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The Singapore Malay Eye Study

Gavin S. Tan, MRCS; Tien Y. Wong, MD, PhD, FRCSE; Chee-Weng Fong, PhD; Tin Aung, PhD, FRCSE

Arch Ophthalmol. 2009;127(10):1354-1361.

Objective  To examine the relationship of diabetes mellitus and metabolic abnormalities with intraocular pressure and glaucoma.

Methods  A population-based study was conducted in 3280 (78.7% response) Malay adults aged 40 to 80 years. Diabetes was defined as a random serum glucose level of 200 mg/dL or greater or physician diagnosis of diabetes mellitus. Metabolic abnormalities including body mass index, lipid levels, and blood pressure were measured. Glaucoma was defined from a standardized examination by means of the International Society for Geographical and Epidemiological Ophthalmology criteria.

Results  There were 764 persons (23.3%) who had diabetes. After controlling for age, sex, education, smoking, central corneal thickness, and diabetes treatment, intraocular pressure was higher in persons with than without diabetes (16.7 vs 15.0 mm Hg, P < .001) and in those with higher serum glucose levels (P < .001), glycosylated hemoglobin concentrations (P < .001), total cholesterol levels (P = .001), triglyceride levels (P = .002), and body mass index (P = .001). However, the prevalence of glaucoma was similar between persons with and without diabetes (4.7% vs 4.5%). In multivariate logistic regression models adjusting for age, sex, education, smoking, central corneal thickness, and diabetes treatment, diabetes was not associated with glaucoma (odds ratio, 1.00; 95% confidence interval, 0.63-1.61).

Conclusion  These data suggest that, although diabetes and metabolic abnormalities may be associated with a small increase in intraocular pressure, they are not significant risk factors for glaucomatous optic neuropathy.

Author Affiliations: Singapore National Eye Centre and Singapore Eye Research Institute, Singapore (Drs Tan, Wong, and Aung); Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (Drs Wong and Aung); Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, The University of Melbourne, East Melbourne, Australia (Dr Wong); and Ministry of Health, Singapore (Dr Fong).

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