Abstract
Whether carotid artery stenosis (CAS) is an independent risk factor for open-angle glaucoma remains unclear. In this study, we investigated the association between CAS and the development of open-angle glaucoma in the Taiwanese population-based cohort derived from a longitudinal database containing claims data from the Taiwan National Health Insurance (NHI) program; this study enrolled 2093 patients with CAS and 8372 patients without CAS matched by age and sex from 1999 to 2010. Diagnoses of open-angle glaucoma (OAG) were identified during a follow-up period lasting through December 31, 2013. A Cox proportional hazards model was applied to evaluate the hazard ratio (HR) for OAG in the CAS cohort compared with the matched cohort. We found that the HR for open-angle glaucoma in the CAS cohort compared with the matched cohort. The adjusted HR for OAG in the CAS cohort was 1.50 (95% confidence interval, 1.11–2.02, P = .008). The Kaplan-Meier analysis revealed that the CAS cohort had a higher cumulative incidence of OAG than did the matched cohort during the follow-up period (log-rank test, P < .001). We concluded that CAS is a significantly independent risk factor for the development of OAG. Our finding is clinically important for the aging population, which has an increasing prevalence of CAS.
Highlights
Ocular blood flow has been known as a major risk factor for glaucoma development and progression [1]
After adjustment for age, sex, hypertension, hyperlipidemia, diabetes, migraine, thyroid disease, and heart failure, patients with carotid artery stenosis (CAS) still had a 1.50-fold higher risk of open-angle glaucoma (OAG) than did the patients in the comparison group in our Cox model (Table 2; adjusted hazard ratio (HR) = 1.50, 95% CI, 1.11–2.02, P = .008)
Our results demonstrate that patients with CAS aged
Summary
Ocular blood flow has been known as a major risk factor for glaucoma development and progression [1]. This association is difficult to study because different techniques are used for measuring different aspects of ocular circulation [2], reduced ocular blood flow has been known to occur in both early and late stages of glaucoma [3, 4]. This phenomenon can be observed within the optic nerve head [5], retinal circulation, choroid [6], retrobulbar [7], and even peripheral blood flow [8].
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