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Chronic hyperglycemia associated with elevated IOP in study
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Patients with chronic hyperglycemia are more likely to have elevated IOP, according to a study by researchers in Japan.
"We [assume] that the increase of IOP [is] related to the accumulation of fibronectin in the trabecular meshwork tissue," said lead investigator Toshiyuki Oshitari, MD, PhD, and colleagues. An excess of fibronectin there is believed to inhibit aqueous outflow, they said.
Dr. Oshitari and colleagues measured IOP in 58 patients with mild hyperglycemia, 72 patients with moderate hyperglycemia and 60 patients with severe hyperglycemia. All patients were diabetic and had hyperglycemia for at least 3 months. Patients with proliferative diabetic retinopathy, secondary glaucoma, or ocular or laser therapy were excluded, the authors said.
The researchers found a statistically significant difference in mean IOP between the mild group and severe group (15.5 mm Hg vs. 16.6 mm Hg; P = .013). Levels of high glycosylated hemoglobin A1c, from which the researchers gauged the severity of hyperglycemia, were positively correlated with IOP (P = .044), they said.
"Our results confirmed our hypothesis that patients with diabetes with chronic hyperglycemia have far higher IOP. Our findings support the report that the prevalence of glaucoma in patients with diabetes is higher than in patients without diabetes," the authors said. They referenced a meta-analysis in which Bonovas and colleagues found an association between diabetes and open-angle glaucoma.
"Long-term follow-up of the cohort to establish whether these patients with higher IOP and higher HbA1c levels are more likely to develop open-angle glaucoma is needed to demonstrate the clinical importance of our findings," the authors said.
The study is published in the February issue of the American Journal of Ophthalmology.