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Konstantin Astafurov, Brian Ibabao, Leslie Hyman, John Danias; Association between periodontal disease and primary open angle glaucoma. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2117.
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Chronic inflammation outside the central nervous system in general, and periodontal disease in particular, have been recently suggested to play a role in the pathogenesis of primary open angle glaucoma (POAG). This research work aimed to investigate the association between moderate/severe periodontal disease and POAG in a retrospective claims-based study.
Billing records from patients >40 years old seen at both the Ophthalmology (n=34, 570 visits) and Dental (n=31,194 visits) Clinics of Kings County Hospital from April 2012 to March 2015 were reviewed for presence/absence of POAG and history of periodontal treatment. Patients with ICD-9 codes for non-POAG glaucoma or various inflammatory and pathologic vascular ocular conditions were excluded from further review. Cases had at least 2 visits to the Ophthalmology Clinic for POAG-associated ICD-9 codes (365.10, 365.11). Controls were patients with at least two visits to the Ophthalmology Clinic for common ocular conditions such as dry eye syndrome, age-related cataract, refractive error, etc without glaucoma-associated ICD-9 codes (365.xx). Presence of moderate/severe periodontitis was defined by whether they had undergone at least one periodontal treatment procedure, indicated by specific dental Current Procedural Terminology (CPT) codes during the study period.
Of the 7,600 patients identified from the record review 392 met the study eligibility criteria for POAG cases and 2414 were eligible as Controls. 3,025 periodontal dental procedures had been performed during the study period. Moderate/severe periodontitis was present in 11.5% of POAG patients and 7.7% of controls (Odds Ratio (OR): 1.61 95% CI (1.15-2.33), p<0.007). Moderate/severe periodontal disease remained associated with POAG in a multivariate logistic regression model adjusting for age and sex (OR: 1.66, 95% CI (1.17-2.35), p < 0.005).
Moderate/severe periodontal disease was associated with POAG in this retrospective claims-based study. Limitations of the study include ascertainment bias, inability to confirm the absence of periodontitis, and possible selection bias. Despite these limitations, the results support a possible link between periodontal disease and POAG.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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