Purpose
To investigate the association between the prevalence of visual field abnormalities and both diabetes status as well as antihypertensive use in a sample of the United States population.
Methods
This cross-sectional study included 4423 participants in the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2008, age≥ 40 years, without diabetic retinopathy, who demonstrated presence or absence of a visual field defect determined by the NHANES 2-2-1 Algorithm for Frequency Doubling Technology (FDT) N-30-5. Demographic, comorbidity, and health-related behavior information was obtained via interview and multiple blood pressure measurements were recorded. Participants with diastolic blood pressure (DBP) ≤80mmHg were divided into four groups defined by whether or not they self-reported antihypertensive medication use and diabetes. Multivariate logistic regression analyses were used to assess the relationship between the prevalence of visual field abnormality and diabetes status as well as the use of antihypertensive treatment. The group without diabetes and antihypertension treatment served as the reference standard in these analyses.
Results
Among participants with DBP ≤80mmHg, those with diabetes who were receiving antihypertensive medications had significantly higher odds of visual field abnormalities compared to participants without diabetes not taking antihypertensives, after adjustment for confounders (OR 1.75, 95% CI 1.05-3.03).
Conclusions
Our finding of significantly increased odds of visual field abnormalities among participants who have diabetes and are taking antihypertensive medications suggests a vascular component in the pathogenesis of glaucomatous disease. Such an effect can be hypothesized to be a consequence of decreased ocular perfusion amongst those with compromised circulation with resultant optic nerve injury.