June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Comorbidity risk of diabetic retinopathy and glaucoma from the IRIS registry
Author Affiliations & Notes
  • Eun Young Choi
    Department of Ophthalmology, Schepens Eye Research Institute of Mass Eye and Ear, Boston, Massachusetts, United States
    Cambridge Health Alliance, Cambridge, Massachusetts, United States
  • Dian Li
    Department of Ophthalmology, Schepens Eye Research Institute of Mass Eye and Ear, Boston, Massachusetts, United States
    Department of Data Sciences, Dana-Farber Cancer Institute and Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States
  • Mengyu Wang
    Department of Ophthalmology, Schepens Eye Research Institute of Mass Eye and Ear, Boston, Massachusetts, United States
  • Yangjiani Li
    Department of Ophthalmology, Schepens Eye Research Institute of Mass Eye and Ear, Boston, Massachusetts, United States
  • Nathan Eli Hall
    Department of Ophthalmology, Schepens Eye Research Institute of Mass Eye and Ear, Boston, Massachusetts, United States
  • Raymond C S Wong
    Department of Ophthalmology, Schepens Eye Research Institute of Mass Eye and Ear, Boston, Massachusetts, United States
  • Hui Wang
    Department of Ophthalmology, Schepens Eye Research Institute of Mass Eye and Ear, Boston, Massachusetts, United States
  • Qingying Jin
    Department of Ophthalmology, Schepens Eye Research Institute of Mass Eye and Ear, Boston, Massachusetts, United States
  • Lucia Sobrin
    Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Joan W Miller
    Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Alice Lorch
    Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States
  • Tobias Elze
    Department of Ophthalmology, Schepens Eye Research Institute of Mass Eye and Ear, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Eun Young Choi, None; Dian Li, None; Mengyu Wang, None; Yangjiani Li, None; Nathan Hall, None; Raymond C S Wong, None; Hui Wang, None; Qingying Jin, None; Lucia Sobrin, None; Joan Miller, Genentech/Roche (C), Genentech/Roche (R), KalVista Pharmaceuticals (C), Lowy Medical Research Institute (F), ONL Therapeutics (C), ONL Therapeutics (P), ONL Therapeutics (I), ONL Therapeutics (R), Sunovion (C), Valeant Pharmaceuticals/Mass. Eye and Ear (P), Valeant Pharmaceuticals/Mass. Eye and Ear (R); Alice Lorch, None; Tobias Elze, None
  • Footnotes
    Support  NIH R21 EY030142, R21 EY030631, R01 EY030575, K99 EY028631, P30 EY003790; BrightFocus Foundation; Grimshaw-Gudewicz Foundation; Research to Prevent Blindness; Lions Foundation; Alice Adler Fellowship
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 3819. doi:
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    • Get Citation

      Eun Young Choi, Dian Li, Mengyu Wang, Yangjiani Li, Nathan Eli Hall, Raymond C S Wong, Hui Wang, Qingying Jin, Lucia Sobrin, Joan W Miller, Alice Lorch, Tobias Elze; Comorbidity risk of diabetic retinopathy and glaucoma from the IRIS registry. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3819.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Diabetes mellitus (DM) has been identified as a risk factor for glaucoma, and previous studies have suggested an association between diabetic retinopathy (DR) and glaucoma. The purpose of this study was to assess the comorbidity risk of DR and glaucoma on a population level using the American Academy of Ophthalmology’s IRIS Registry (Intelligent Research in Sight).

Methods : In this retrospective study, all patients of at least 50 years of age with an ICD-10 diagnosis documented in 2017 were included. Patients with a diagnosis of DR were subdivided according to their DR type: Type 1 DM (E10.3) or Type 2 DM (E11.3) with unspecific DR, mild to severe non-proliferative DR, and proliferative DR. The comorbidity risk ratio (cRR) was calculated for (1) all types of glaucoma, including suspects (H40.*), (2) open-angle glaucoma (OAG; H40.1), and (3) primary angle closure glaucoma (PACG; H40.2). The cRR was defined as the probability of having glaucoma while being diagnosed with DR, divided by the probability of having glaucoma without a diagnosis of DR. P values were calculated using Fisher’s exact test. All statistical analyses were performed using R.

Results : A total of 15,907,109 patients were selected (mean age: 68.5 years, 41.1% male). Of these, 2,853,400 (17.9%) had a form of glaucoma, and 1,142,408 (7.2%) had DR due to Type 1 or Type 2 DM (see Fig. 1 for details). Fig. 2 illustrates the cRR results: there was a significantly increased risk of all 3 glaucoma conditions for those with any stage of DR compared to those without DR (cRRs between 1.02 and 5.63, all P<0.001). The highest comorbidity risks were seen with PACG: the cRR peaked for severe non-proliferative DR at 5.63 (95% CI: [5.33, 5.96], P=0) and decreased for proliferative DR to 2.68 (95% CI: [2.56, 2.80], P=8.85 x 10-301; values shown for Type 2 DM). For OAG, a higher comorbidity risk was seen with proliferative DR than with non-proliferative DR in Type 2 DM, while no clear effects of DR severity were noted in Type 1 DM.

Conclusions : There is a significantly increased comorbidity risk of glaucoma with both proliferative and non-proliferative DR at all stages. The risk is particularly pronounced for PACG, with those with severe non-proliferative DR having a 5-to-6-fold higher risk of PACG than those without DR.

This is a 2020 ARVO Annual Meeting abstract.

 

Figure 1. Demographic and clinical characteristics of the study population.

Figure 1. Demographic and clinical characteristics of the study population.

 

Figure 2. Comorbidity risk ratios for glaucoma and different stages of DR.

Figure 2. Comorbidity risk ratios for glaucoma and different stages of DR.

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