Gayathiri, R (2020) A Study on Diabetes Mellitus as a Risk Factor for Primary Open Angle Glaucoma. Masters thesis, Thanjavur Medical College, Thanjavur.
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Abstract
INTRODUCTION: Glaucoma is a chronic degenerative optic neuropathy which may or may not be associated with raised intraocular pressure (IOP). It is estimated to contribute to blindness in 11.2 million people with prevalence reaching approximately 80 million. Diabetes has been proposed as one of the many risk factors in POAG. In the paper published by Armstrong et al, POAG was prevalent in 4.1% of diabetics and 1.7% of diabetics were found to have (1). Increased prevalence (6 -11%) of Diabetes has been reported in Glaucoma populations. In comparison of diabetic and non-diabetic population with POAG, there was a higher proportion of patients with elevated mean IOP. It was also found that there is a higher prevalence of glaucoma among diabetics as compare to the general population. AIM & OBJECTIVE: To study the role of diabetes mellitus (DM) and glycemic exposure in predicting outcomes in primary open angle glaucoma (POAG). METHODOLOGY: This was a prospective observational study. Intra-ocular pressure (IOP) measured by applanation tonometry, fundus examination to determine Cup-disc ratio (CDR), neuroretinal rim thinning (NRR), glaucomatous optic atrophy (GOA), Visual field assessment by automated perimetry and Visual acuity by Snellen’s chart were compared to the level of Glycated Hemoglobin (HbA1c) in POAG patients with diabetes mellitus. RESULTS: Out of 120 patients diagnosed with POAG, 76 were diabetic. In patients with HbA1c > 9 g%, 78.4% had IOP >30 mmHg, 54.1% had poor vision (no PL, PL, CFCF, HM), 89.2% had advanced field changes and 54.1% had CDR >= 0.8. 83.6% had thinning of NRR and 21.6% had GOA. These correlations were statistically significant. Central corneal thinning was found in 62.2% of patients in this group. However, this correlation was not statistically significant. CONCLUSION: HbA1c correlates with poorer visual outcomes in POAG and quality glycemic control over a period of time may retard the progression of visual loss. Glaucomatous patients with higher blood glucose values may require more rigid control. Though central corneal thinning was found to be associated with POAG, the correlation was not statistically significant.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 221713152 |
| Uncontrolled Keywords: | Primary open angle glaucoma, Diabetes mellitus, Glycated hemoglobin, Visual outcomes. |
| Subjects: | MEDICAL > Ophthalmology |
| Depositing User: | Subramani R |
| Date Deposited: | 14 Feb 2021 09:54 |
| Last Modified: | 14 Feb 2021 09:54 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14179 |
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