International Journal of Health Research and Medico Legal Practice

Open Access Open Access  Restricted Access Subscription Access

Prevalence of Glaucoma amongst Diabetic Patients Attending a Tertiary Health Care in North Eastern India


Affiliations
1 Dept. of Ophthalmology, RIO, Gauhati Medical College & Hospital (GMCH), Guwahati-32, Assam, India
 

Introduction: Glaucoma and the angiopathy of Diabetes Mellitus (DM) constitute a significant amount of blinding diseases of human beings. DM has been suggested as risk factors for Primary Open Angle Glaucoma (POAG) and Neovascular Glaucoma (NVG). Thus, with the alarming rise in Diabetes prevalence globally; the establishment of DM as a major risk factor for POAG and NVG and the matter of blindness following glaucoma and its management are of grave concern. Methods: The present study was conducted on 1200 diabetic patients between 15 - 75 years of age attending the Endocrinology and Ophthalmology departments. Systemic, routine ophthalmic examination and laboratory investigations were done in all cases. Applanation tonometry, slit lamp biomicrocopy, gonioscopy and disc evaluation using Goldman 3 -mirror lens, +90 D lens and visual field examination (using Humphrey visual field analyzer utilizing SITA standard strategy program 30-2) was performed. Results and Discussions: Among 1200 patients, POAG was found in 7.0% (n=84), Ocular hypertension (OHT) in 3.33% (n=40) and NVG in 2.33% (n=28). The prevalence of POAG in this study was nearly 5-6 times higher than that as seen in the general population. All the patients with NVG had PDR. Pupillary margin neovascularization preceded anterior chamber angle neovascularization in all these patients. POAG was seen to be more prevalent amongst OHA treated diabetics (8.25%), neovascular glaucoma amongst insulin treated (3.18%) and ocular hypertension showed no relationship to treatment pattern. Conclusion: POAG was found to be more prevalent amongst patients suffering from diabetes mellitus as compared to the general population and NVG was found in a significant proportion of diabetics with proliferative diabetic retinopathy.

Keywords

Diabetes Mellitus, Primary Open Angle Glaucoma, Neovascular Glaucoma.
User
Notifications
Font Size

  • Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol 2006;90(3):262-7.

  • Krishnaiah S, Kovai V, Srinivas M, Bindiganavale RS, Rao GN, Thomas R. Awareness of Glaucoma in the Rural Population of Southern India. Indian J Ophthalmol 2005 Sep;53:205-208.

  • Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Prac 2010 Jan;87(1):4-14.

  • Armstrong JR, Daily RK, Dobson HL, Girard LJ. The incidence of glaucoma in diabetes mellitus. A comparision with the incidence of glaucoma in the general population. Am J Ophthalmol 1960;50:55.

  • Klein BE, Klein R, Jensen SC. Open angle glaucoma and older onset diabetes. The Beaver Dam Eye Study. Ophthalmology 1994 Jul;101(7):1173-7.

  • Ohrt V. The frequency of rubeosis iridis in diabetic patients. Acta Ophthalmol 1971;49:301.

  • Shaffer RN. Symposium: Primary glaucomas- gonioscopy, ophthalmoscopy and perimetry. Trans Am Acad Ophthalmol Otol 1960;62:112.

  • Deepthi S, Gopal B. Prevalence of different types of glaucoma in type 2 diabetics and non-diabetics – A comparative study. Intl J Current Med Res 2015 June;4(6):379-380.

  • Nielsen NV. The prevalence of Glaucoma and Ocular hypertension in type 1 and 2 Diabetes mellitus on epidemiological study of diabetes on the island of Falster, Denmark. Acta Ophthalmol 1983;61:662-72.

  • Greco AV, Ricci B, Ghirlanda G, Fedeli G. Diabetes mellitus and Glaucoma, Ophthalmol Lit 1974;26:487.

  • Ellis JD, Evans JMM, Ruta AR, Baines PS, Leese G, Mac Donald TM. Glaucoma incidence in an unselected cohort of diabetic patients: Is diabetes mellitus a risk factor for glaucoma? Br J Ophthalmol 2000 Nov;84:1218-1224.

  • Shukla AK, Shankar V. Are patients with diabetes more susceptible to open angle glaucoma? Ophthalmology Times Europe [Internet]. 2009 April; Available from: www.oteurope.com/ophthalmologytimeseurope/article/articleDetail.jsp?id=590441&sk=date=&pageID=2

  • Becker B, Roth FD, Kolker AE. Glaucoma Family Study. Am J Ophthalmol 1960;50(4):557-567.

  • E Marre. Glaucoma in diabetes mellitus. Ophthalmol Lit 1968;22:324.

  • Mitchell P, Smith W, Chey T, Healey P. Open–angle glaucoma and diabetes: the Blue Mountain Eye Study,Australia. Ophthalmol 1997;104:712-718.

  • Pasquale LR, Kang JH, Manson JE, Willet WC, Rosner BA, Hankinson SE. Prospective study of type 2 diabetes mellitus and risk of primary open-angle glaucoma in women. Ophthalmol 2006;113:1081-1086.

  • Chopra V, Varma R, Francis BA, Wu J, Torres M, Azen SP. Type 2 diabetes mellitus and the risk of open-angle glaucoma: the Los Angeles Latino Eye Study. Ophthalmol 2008;115:227-232.

  • Leske MC, Wu SY, Hennis A, Honkanen R, Nemesure B, BESs Study Group. Risk factors for incidence of open-angle glaucoma. The Barbados Eye Studies. Ophthalmol 2008;115:85-93.

  • Le A, Mukesh BN, McCarty CA, Taylor HR. Risk factors associated with the incidence of open-angle glaucoma: the Visual Impairment Project. Invest Ophthalmol Vis Sci 2003;44:3783-3739

  • Bankes JLK. Ocular tension and diabetes mellitus. Br J Opthalmol 1967;51:557-561.

  • Tielsch JM, Katz J, Quigley HA, Javitt JC, Sommer A. Diabetes, intraocular pressure and primary open-angle glaucoma in the Baltimore Eye Survey. Ophthalmol 1995 Jan;102(1):48-53

  • Becker B, Bresnik G, Chevrette L, Kolker AE, Oaks MC, Cibis A. Intraocular pressure and its response to topical corticosteroids in diabetes. Arch Ophthalmol 1966;76:477-483.

  • Jain IS,Luthra CL. Diabetic retinopathy:Its relationship with intraocular pressure. AMA Arch Opthalmol 1967;78:198.

  • Grimaldi A, Basquet F. La medicine en France 1989;35:62-65.

  • Xu L, Xie XW, Wang YX, Jonas JB. Ocular hypertension and diabetes mellitus in the Beijing Eye Study. J Glaucoma 2009 Jan;18(1):21-5

  • Poinoosawmy D, Gloster J, Nagasubramanian S, Hitchings RA. Association between optic disc hemorrhages in glaucoma and abnormal glucose tolerance. Br J Ophthalmol 1986;70:599.

  • Zeiter JH, Shin DH, Back NH. Visual Field defects in diabetic patients with primary open angle glaucoma. Am J Ophthalmol 1991 May;111(5):581-4.

  • Armaly MF, Baloglou PJ. Diabetes and the eye. Change in the Anterior Segment. Arch Ophthalmol 1967;77:485.

  • Yanoff M, Fine BS. Ocular pathology: A text and atlas, Harper and Row Publishers. 1982;2:844-51.

  • Browning DJ. Risk of missing angle neovascularization by omitting screening gonioscopy in patients with diabetes mellitus (letter). Am J Ophthalmol 1991;112:212.

  • Kevin JB, Friedman SM, Mames RN. Diabetic Iris neovasculariation. AJO 1995;120:393-395.

  • Tiech SA,Walsh JB. A grading system for iris neovascularization: prognostic implications for treatment. Ophthalmol 1981;88:1102-6.

  • Ohrt V. Glaucoma due to rubeosis iridis diabetic. Ophthalmologica 1961;142:356.


Abstract Views: 139

PDF Views: 75




  • Prevalence of Glaucoma amongst Diabetic Patients Attending a Tertiary Health Care in North Eastern India

Abstract Views: 139  |  PDF Views: 75

Authors

Deka C. Dipali
Dept. of Ophthalmology, RIO, Gauhati Medical College & Hospital (GMCH), Guwahati-32, Assam, India
Sarma Santana
Dept. of Ophthalmology, RIO, Gauhati Medical College & Hospital (GMCH), Guwahati-32, Assam, India

Abstract


Introduction: Glaucoma and the angiopathy of Diabetes Mellitus (DM) constitute a significant amount of blinding diseases of human beings. DM has been suggested as risk factors for Primary Open Angle Glaucoma (POAG) and Neovascular Glaucoma (NVG). Thus, with the alarming rise in Diabetes prevalence globally; the establishment of DM as a major risk factor for POAG and NVG and the matter of blindness following glaucoma and its management are of grave concern. Methods: The present study was conducted on 1200 diabetic patients between 15 - 75 years of age attending the Endocrinology and Ophthalmology departments. Systemic, routine ophthalmic examination and laboratory investigations were done in all cases. Applanation tonometry, slit lamp biomicrocopy, gonioscopy and disc evaluation using Goldman 3 -mirror lens, +90 D lens and visual field examination (using Humphrey visual field analyzer utilizing SITA standard strategy program 30-2) was performed. Results and Discussions: Among 1200 patients, POAG was found in 7.0% (n=84), Ocular hypertension (OHT) in 3.33% (n=40) and NVG in 2.33% (n=28). The prevalence of POAG in this study was nearly 5-6 times higher than that as seen in the general population. All the patients with NVG had PDR. Pupillary margin neovascularization preceded anterior chamber angle neovascularization in all these patients. POAG was seen to be more prevalent amongst OHA treated diabetics (8.25%), neovascular glaucoma amongst insulin treated (3.18%) and ocular hypertension showed no relationship to treatment pattern. Conclusion: POAG was found to be more prevalent amongst patients suffering from diabetes mellitus as compared to the general population and NVG was found in a significant proportion of diabetics with proliferative diabetic retinopathy.

Keywords


Diabetes Mellitus, Primary Open Angle Glaucoma, Neovascular Glaucoma.

References