Association between Body Mass Index and Primary Open-Angle Glaucoma in Three Cohorts

Abstract

Purpose: To evaluate the relationship between body mass index (BMI) and glaucoma progression. DESIGN: Multicohort observational study Methods: This study combined a retrospective longitudinal analysis of suspect and early manifest primary open-angle glaucoma cases from the Progression Risk of Glaucoma: RElevant SNPs with Significant Association (PROGRESSA) study, with two replication cohorts from the UK Biobank and the Canadian Longitudinal Study of Ageing (CLSA). In the PROGRESSA study, multivariate analysis correlated BMI with longitudinal visual field progression in 471 participants. BMI was then associated with glaucoma diagnosis and cross-sectional VCDR measurements in the UK Biobank, and finally prospectively associated with longitudinal change in VCDR in the CLSA study, and with Results: In the PROGRESSA study, a lower BMI conferred a faster rate of visual field progression (Mean duration of monitoring (5.28±1.80years (10.6±3.59 visits) (beta: 0.04dB/year/SD [0.005, 0.069] P=0.013). In the UK Biobank a 1 standard deviation lower BMI was associated with a worse cross-sectional VCDR (beta: -0.048/SD [-0.056, 0.96] P<0.001), and with a 10% greater likelihood of glaucoma diagnosis, as per specialist grading of retinal fundus imaging (OR: 0.90 [0.84, 0.98] P=0.011). Similarly, a lower BMI was associated with a greater risk of glaucoma diagnosis as per International Classification of Disease data (OR: 0.94/SD 95% CI: [0.91, 0.98] P=0.002). BMI was also positively correlated with IOP (beta: 0.11/SD 95% CI: [0.06, 0.15] P<0.001). Finally, a lower BMI was then associated with greater VCDR change in the CLSA (beta: -0.007/SD 95% CI: [-0.01, -0.001] P=0.023). Conclusions: Body mass index was correlated with longitudinal and cross-sectional glaucomatous outcomes. This supports previous work illustrating a correlation between BMI and glaucoma.