Relationship between primary open-angle glaucoma and mortality not clear

BOSTON — The relationship between primary open-angle glaucoma and patient mortality remains unknown, according to a physician here.

Louis R. Pasquale

Louis R. Pasquale, MD, presented results of his meta-analysis of nine population-based studies at the World Glaucoma Congress.

"Primary open-angle glaucoma is a poorly understood form of neurodegeneration. Blood pressure, diabetes and body mass index are associated with increased mortality, which are positively related to IOP. But the relationship to primary open-angle glaucoma is complex and controversial. The answer to the question 'Can primary open-angle glaucoma kill you?' is not intuitively obvious," he said.

Dr. Pasquale said his study of the nearly 3,000 cases of primary open-angle glaucoma did not support an association between primary open-angle glaucoma and all-cause or cardiovascular mortality.

However, he said the study was unable to control for treatment and he was unable to perform meta-regression by race. Variation in disease definition and disease misclassification also could have had unpredictable effects on the study's outcome. He said the majority of the studies did not control for blood pressure, diabetes or body mass index.

"The true relationship between primary open-angle glaucoma and mortality remains unknown," Dr. Pasquale said. "Future analyses should use incident cases, and control for treatment and covariance."