Type 2 diabetes mellitus and risk of open-angle glaucoma development in Koreans: An 11-year nationwide propensity-score-matched study.

PURPOSE: To evaluate the risk of primary open-angle glaucoma (POAG) development in type 2 diabetes mellitus (T2DM) patients. METHODS: In this 11-year longitudinal study based on the Korean National Health Insurance research database, the data collected comprised 1,025,340 (2.2%) participants who were randomly selected from 46,605,433 Korean residents in 2002. The database was analyzed to identify participants with an initial diagnosis of T2DM in 2003-2004. The control group was composed of participants without T2DM who were propensity-score-matched, five controls per T2DM patient, according to age, gender, household income, residential area and underlying diseases, including hypertension, dyslipidaemia, coronary heart disease, cerebrovascular disease and thyroid disease. Cox proportional-hazards regression was used to calculate the overall hazard ratios (HRs) in participants with and without T2DM for development of POAG before and after adjusting for confounding factors. RESULTS: There were 12,657 participants with T2DM and 63,285 propensity-score-matched controls without T2DM. POAG developed in 413 (3.3%) and 1188 (1.9%) participants in the T2DM and control groups, respectively. T2DM was associated with an increased risk of POAG development [HR: 1.80; 95% confidence interval (CI): 1.58-2.04] after adjusting for age, gender, household income and other potential confounders. CONCLUSION: T2DM was significantly associated with the development of POAG after adjusting for potential confounders in the Korean population.

Posterior staphyloma is related to optic disc morphology and the location of visual field defect in normal tension glaucoma patients with myopia.

PURPOSE: To determine the morphologic features of the optic disc and the location of visual field (VF) defect in relation to posterior staphyloma in normal tension glaucoma (NTG) eyes with myopia. METHODS: One hundred and thirty-four NTG patients with myopia were enrolled. B-scan ultrasonography was performed in enrolled patients. Disc tilt ratio, disc torsion, and area of peripapillary atrophy were measured from disc photographs. Patients were classified according to the presence of posterior staphyloma and its location: staphyloma involving the optic disc, staphyloma involving either the supero-temporal side of the optic disc or the infero-temporal side of the optic disc. The relationship between the location of the posterior staphyloma and that of the VF defect was analyzed. RESULTS: Among 134 eyes, 74 eyes (55.2%) had posterior staphyloma on B-scan ultrasonography. Mean torsion degree was significantly greater in eyes with staphyloma involving the temporal side of the optic disc (19.78±18.00°) compared with eyes with staphyloma involving the optic disc (4.65±4.92°, P=0.001). The frequency of the location of VF damage differed significantly between eyes with staphyloma involving the supero-temporal side and those involving the infero-temporal side of the optic disc (P=0.008), which was not significant in eyes with staphyloma involving the optic disc (P=0.813). CONCLUSIONS: Optic disc torsion was a prominent finding in myopic NTG eyes when posterior staphyloma was located temporal to the optic disc. The location of posterior staphyloma was related to the direction of disc torsion and the location of VF defect.