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Jessica Prince, Noah Geberer, Wen-Jeng (Melissa) Yao, Barrett Katz; The Relationship of Body Mass Index (BMI) to Glaucoma. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3510.
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Glaucoma is a pressure-related progressive optic neuropathy characterized by optic disc excavation and visual field loss. Variables found to be risk factors in addition to elevated intraocular pressure include thin corneal thickness and advancing age. Recently, body mass index (BMI) has been implicated - in an inverse relationship - as an additional risk factor for open angle glaucoma (OAG). The purpose of this study is to explore the relationship of BMI to the prevalence of OAG in an urban population.
Clinical Looking Glass (CLG) is an electronic medical record data set that captures all clinical interactions for all patients seen at our center. This data set was used to identify by ICD-9 codes all subjects aged 18-85 years who had all types of glaucoma and had any visit to Montefiore Medical Center between November 2002 and November 2012. All subjects who carried the diagnosis of glaucoma and had both a documented height and weight value within a year of diagnosis were included in our analysis. BMI was calculated using the standard equation (weight in kg/height in m2) and then stratified into groups for further analysis (BMI < 25 and BMI > 25). Demographic data - including age, race, and gender - were also included in our analysis.
We identified 21,479 unique patients with a diagnosis of glaucoma seen over the last 10 years. Of these, 9,338 subjects (43.5%) had both height and weight measured within a year of when the glaucoma diagnosis was first noted. We calculated BMI values in all our 1,673 subjects with OAG (identified by ICD-9 diagnosis codes 365.10-11). 25.9% (n = 434) of our subjects with OAG had a BMI < 25; 74.1% (n = 1,239) had a BMI > 25. The majority of our OAG patients were African American (n = 957, 57.2%), with average age of 70.2 years; 59% were female.
A BMI > 25 was present in 74.1% of our 1,673 subjects with OAG. This prevalence of high BMI values in our subjects with concomitant OAG differs from recent reports where low BMI had been associated with pressure-related optic neuropathy.
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