RISK FACTORS FOR THE OCCURRENCE OF PRIMARY OPEN-ANGLE GLAUCOMA IN PATIENTS WITH DIABETIC RETINOPATHY AND TYPE 2 DIABETES

The aim of this work was to identify risk factors for the occurrence of primary open-angle glaucoma in patients with diabetic retinopathy and type 2 diabetes mellitus by conducting a regression analysis of the mutual influence of these diseases. We examined 649 patients (649 eyes), among whom 301 patients (301 eyes) had diabetic retinopathy and glaucoma; 164 patients (164 eyes) had diabetic retinopathy only; 81 patients (81 eyes) had only glaucoma and 103 patients (103 eyes) did not have these diseases (control). The construction of logistic regression models was carried out in the GLZ module of the Statistica 10 software (StatSoft, Inc. USA). It was found that the development of primary open-angle glaucoma directly depended on the duration of diabetes and the intraocular pressure level, and vice versa — on visual acuity (p < 0.001). The development of diabetic retinopathy did not depend on the presence of glaucoma, but it was directly dependent on the blood content of glucose and glycated hemoglobin. Men had a lower risk of developing diabetic retinopathy than women(OR = 0.800; 95% CI 0.76-0.84). Also, men had a lower risk of glaucoma (OR = 0.95; 95% CI 0.94–0.96). Stratification by stages of diabetic retinopathy showed the effect of intraocular pressure, decreased visual acuity and glaucoma stages on the development of proliferative diabetic retinopathy (p < 0.001). Increased intraocular pressure was an independent factor in the development of retinopathy. The development of glaucoma of the initial stage was directly influenced by an increase of blood glycated hemoglobin and by the stage of diabetic retinopathy. The occurrence of stage 2 glaucoma was influenced by the duration of diabetes and visual acuity, stage 3 glaucoma — by visual acuity, and stage 4 glaucoma – by the age and duration of diabetes. Independent risk factors for glaucoma were duration of diabetes, increased intraocular pressure, and low visual acuity. When stratified by stage, there was no evidence of a reduction in the risk of developing diabetic retinopathy and glaucoma in men. Thus, the features of the mutual influence of the development of diabetic retinopathy and primary open-angle glaucoma in type 2 diabetes mellitus have been established.