Association Between Body Mass Index and Primary Open Angle Glaucoma in Three Cohorts

PURPOSE: To evaluate the relationship between body mass index (BMI) and glaucoma progression.DESIGN: Multicohort observational study.METHODS: This study combined a retrospective lon-gitudinal analysis of suspect and early manifest primary open angle glaucoma cases from the Progression Risk of Glaucoma: RElevant SNPs with Significant Association (PROGRESSA) study with 2 replication cohorts from the UK Biobank and the Canadian Longitudinal Study of Ageing (CLSA). In the PROGRESSA study, multivari-ate analysis correlated BMI with longitudinal visual field progression in 471 participants. The BMI was then asso-ciated with glaucoma diagnosis and cross-sectional ver-tical cup-disc ratio (VCDR) measurements in the UK Biobank, and finally prospectively associated with longi-tudinal change in VCDR in the CLSA study.RESULTS: In the PROGRESSA study, a lower BMI conferred a faster rate of visual field progression (mean duration of monitoring (5.28 +/- 1.80 years (10.6 +/- 3.59 visits) ( 0 0.04 dB/year/SD95% CI [0.005, 0.069]; P = .013). In the UK Biobank, a 1 standard deviation lower BMI was associated with a worse cross-sectional VCDR ( 0 -0.048/SD 95% CI [-0.056, 0.96]; P < .001) and a 10% greater likelihood of glaucoma diagnosis, as per specialist grading of retinal fundus imaging (OR 0.9095% CI [0.84, 0.98]; P = .011). Similarly, a lower BMI was associated with a greater risk of glaucoma di-agnosis as per International Classification of Disease data (OR 0.94/SD; 95% CI [0.91, 0.98]; P = .002). Body mass index was also positively correlated with intraocular pressure ( 0 0.11/SD; 95% CI [0.06, 0.15]; P < .001). Finally, a lower BMI was then associated with greater VCDR change in the CLSA ( 0 -0.007/SD; 95% CI [- 0.01, -0.001]; P = .023).CONCLUSIONS: Body mass index correlated with longi-tudinal and cross-sectional glaucomatous outcomes. This supports previous work illustrating a correlation between BMI and glaucoma.