Open-angle glaucoma and ocular hypertension: The Long Island Glaucoma Case-control Study

Abstract

This case-control study evaluated risk factors for open-angle glaucoma (OAG) and high intraocular pressure (IOP), including systemic hypertension and its treatment, other systemic factors, familial, and demographic variables. The three study groups were based on masked ophthalmologic gradings of visual fields and fundus photographs, as well as tonometry. The OAG group (n=122) had OAG field defects, IOP > 21 mmHg, and cup-disc ratios > 0.5 and/or evidence of glaucoma disc damage. The ocular hypertensives (n= 108) had no field defects, IOP > 21 mmHg and normal discs. The controls (n= 190) had no field defects, IOP < 21 mmHg and normal discs. The data collection protocol included a standardized interview and measurements. Medical history was confirmed by contacting the primary care physicians (89% response from physicians).

Study groups were compared by polychotomous logistic regression analyses. Men were more likely to have OAG and less likely to have ocular hypertension. Systemic hypertension was more frequent in ocular hypertensives (Odds Ratio=2.36); high diastolic pressure was associated with OAG and ocular hypertension (OR=2.13 and 2.21, respectively). Treatment for systemic hypertension was unrelated to OAG risk. Low perfusion pressures (blood pressure-IOP differences) were strongly associated with OAG and ocular hypertension, a finding that could be due to the high IOP in these groups. A family history of glaucoma was more frequent in OAG (OR=3.08) and ocular hypertension (OR=2.38) than in controls. Alcohol consumption was related to ocular hypertension (OR=2.32). No other associations were significant.

The results confirm an association of blood pressure with intraocular pressure. Since the OAG and ocular hypertensive groups had similar blood pressure results, an independent effect of blood pressure on OAG was not substantiated.

Key Words:

• risk factors
• open-angle glaucoma
• systemic hypertension
• ocular hypertension
• perfusion pressures