Systematic review of the association between Alzheimer’s disease and chronic glaucoma

• Main Authors: Tsilis AG, Tsilidis KK, Pelidou SH, Kitsos G
• Format: Article
• Language: English
• Published: Dove Medical Press 2014-10-01
• Series: Clinical Ophthalmology
• Online Access: http://www.dovepress.com/systematic-review-of-the-association-between-alzheimerrsquos-disease-a-peer-reviewed-article-OPTH

Alexandros G Tsilis,1 Konstantinos K Tsilidis,2 Sygkliti-Henrietta Pelidou,3 George Kitsos1 1Department of Ophthalmology, 2Department of Hygiene and Epidemiology, 3Department of Neurology, University of Ioannina School of Medicine, Ioannina, Greece Abstract: A potential association between Alzheimer’s disease (AD) and chronic glaucoma has been suggested but results of epidemiological studies have been inconsistent. Therefore, we performed a systematic review and critical appraisal of this literature. We searched systematically in PubMed from December 1964 to September 2013 and identified 239 articles potentially relevant for abstract and full-text review. Statistical heterogeneity (variability) across studies was evaluated using the Cochran Q test and the I2 statistic, and the Newcastle-Ottawa score was used to assess study quality. Ten studies were finally selected. Compared to non-demented participants, patients with AD had a statistically significant decreased risk of glaucoma but the results were very heterogeneous, and thus summary estimates were not reported (I2, 89%; Pheterogeneity, <0.001). The study results ranged from large positive relative risks identified in small and poorly-conducted studies to weak inverse associations or null estimates observed in some cohort and record-linkage studies, but the summary estimates were essentially driven by a large retrospective cohort using medical claims that may be afflicted by underdiagnosis bias. There was also evidence for substantial publication bias (Egger’s P≤0.01). The association of AD and glaucoma is heterogeneous and most studies are small and inadequately designed. Large prospective studies with long follow-ups are warranted to clarify this association. Keywords: systematic review, Alzheimer disease, neurodegenerative diseases, glaucoma