Predictors of Early-Onset Glaucoma

The authors studied 389 primary open-angle glaucoma (POAG) patients (average age, 71.4 years) over 6 months to see if there was an association “between the age at diagnosis of hypertension (HTN), type 2 diabetes (DM2), history of migraine or obstructive sleep apnea (OSA), and the age at POAG diagnosis.” Their findings revealed that “the mean age at POAG diagnosis was 58.58 years (±14.3), and the mean ages at HTN and DM2 diagnoses were 52.95 years (±13.28) and 55.32 years (±11.6), respectively.” Stepwise multiple regression analysis of age at POAG diagnosis “indicate that the earlier a patient is diagnosed with HTN or DM2, the earlier they are diagnosed with POAG.” Furthermore, Asian race/ethnicity “was associated with earlier development of POAG for patients with DM2 with or without HTN.” There was no significant difference in the mean age of POAG diagnosis between patients with a history of OSA or migraine and those without a history of OSA or migraine.

Wooliscroft et al noted that OSA and a history of migraine were not significant risk factors for the development of POAG. The authors acknowledged that this is at variance from reports of other studies. Nonetheless, I agree with the authors' conclusion that “patients with early-onset DM2 or HTN may benefit from earlier POAG screening, especially if they have other significant risk factors (ie, family history).”