Development of Open-Angle Glaucoma in Adults With Seropositive Rheumatoid Arthritis in Korea

Area of Science:

• Ophthalmology
• Rheumatology
• Immunology

Background:

• Emerging evidence suggests autoimmunity's role in neurodegeneration in glaucoma.
• Limited data exists on the connection between rheumatoid arthritis (RA) and primary open-angle glaucoma (POAG).

Purpose of the Study:

• To investigate the association between rheumatoid arthritis (RA) and the risk of developing primary open-angle glaucoma (POAG) in older Korean adults.

Main Methods:

• A nationwide propensity-matched cohort study using Korean National Health Insurance Service-Senior data (2002-2013).
• Kaplan-Meier, Poisson regression, and Cox proportional hazards models were employed.
• 2049 patients with incident seropositive RA were matched with 8196 controls.

Main Results:

• Patients with RA had a higher cumulative incidence of POAG compared to controls.
• The incidence rate of POAG was 981.8 per 100,000 person-years in the RA cohort versus 679.5 in controls.
• RA was associated with a 1.44-fold increased risk of POAG (HR, 1.13-1.84), with higher risk observed within 2 years (HR, 1.83) and in those aged ≥75 years (HR, 2.12).

Conclusions:

• Rheumatoid arthritis (RA) is associated with an elevated risk of primary open-angle glaucoma (POAG).
• The increased risk is pronounced within two years post-diagnosis and in older individuals (≥75 years).
• Potential shared immune-mediated pathophysiological pathways warrant further investigation.