title: Do non-communicable diseases such as hypertension and diabetes associate with primary open-angle glaucoma? Insights from a case-control study in Nepal.
abstract: BACKGROUND
  Non-communicable diseases (NCDs) such as hypertension and diabetes are rapidly emerging public health problems worldwide, and they associate with primary open-angle glaucoma (POAG). POAG is the most common cause of irreversible blindness. The most effective ways to prevent glaucoma blindness involve identifying high-risk populations and conducting routine screening for early case detection. This study investigated whether POAG associates with hypertension and diabetes in a Nepalese population.
  
  
  METHODS
  To explore the history of systemic illness, our hospital-based case-control study used non-random consecutive sampling in the general eye clinics in three hospitals across Nepal to enroll patients newly diagnosed with POAG and controls without POAG. The study protocol included history taking, ocular examination, and interviews with 173 POAG cases and 510 controls. Data analysis comprised descriptive and inferential statistics. Descriptive statistics computed the percentage, mean, and standard deviation (SD); inferential statistics used McNemar's test to measure associations between diseases.
  
  
  RESULTS
  POAG affected males more frequently than females. The odds of members of the Gurung ethnic group having POAG were 2.05 times higher than for other ethnic groups. Hypertension and diabetes were strongly associated with POAG. The overall odds of POAG increased 2.72-fold among hypertensive and 3.50-fold among diabetic patients.
  
  
  CONCLUSIONS
  POAG associates significantly with hypertension and diabetes in Nepal. Thus, periodic glaucoma screening for hypertension and diabetes patients in addition to opportunistic screening at eye clinics may aid in detecting more POAG cases at an early stage and hence in reducing avoidable blindness.
authors.affiliation: Department of Ophthalmology, Nepal Medical College Teaching Hospital, Kathmandu, Nepal; Nordic School of Public Health NHV, Gothenburg, Sweden.
authors.forename: Suraj
authors.initials: S
authors.lastname: Shakya-Vaidya
authors.forename: Umesh Raj
authors.initials: UR
authors.lastname: Aryal
authors.forename: Madan
authors.initials: M
authors.lastname: Upadhyay
authors.forename: Alexandra
authors.initials: A
authors.lastname: Krettek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D005902:Glaucoma, Open-Angle / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D015995:Prevalence; D012737:Sex Factors; D014792:Visual Acuity; D055815:Young Adult
keywords: blindness; diabetes mellitus; hypertension; non-communicable disease (NCD); primary open-angle glaucoma (POAG)