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The Singapore Malay Eye Study

V. Swetha E. Jeganathan, MD; Tien Yin Wong, FRCS, PhD; Paul J. Foster, FRCS, PhD; Jonathan G. Crowston, PhD, FRCOphth; Wan Ting Tay, BSC; Su Chi Lim, MD; Seang-Mei Saw, PhD; E. Shyong Tai, MCRP; Tin Aung, MBBS, PhD, FRCS(Edin)

Arch Ophthalmol. 2009;127(7):888-893.

Objective  To examine the relationship between peripheral artery disease (PAD) and glaucoma.

Methods  As part of a population-based study of 3280 persons of Malay descent (78.7% response) aged 40 to 80 years examined between August 1, 2004, and June 30, 2006, the ankle-brachial index (ABI) was assessed in all persons with known diabetes mellitus and every fifth systematically sampled participant without diabetes. Peripheral artery disease was deemed present if the ABI was 0.9 or less. Glaucoma was diagnosed using International Society of Geographical and Epidemiological Ophthalmology criteria.

Results  Of the 922 participants who had ABI measured, 79 (8.6%) had PAD and 42 (4.6%) had glaucoma. Persons with PAD were more likely to have glaucoma (11.4% vs 3.9%; age- and sex-adjusted odds ratio [OR], 2.80; 95% confidence interval [CI], 1.26-6.24), higher intraocular pressure (age- and sex-adjusted mean, 16.4 vs 15.5; P = .05), and a larger vertical cup-disc ratio (age- and sex-adjusted mean, 0.45 vs 0.40; P = .02). The association of PAD with glaucoma persisted while controlling for hypertension, diabetes, body mass index, serum triglyceride levels, and β-blocker use (multivariable-adjusted OR, 2.55; 95% CI, 1.09-5.98) and was stronger in people with diabetes (multivariable-adjusted OR, 2.91; 95% CI, 1.14-7.44).

Conclusions  Peripheral artery disease was related to glaucoma, supporting an association between large-vessel atherosclerotic disease and glaucoma. However, because the study sample included a high proportion of persons with diabetes, further research is needed to determine the relevance of these results to the general population.

Author Affiliations: Centre for Eye Research Australia, University of Melbourne, Victoria (Drs Jeganathan, Wong, and Crowston); UCL Institute of Ophthalmology, University College London (Dr Foster), and National Institute for Health Research Biomedical Research Centre, Moorfields Eye Hospital (Dr Foster), London, England; and Singapore Eye Research Institute (Drs Jeganathan, Wong, Saw, and Aung and Ms Tai) and Department of Community, Occupational & Family Medicine (Dr Saw), Yong Loo Lin School of Medicine, National University of Singapore, Department of Medicine, Alexandra Hospital (Dr Lim), and Department of Endocrinology, Singapore General Hospital (Dr Tai), Singapore.

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