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Year : 2020  |  Volume : 68  |  Issue : 13  |  Page : 32-36

Spectrum of Eye Disease in Diabetes (SPEED) in India: A prospective facility-based study. Report # 4. Glaucoma in people with type 2 diabetes mellitus

1 Retina Vitreous Service, L V Prasad Eye Institute, Bhubaneswar, Odisha, India
2 Retina Vitreous Service, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
3 Retina Vitreous Service, L V Prasad Eye Institute, Hyderabad, Telangana, India
4 Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
5 Department of Clinical Research, Indian School of Public Health, Public Health Foundation of India, Hyderabad, Telangana, India
6 Department of Ophthalmology, Dr Mohan's Diabetes Foundation, Chennai, Tamil Nadu, India

Correspondence Address:
Dr. Umesh C Behera
L V Prasad Eye Institute, Patia, Bhubaneswar - 751 024, Odisha
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijo.IJO_1948_19

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Purpose: To estimate the proportion of people with type 2 diabetes mellitus (T2DM) and glaucoma in a facility-based cross-sectional observational study in India. Methods: All people received a comprehensive eye examination. Glaucoma-specific examinations included applanation tonometry, optic disc and cup evaluation, and stereo biomicroscopy in all people; gonioscopy and visual field testing in glaucoma suspects. The International Society of Geographic and Epidemiologic Ophthalmology guidelines were used to diagnose and classify glaucoma. Results: The study recruited 11,182 people (average age: 58.2 ± 10.6; range 39–96 years). Glaucoma was diagnosed in 4.9% (n = 547) people. About 76.8% (n = 420) of those with glaucoma had bilateral disease, and 98.7% (n = 540) were >40 years. Among people with bilateral disease, 94.5% (n = 397) had primary glaucoma – open angle in 59.3% (n = 228) and angle closure in 40.2% (n = 169). Diabetes duration was ≤10 years in 71.5% (n = 300) people. On linear regression, the following were associated with glaucoma: advancing age [compared with <40 years age group; odds ratio [OR] in 50-60 year age group: 1.36 [95% confidence interval (CI): 1.01–1.8], P < 0.035); >60 years age group (OR: 2.05, 95% CI: 1.57–2.67; P < 0.001), and diabetic neuropathy (OR: 2.62, 95% CI: 1.35–5.10, P < 0.003). Glycemic control did not have significant association (P = 0.425). Conclusion: Presence of glaucoma in people with T2DM in this cohort was similar to the general population prevalence studies in India. Glaucoma was invariably bilateral. A comprehensive eye examination in people age 40 years and older with diabetes and/or glaucoma is beneficial.

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