Evaluating the association between autoimmune disease and normal tension glaucoma: a retrospective case-control study

Limited population-based data as well as proposed mechanisms of retinal ganglion cell (RGC) loss suggest autoimmune disease may be a risk factor for glaucoma, the leading cause of irreversible blindness worldwide. Though intraocular pressure (IOP) is the leading risk factor for glaucoma onset and progression, a subset of glaucoma referred to as normal tension glaucoma (NTG) may be more likely to be associated with IOP-independent mechanisms of RGC injury including those of an inflammatory or immune nature.

This retrospective case-control study enrolled 277 patients with NTG and the same number of age- and sex-matched controls to determine whether autoimmune disease diagnosis, treatment thereof, or relevant laboratory markers are associated with NTG.

There was no significant difference between the two groups in frequency of autoimmune disease overall, autoimmune disease catagorized by mechanism or organ involvement, or individual autoimmune disease including psoriasis (6% vs. 5%), rheumatoid arthritis (5% vs. 4%), inflammatory bowel disease (2% vs. 3%), Sjögren's syndrome (1% vs. 1%), sarcoidosis (1% vs. 1%), autoimmune thyroiditis (1% vs. 0%), type 1 diabetes (1% vs. 0%), or systemic lupus erythematosus (1% vs. 0%). There was also no significant difference in laboratory values or treatment of identified autoimmune conditions.

Our study found no significant association between autoimmune disease and NTG, suggesting that other factors may play a more significant role in the pathogenesis of NTG.