Studies have speculated that glaucoma and Alzheimer’s disease share common pathophysiology. Findings of a new retrospective study from Taiwan presented at the American Academy of Ophthalmology (AAO) 2022 Annual Meeting in Chicago has demonstrated an association between the two. According to the new study, over half of the individuals with normal tension glaucoma are likely to develop Alzheimers disease compared to those who do not have glaucoma.^1,2

A total of 15,317 patients with normotensive glaucoma diagnoses between January 2001 and December 2013 and age- and sex-matched 61,268 persons as controls were selected for the study from the Taiwan National Health Insurance Database. The patients were followed-up for 13 years (median).

The incidence of Alzheimer’s disease in patients with normal-tension glaucoma was 6.7% compared to 4.2% in those who did not have normal-tension glaucoma with an adjusted hazard ratio of 1.52. Patients with normotensive glaucoma had higher prevalence of hyperlipidemia, hypertension, diabetes and coronary artery disease. The risk for Alzheimer’s disease remained significant even after adjusting for these variables. Age, female sex and a history of stroke were significantly associated with the risk of Alzheimer’s disease among patients with normal-tension glaucoma. No association was found between the various glaucoma medications and Alzheimer’s disease.

Normal-tension glaucoma is a subtype of primary open-angle glaucoma, but with normal intra-ocular pressures. The disease can progress from loss of vision to bilateral blindness. It is often an incidental diagnosis. Clinicians should be aware of the association between Alzheimer’s disease and normal-tension glaucoma. All patients of normal tension glaucoma, particularly those at risk, should therefore be screened for Alzheimer’s disease.

References

1. American Academy of Ophthalmology (AAO) 2022 Annual Meeting: Poster 133. Presented September 29, 2022. https://www.medscape.com/viewarticle/981976.

2. Source Reference: Chen YY, et al. Association between NTG and the risk of Alzheimer disease. AAO 2022; Abstract PO133. https://www.medpagetoday.com/meetingcoverage/aao/101099.