Data Show Dyslipidemia as Independent Risk Factor for Primary Open-Angle Glaucoma

Investigators have found dyslipidemia to be an independent risk factor for primary open-angle glaucoma (POAG), with higher serum lipid levels linked to the presence of the disease, according to a study published in Cureus. Glaucoma has been a major contributor to blindness worldwide, and elevated intraocular pressure has been identified as a key risk factor.¹

Glaucoma, Cholesterol, Lipid | Image Credit: © Saiful52 | stock.adobe.com

According to the American Academy of Ophthalmology, there are 2 major types of glaucoma, including open angle and angle closure—also known as closed angle or narrow angle. Open-angle glaucoma is the most common type, in which the eye does not drain fluid like it should and the eye pressure increases and damages the optic nerves. It happens gradually and typically is painless, with no vision changes initially. In angle-closure glaucoma, the iris is very close to the drainage angle, leading to the iris blocking it. When it gets blocked, the eye pressure rises quickly and is called an acute attack, causing suddenly blurry vision, severe eye pain, headache, nausea, and vomiting.²

Dyslipidemia is a condition in which there are abnormal levels of lipids in the blood stream. Approximately 20% of adolescents in the US have dyslipidemia, and many young and middle-aged adults with heart disease had untreated dyslipidemia in adolescence. It can include high levels of low-density lipoprotein (LDL) cholesterol, low levels of high-density lipoprotein (HDL) cholesterol, and/or high levels of triglycerides, according to the Children’s Hospital of Philadelphia.³

In the current study, investigators aimed to better understand the potential association between serum lipid levels and the development of POAG. The study was case controlled and used data from November 2019 to August 2021 from the Regional Institute of Ophthalmology of the Banaras Hindu University in Varanasi, India. A total of 120 individuals were included, about 60 of whom were diagnosed with POAG and 60 who had no eye disorders. Individuals were aged 18 and older and did not have any additional ocular diseases. Those with a history of angle-closure glaucoma, non-dilating pupils, ocular trauma, other ocular conditions, or systemic diseases that affect the eye (ie, diabetes and hypertension) were excluded from the study.¹

The average age was 58 years in the glaucoma group and 60 years in the control group. For glaucoma cases, 65% were from urban areas compared with 73% in the control group. In the glaucoma group, the mean cholesterol level was 204.22 mg/dl, mean triglycerides were 162.25 mg/dl, mean LDL was 123.71, and mean HDL was 39.99, compared with 162.81, 111.43, 105.81, and 41.75, respectively, in the control group. Elevated cholesterol levels were seen among 56.7% of patients with glaucoma compared with 11.7% in the control group. High triglyceride levels were in 75% of the glaucoma group and 18.3% of the control group, raised LDL levels were in 55% and 8.3%, and low HDL levels in 41.7% and 26.7%, respectively.¹

Investigators reported no significant differences in mean age or sex for both groups, but the mean cholesterol, triglyceride, and LDL levels were significantly higher in the glaucoma group compared with the control group. HDL levels were lower in the case group compared with the control group, but investigators said this was not statistically significant.¹

REFERENCES

1. Karn MK, Sinha M, Mishra D, Anand A. Assessing Serum Lipid Levels in Patients Diagnosed With Primary Open-Angle Glaucoma. Cureus. 2024;16(11):e74582. Published 2024 Nov 27. doi:10.7759/cureus.74582

2. Boyd K. Understanding Glaucoma: Symptoms, Causes, Diagnosis, Treatment. American Academy of Ophthalmology. October 29, 2024. Accessed January 7, 2025. https://www.aao.org/eye-health/diseases/what-is-glaucoma

3. Children’s Hospital of Philadelphia. Dyslipidemia. Accessed January 7, 2025. https://www.chop.edu/conditions-diseases/dyslipidemia-in-children