Abstract
Purpose :
Age-related macular degeneration (AMD) and glaucoma are both leading causes of vision loss. Glaucoma affects the optic nerve while AMD affects the macular retinal pigment epithelium. Both result in vision impairment, with AMD primarily affecting central vision and glaucoma typically affecting peripheral vision. Each condition has been associated with increased systemic comorbidities compared to control populations. However, no literature discusses comorbidities seen in patients simultaneously affected with glaucoma and AMD. We investigate whether there is an increased association with other systemic conditions in these patients, as presenting with both ophthalmologic conditions may provide greater insight into a patient’s overall health or response to stress.
Methods :
The i2b2 interface was used to access the Carolina Data Warehouse, which contains clinical data for patients seen in the University of North Carolina Health System. Datasets of patients seen from April 2004 to June 2018 were created by searching ICD codes, yielding a set comprised of patients with each of the following diagnoses: glaucoma only, AMD only, glaucoma and AMD, and cataracts. Within each group, prevalence of systemic diseases was searched, and a Friedman’s two-way analysis of variance compared prevalence between groups. Groups were further compared on race, age, and sex distributions to rule out confounders.
Results :
The i2b2 database identified 5243 patients with glaucoma only, 6726 with AMD only, 402 with combined disease, and 25450 with cataracts only. Patients with both glaucoma and AMD compared to groups with glaucoma alone and cataracts alone were more likely to have heart failure (p=.036, .036, respectively) and dementia (p=.023, .00349). Demographic analysis indicated a statistically significantly older population with both glaucoma and AMD compared to glaucoma alone, but no other differences were seen between group demographics.
Conclusions :
The significantly increased prevalence in heart failure and dementia in the group with both glaucoma and AMD may suggest an increased propensity to developing these diseases in patients with both ophthalmologic conditions. These associations and underlying pathologic mechanisms may provide insight into health management and prognostication for these individuals.
This is a 2021 ARVO Annual Meeting abstract.