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Association Between Diabetes, Diabetic Retinopathy, and Glaucoma
Yangjiani Li1,2, William Mitchell3,4, Tobias Elze1
1Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA.
Current Diabetes Reports
|September 8, 2021
Summary
The link between diabetes, diabetic retinopathy (DR), and glaucoma is debated. This review examines evidence for and against their association, exploring shared pathways and treatment implications.
Area of Science:
- Ophthalmology
- Endocrinology
- Medical Research
Background:
- The relationship between diabetes, diabetic retinopathy (DR), and glaucoma is complex and not fully understood.
- Existing research presents conflicting evidence regarding whether diabetes or DR increases glaucoma risk.
Purpose of the Study:
- To review and synthesize evidence supporting and refuting the association between diabetes, DR, and glaucoma.
- To explore potential mechanistic, pathological, and treatment-related links between these conditions.
Main Methods:
- Comprehensive literature review of studies investigating the co-occurrence and relationship between diabetes, DR, and glaucoma.
- Analysis of proposed indirect and direct pathways linking diabetes/DR to glaucomatous optic neuropathy.
- Examination of how diabetes and its treatments may influence glaucoma progression and surgical outcomes.
Main Results:
- Evidence for diabetes/DR increasing glaucoma risk is inconsistent.
- Potential links include increased intraocular pressure, vasculopathy, and direct optic nerve damage.
- Some aspects of diabetes and its treatments may paradoxically slow glaucoma progression or aid management, but diabetes negatively impacts glaucoma surgery outcomes.
Conclusions:
- The association between diabetes/DR and glaucoma remains controversial.
- Multiple mechanistic connections in pathophysiology and management exist, but require further investigation.
- A deeper understanding of the causal factors underlying the disease association is needed.
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