Evaluation of The Relation Between Glaucoma Parameters and Haemoglobin A1c in Patients with Primary Open Angle Glaucoma and Diabetes Mellitus

Year 2023, , 72 - 77, 19.06.2023

Berna Yüce , Atılım Armağan Demirtaş , Bediz Özen

https://doi.org/10.57221/izmirtip.1261672

Abstract

Aim: To evaluate the relationship between haemoglobin A1c (HbA1c) levels and glaucoma parameters. Materials and methods: Fasting blood glucose (FBG), postprandial blood glucose (PBG) and HbA1c levels of patients with Primary Open Angle Glaucoma (POAG), within 3 months of ophthalmic examination were recorded. Patients were classified into two groups according to the HbA1c levels and the parameters of the right eyes of each were included. Parameters of 37 patients with a level of HbA1c≤ 6% (Group 1) were compared with 43 patients with a level of HbA1c> 6% (Group 2). Best corrected visual acuity, (intraorbital pressure (IOP), cup/disc (c/d) ratio, retinal nerve fiber layer (RNFL) thickness and mean deviation (MD) score of visual field test were recorded. Results: There were no statistically significant difference between the groups in terms of age and gender (p=0.757, p=0.422; respectively). Although FBG was not significantly different between the groups, PBG was significantly higher in the Group 2 (p=0.097, p=0.015; respectively). No significant differences were detected for the mean IOP, c/d ratio, RNFL and MD scores between the groups (p=0.601, p=0.092, p=0.809, p=0.325; respectively). Significant positive correlation was detected between FBG, PBG and HbA1c levels (r=0.335, p=0.002; r=0.560, p=0.016; respectively). Conclusion: No significant relation was detected between HbA1c levels and IOP, c/d ratio, RNFL and MD parameters related to glaucoma in our study. Although it is a risk factor for glaucoma occurrence, no effect of diabetes on glaucoma progression was seen.

Keywords

Diabetes, glaucoma, intraocular pressure, haemoglobin A1c, RNFL

Diabetes Mellituslu Primer Açık Açılı Glokom Hastalarında Glokom Parametreleri ve Hemoglobin A1c Düzeylerinin İlişkisinin İncelenmesi

Abstract

Amaç: Çalışmamızda, glokom tanılı hastalarda hemoglobin A1c (HbA1c) düzeyi ile glokom parametreleri arasındaki ilişkinin araştırılması amaçlandı. Gereç ve yöntemler: Glokom Birimi’mizde takip edilmekte olan primer açık açılı glokom (PAAG) tanılı hastaların göz muayenesinden önceki veya sonraki 3 ay içinde ölçülmüş açlık kan şekeri (AKŞ) ve tokluk kan şekeri (TKŞ) ile HbA1c düzeyleri kaydedildi. Hastalar, HbA1c düzeyine göre iki gruba ayrıldı ve sağ gözlerine ait oftalmolojik muayene bulguları kaydedildi. HbA1c≤ %6 olan (Grup 1) 37 hastanın verileri, HbA1c> %6 olan (Grup 2) 43 hasta ile karşılaştırıldı. Tüm hastaların en iyi düzeltilmiş görme keskinlikleri, göz içi basınç (GİB), cup/disk (c/d) oranı, retina sinir lifi tabakası (RNFL) kalınlığı ve görme alanı mean deviasyon (MD) skoru kaydedildi. Bulgular: İki gruptaki hastaların yaş ve cinsiyet dağılımları arasında anlamlı farklılık bulunmadı (sırasıyla; p=0.757, p=0.422). Gruplar arasında ortalama AKŞ açısından anlamlı farklılık olmadığı, ortalama TKŞ değerinin ise Grup 2’de anlamlı olarak daha yüksek olduğu görüldü (sırasıyla; p=0.097, p=0.015). Ortalama GİB, c/d, RNFL ve MD skoru açısından gruplar arasında anlamlı farklılık saptanmadı (sırasıyla; p=0.601, p=0.092, p=0.809, p=0.325). AKŞ ve TKŞ değerlerinin, HbA1c düzeyi ile istatistiksel olarak anlamlı pozitif korelasyon gösterdiği görüldü (sırasıyla; r=0.335, p=0.002; r=0.560, p=0.016). Sonuç: Çalışmamızda HbA1c düzeyinin; göz içi basıncı (GİB), c/d oranı, RNFL ve MD skoru gibi glokom ile ilişkili parametreler üzerinde anlamlı etkisinin olmadığı görüldü. Diabet, glokom ortaya çıkışı ya da GİB yüksekliği için risk faktörü iken diabet varlığının glokom progresyonunda bir etkisi görülmemiştir.

Keywords

Diabet, Glokom, Göz içi basıncı, Hemoglobin A1c, RNFL

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