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

To compare the patterns of association between two subtypes of open-angle glaucoma, primary open-angle glaucoma (POAG) and normal tension glaucoma (NTG), and systemic cardiovascular, neurologic, and autoimmune conditions in a large sample.

This cross-sectional study generated propensity score-matched cohorts of patients with and without the above systemic conditions, based on International Classification of Diseases (ICD) encounter diagnosis codes, using the TriNetX platform, containing data from >120 million patients. Patients were matched across age, sex, race, and ethnicity. Cohorts for autoimmune conditions were additionally matched for long-term corticosteroid use. Primary outcomes were odds of either POAG or NTG. OR threshold of significance was defined as >1.1 or <0.9 to improve signal-to-noise ratio.

The only systemic conditions associated with POAG were autoimmune disorders, namely Raynaud's syndrome (OR = 1.15, 95% CI 1.08-1.23), giant cell arteritis (OR = 1.15, 95% CI 1.06-1.24), and Graves' disease (OR = 1.26, 95% CI 1.18-1.34). POAG was not associated with cardiovascular or neurologic conditions. NTG was positively associated with conditions across all three categories of systemic conditions, with stronger positive associations with each condition compared to POAG.

POAG was not associated with cardiovascular or neurological conditions in a very large, propensity score-matched sample, but was positively associated with certain autoimmune conditions. NTG was positively associated with conditions across multiple organ systems. These findings indicate that both glaucoma subtypes likely have multifactorial etiologies of disease, one component of which may be auto-inflammatory.