Abstract
Purpose :
To identify the risk of development of primary open angle glaucoma (POAG) in patients diagnosed with and without mitral valve prolapse
Methods :
A retrospective cohort analysis was conducted using TriNetX, an international federated database of approximately 110 million patients across 80 healthcare organizations. Adult Patients (>17 years) from the ambulatory setting were identified and split into those with and without mitral valve prolapse. 1:1 propensity score matching was performed, controlling for age, sex and race, to calculate lifetime adjusted risk ratios (aRR) for a new instance of glaucoma diagnosis, new need for reducing intraocular pressure (IOP) drops, or first-time glaucoma-related procedure. Patients with any history of ischemic heart disease, heart failure, diabetes, essential hypertension, sleep apnea, hyperlipidemia, uveitis, myopia or any occurrence of an assessed outcome prior to the study window were excluded from analysis to eliminate confounding variables.
Results :
Around 45,216,485 adult patients meeting the inclusion/exclusion criteria were identified where 0.5% had an MVP history. A matched cohort of 218,351 patients revealed the MVP cohort was at significantly higher risk for developing a new glaucoma diagnosis (aRR(95%CI)=1.42[1.3,1.6]) and receiving a new prescription for IOP drops (1.52[1.4,1.6]). There was no difference in risk of undergoing a first time glaucoma-related procedure (0.85[0.7,1.1]).
Conclusions :
The findings of our study suggest that patients with a diagnosis of mitral valve prolapse are more likely to develop primary open angle glaucoma. This association has not thoroughly been researched, but we hypothesize it may be attributed to similarities in pathophysiology between the two conditions. In MVP, deposition of glycosoaminoglycans in the mitral valve can lead to valvular dysfunction. Just like MVP, pathophysiology of POAG is multifactorial but partly due to dysfunction of the trabecular meshwork due to deposition of collagen and its metabolites. This study helps to confirm that in patients with MVP, POAG should be strongly considered.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.