Type 2 diabetes mellitus and the risk of open-angle glaucoma the Los Angeles Latino Eye Study

Abstract

Purpose: To examine the relationship between type 2 diabetes mellitus (T2DM) and the risk of having open-angle glaucoma (OAG) in an adult Latino population.

Design: Population-based cross-sectional study.

Participants: Latinos 40 years and older (n = 5894) from 6 census tracts in Los Angeles, California.

Methods: Participants from the Los Angeles Latino Eye Study (LALES), a large population-based study of self-identified adult Latinos, answered an interviewer-administered questionnaire and underwent a clinical and complete ocular examination, including visual field (VF) testing and stereo fundus photography. A participant was defined as having diabetes mellitus (DM) if she or he had a history of being treated for DM, the participant's glycosylated hemoglobin was measured at 7.0% or higher, or the participant had random blood glucose of 200 mg% or higher. Type 2 DM was defined if the participant was 30 years or older when diagnosed with DM. Open-angle glaucoma was defined as the presence of an open angle and a glaucomatous VF abnormality and/or evidence of glaucomatous optic disc damage in at least one eye. Logistic regression analysis was used to identify the risk of having OAG in persons with T2DM.

Main outcome measure: Prevalence of OAG.

Results: Of the 5894 participants with complete data, 1157 (19.6%) had T2DM and 288 (4.9%) had OAG. The prevalence of OAG was 40% higher in participants with T2DM than in those without T2DM (age/gender/intraocular pressure-adjusted odds ratio, 1.4; 95% confidence interval, 1.03-1.8; P = 0.03). Trend analysis revealed that a longer duration of T2DM (stratified into 5-year increments) was associated with a higher prevalence of OAG (P<0.0001).

Conclusion: The presence of T2DM and a longer duration of T2DM were independently associated with a higher risk of having OAG in the LALES cohort. The high prevalences of T2DM and OAG and their association in this fastest growing segment of the United States population have significant implications for designing screening programs targeting Latinos.

Figure 1

Duration of type 2 diabetes mellitus versus estimated probability of open-angle glaucoma (OAG) in the Los Angeles Latino Eye Study participants. The LOWESS plot (a locally weighted regression), with 95% confidence intervals, uses an iterative, locally weighted, least-squares method to plot the best-fit line and has been adjusted for age, gender, and intraocular pressure.