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M. Hsu, H. N. Saeed, C. Mata, C. Song, U. Tailor, V. Badlani; The Association of Primary Open Angle Glaucoma and Diabetes Mellitus in the Hines Veterans Population. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3973.
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Primary open angle glaucoma (POAG) is one of the leading causes of blindness worldwide. There is still much debate regarding the effects of diabetes mellitus (DM) on the progression or development of POAG. The primary goal of our retrospective chart review of 8602 charts was to explore the association between DM and POAG in the veteran patient population at the Hines Veterans Affair's (HVA) eye clinic.
A database search was conducted of the national VA administrative data identifying all patients seen in the HVA eye clinic for fiscal years (FY) 2007 and 2008. Patients were grouped by the presence of DM and/or POAG as determined by ICD-9 coding. The patients' charts were reviewed to identify any reasons for exclusion including glaucoma classified as anything other than POAG, optic neuropathy, or any diagnosis that could produce confounding visual fields or elevate intraocular pressure.Baseline data was also recorded from all HVA patients seen in FY 2007 and 2008. This included age, race, and sex which was obtained from the demographic information from the electronic medical record. A history of migraine, hypertension, or cerebral vascular accident was also recorded.
Numerous studies have previously examined the association between DM and POAG, but no agreement has been reached on this association. It is uncertain whether DM is protective, increases the risk of POAG, or has no effect. Our study aimed to offer further evidence in support of one of these possible outcomes. Our final data based on ICD-9 coding shows no association between POAG and DM. Statistical significance was reached with c2 = 5.81, p = .016, but the difference in percentages of those with POAG (21.3% vs. 19.2%) was too close to be of clinical utility. In the future, we hope to retrospectively review these charts to confirm the diagnosis of DM and POAG by the most recent primary care provider's note and ophthalmology clinic note, respectively, in order to determine the accuracy of ICD-9 coding at the HVA eye clinic.
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