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M. S. Lee, D. Grossman, A. R. Harrison, F. A. Sloan; Benign Essential Blepharospasm Increases Risk of Open Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5845.
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The intraocular pressure rises substantially with forced eyelid closure. Patients with benign essential blepharospasm (BEB) experience increased frequency of blinking and spastic closure of the eyelids. Intraocular pressure variability is a risk factor for progression in primary open angle glaucoma (POAG). We sought to determine if patients with BEB are more likely to develop open angle glaucoma than a control population.
Medicare claims files were used to identify a nationally-representative sample of patients who received a diagnosis of BEB from 1994-2000. A randomly-selected control group without BEB matched for gender, race, age, and year of study entry was created. BEB patients and controls were followed for the development of primary open angle glaucoma (POAG), closed angle glaucoma, other glaucoma (glaucoma besides POAG and closed angle), and any glaucoma over the course of the following 2,190 days or until they left the Medicare system.
There were 1,829 BEB patients in the analysis sample and 1,829 control patients. Each group comprised 29% men, 92% white, and the mean age was 76 years. In the unadjusted model, persons in the BEB group were significantly more likely to develop POAG (Hazard ratio (HR): 1.557; 95% Confidence Interval (CI): 1.183,2.048), other glaucoma(HR: 1.397; 95% CI: 1.008,1.936), and any glaucoma (HR: 1.311: 95% CI:1.057,1.626) compared to controls. The BEB group did not develop closed angle glaucoma more often than the non BEB control group (HR: 0.872; 95% CI: 0.581,1.897). Adjusting for age, gender, race, and other eye disease, persons diagnosed with BEB were still significantly more likely to develop POAG (HR: 1.547; 95% CI: 1.174,2.037) and any glaucoma (HR: 1.297; 95% CI: 1.045,1.610). Persons diagnosed with BEB were no longer statistically significantly more likely to develop other glaucoma (HR: 1.372; 95% CI: 0.988,1.905). A diagnosis of BEB did not affect a person's adjusted likelihood of developing closed angle glaucoma (HR: 1.023; 95% CI: 0.566,1.850).other glaucoma (HR: 1.285; 95% CI:1.069,1.544)
Benign essential blepharospasm increases the risk of developing open angle glaucoma. It does not affect the likelihood of the development of closed angle glaucoma or other forms of glaucoma.
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