Department of Public Health, Unit of Health-Care Epidemiology, University of Oxford, Oxford, UK.
Br J Ophthalmol. 2012 Jun;96(6):872-6. doi: 10.1136/bjophthalmol-2012-301519. Epub 2012 Apr 4.
Associations among hypertension, diabetes mellitus and some ophthalmic diseases are well established; associations with others are more equivocal. The aim was to quantify associations accurately using large epidemiological datasets.
Analysis of the Oxford Record Linkage Study (ORLS), 1963-1998, and English linked hospital episode statistics (LHES), 1999-2010; calculation of rate ratios of eye disease in a hypertension cohort and a diabetes cohort, compared with a reference cohort as control.
Risk of cataract following hypertension was marginally elevated (rate ratio ORLS 1.15, 95% CI 1.00 to 1.31; LHES 1.06, 1.01 to 1.10), as was risk of glaucoma (LHES 1.07, 1.00 to 1.14) and age-related macular degeneration (AMD) (LHES 1.14, 1.02 to 1.27). Risk of retinal vein or artery occlusion was elevated three- to fivefold in both populations. Risk of retinal detachment was elevated in LHES at 1.52 (1.43 to 1.73). Risk of cataract in diabetes was high in ORLS and LHES at, respectively, 2.95 (2.75 to 3.16) and 2.30 (2.24 to 2.35), as was risk of glaucoma: 2.47 (2.14 to 2.84) and 2.23 (2.15 to 2.30). Risks were high for AMD (10.3, 8.1 to 13.1, and 3.46, 3.35 to 3.58) and retinal detachment (3.41, 2.71 to 4.25, and 7.96, 7.63 to 8.30), and very high for retinal vein and artery occlusion.
With the exception of retinal vascular occlusion, elevations of risk of the ophthalmic diseases studied in hypertension were modest. By contrast, there were significant and substantial increases of risk for each eye disease in people with diabetes.
高血压、糖尿病与一些眼部疾病之间的关联已得到充分证实，而与其他一些疾病的关联则较为模糊。本研究旨在使用大型流行病学数据集准确量化这些关联。
分析牛津病历链接研究（ORLS）（1963-1998 年）和英国链接医院发病统计数据（LHES）（1999-2010 年）；计算高血压队列和糖尿病队列中眼部疾病的发病率比值（与参照队列相比）。
高血压后白内障的风险略有升高（ORLS 比值比 1.15，95%置信区间 1.00 至 1.31；LHES 比值比 1.06，1.01 至 1.10），青光眼（LHES 比值比 1.07，1.00 至 1.14）和年龄相关性黄斑变性（AMD）（LHES 比值比 1.14，1.02 至 1.27）的风险也有所升高。在两个人群中，视网膜静脉或动脉阻塞的风险均升高了三至五倍。LHES 中视网膜脱离的风险升高到 1.52（1.43 至 1.73）。ORLS 和 LHES 中糖尿病患者的白内障风险分别为 2.95（2.75 至 3.16）和 2.30（2.24 至 2.35），青光眼的风险也很高：2.47（2.14 至 2.84）和 2.23（2.15 至 2.30）。AMD（10.3，8.1 至 13.1 和 3.46，3.35 至 3.58）和视网膜脱离（3.41，2.71 至 4.25 和 7.96，7.63 至 8.30）的风险很高，视网膜静脉和动脉阻塞的风险非常高。
除视网膜血管阻塞外，高血压患者的眼部疾病风险升高幅度较小。相比之下，糖尿病患者的每种眼部疾病的风险均显著增加。
