaucoma: a meta-analysis. AU - Zhao,Di, AU - Cho,Juhee, AU - Kim,Myung Hun, AU - Friedman,David S, AU - Guallar,Eliseo, Y1 - 2014/10/03/ PY - 2014/04/02/received PY - 2014/05/16/revised PY - 2014/07/28/accepted PY - 2014/10/7/entrez PY - 2014/10/7/pubmed PY - 2015/3/13/medline SP - 72 EP - 8 JF - Ophthalmology JO - Ophthalmology VL - 122 IS - 1 N2 - TOPIC: We performed a systematic review to summarize the association of diabetes and blood glucose levels with glaucoma, intraocular pressure (IOP), and ocular hypertension in the general population. CLINICAL RELEVANCE: Diabetes has been proposed as a risk factor for glaucoma, but epidemiologic studies have been inconsistent, and the association is still controversial. Furthermore, no systematic reviews evaluated other metabolic abnormalities, such as the metabolic syndrome, with the risk of glaucoma. METHODS: We identified the studies by searching the PubMed and EMBASE databases. We used inverse-variance weighted random-effects models to summarize relative risks across studies. RESULTS: We identified 47 studies including 2 981 342 individuals from 16 countries. The quality of evidence generally was higher in the cohort compared with case-control or cross-sectional studies. The pooled relative risk for glaucoma comparing patients with diabetes with those without diabetes was 1.48 (95% confidence interval [CI], 1.29-1.71), with significant heterogeneity across studies (I(2) = 82.3%; P < 0.001). The risk of glaucoma increased by 5% (95% CI, 1%-9%) for each year since diabetes diagnosis. The pooled average difference in IOP comparing patients with diabetes with those without diabetes was 0.18 mmHg (95% CI, 0.09-0.27; I(2) = 73.2%), whereas the pooled average increase in IOP associated with an increase in 10 mg/dl in fasting glucose was 0.09 mmHg (95% CI, 0.05-0.12; I(2) = 34.8%). CONCLUSIONS: Diabetes, diabetes duration, and fasting glucose levels were associated with a significantly increased risk of glaucoma, and diabetes and fasting glucose levels were associated with slightly higher IOP. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/25283061/Diabetes_fasting_glucose_and_the_risk_of_glaucoma:_a_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(14)00697-6 DB - PRIME DP - Unbound Medicine ER -