Severity of primary open-angle glaucoma in patients with hypertension and diabetes

Anadi Khatri,1 Jeevan Kumar Shrestha,2 Madhu Thapa,2 Bal Kumar Khatri,3 Muna Kharel3 1Department of Ophthalmology, Vitreo-Retina Fellow, Lumbini Eye Institute, Siddharthanagar, Nepal, 2Department of Ophthalmology, B. P. Koirala Lions Centre for Ophthalmic Studies, Institute of Medicine, Tribhuvan University Maharajgunj, Kathmandu, Nepal, 3Birat Eye Hospital, Biratnagar, Nepal Background: Primary open-angle glaucoma (POAG) is a progressive optic neuropathy with numerous risk factors. Its severity with associated risk factors remains a widely debated topic. Aim: To evaluate the severity of POAG in patients with hypertension (HTN) and diabetes or both. Patients and methods: This hospital-based, cross-sectional descriptive study was conducted for a period of 18 months from January 2016 to June 2017. Diagnosed cases of POAG were evaluated for severity with associated risk factors. Results: A total of 221 patients were enrolled in the study. The mean age of the patients was 54.4 (SD ± 15.9) years with a male to female ratio of 0.93:1. Of the 221 patients, 68 (31%) had a family history of POAG. Mean intraocular pressure was 15.8±4.87 mmHg, and mean central corneal thickness was 535.4±34.9 μm. A total of 81 (36%) patients had HTN, 21 (9.50%) had diabetes mellitus (DM), and 15 (6.80%) had both HTN and DM. Analysis using SPSS version 20 was done. The severity of POAG was found to be significantly higher in patients with HTN, DM, or both when evaluated on the basis of anatomical and functional loss. Conclusion: POAG patients with HTN, DM, or both were found to have more severe POAG. Patients with these risk factors could represent “high-risk patients” with POAG. Patients with HTN and DM, or both may require evaluations on a more frequent basis to access the progression/severity of POAG. Keywords: glaucoma in Nepal, POAG in Nepal, severity of POAG, hypertension, diabetes, systemic disorders in POA