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Speaker elucidates non-ocular risk factors for glaucoma
AMSTERDAM — Family history, older age and race are the three factors most strongly supported by literature as being risk factors for incidence, progression of glaucoma and progression of ocular hypertension to glaucoma, according to a speaker.
Older age has been consistently a risk factor for glaucoma in all races studied, Fotis Topouzis, MD, said at Glaucoma Subspecialty Day preceding the European Society of Cataract and Refractive Surgeons meeting. Because age has been a consistent risk factor, Topouzis said that rather than dealing aggressively with older patients, one should be cautious in dealing with younger patients who have an increased risk to be blind during their lifetime.
Among races, prevalence of glaucoma was 4.7 in blacks and 1.3 in whites, according to survey data, Topouzis said. Prevalence in Latinos was similar to that in blacks. However, within a race there may be large variations in prevalence rates of glaucoma.
“For example, populations from West Africa have not the same ratio compared to other African populations,” Topouzis said.
Topouzis clarified that race alone is not an independent risk factor for glaucoma, but associated environmental, nutritional and social elements should also be considered.
Regarding vascular factors, the role of blood pressure remains controversial, he said, suggesting that low and not high blood pressure may have a role in promulgating glaucoma, because low perfusion pressure leads to breakdown of autoregulation and less perfusion to the optic nerve. However, there are too many variables to make conclusive associations either way, he said. The relationship between diabetes and glaucoma is also unclear, he said.
Disclosure: Topouzis has been a consultant, on the advisory board for or on the speakers bureau for Alcon, Merck and Pfizer. He has received research support from Alcon, Pfizer and Heidelberg Engineering.