Systemic Conditions Associated with Primary Open-Angle Glaucoma and Normal Tension Glaucoma in a Large US Adult...

Area of Science:

• Ophthalmology
• Systemic Health
• Autoimmune Diseases

Background:

• Glaucoma, a leading cause of irreversible blindness, encompasses subtypes like primary open-angle glaucoma (POAG) and normal tension glaucoma (NTG).
• The relationship between glaucoma subtypes and systemic conditions remains incompletely understood, potentially indicating shared etiological pathways.

Purpose of the Study:

• To investigate the association patterns between POAG and NTG with systemic cardiovascular, neurologic, and autoimmune conditions.
• To compare these associations across different glaucoma subtypes in a large patient cohort.

Main Methods:

• A cross-sectional study utilizing the TriNetX platform with over 120 million patient records.
• Propensity score-matched cohorts were generated based on ICD codes, controlling for age, sex, race, and ethnicity.
• An odds ratio (OR) threshold of >1.1 or <0.9 was used to define significant associations.

Main Results:

• Primary open-angle glaucoma (POAG) showed significant associations only with autoimmune disorders: Raynaud's syndrome (OR=1.15), giant cell arteritis (OR=1.15), and Graves' disease (OR=1.26).
• POAG was not associated with cardiovascular or neurologic conditions.
• Normal tension glaucoma (NTG) exhibited positive associations with conditions across all three systemic categories (cardiovascular, neurologic, autoimmune), with stronger links than POAG.

Conclusions:

• Primary open-angle glaucoma (POAG) is not associated with cardiovascular or neurological diseases but is linked to specific autoimmune conditions.
• Normal tension glaucoma (NTG) demonstrates broader systemic associations, affecting multiple organ systems.
• These findings suggest that both POAG and NTG likely arise from multifactorial etiologies, with an auto-inflammatory component potentially playing a role.