RESUMEN
PURPOSE: To evaluate corneal hysteresis (CH), acquired with ocular response analyzer (ORA), as a risk factor for glaucoma progression in early-stage primary open-angle glaucoma (POAG). METHODS: In a historical cohort study, patients diagnosed in 2011 with early-stage POAG according to the Hodapp, Parrish and Anderson classification modified for Octopus perimetry and followed up until glaucomatous progression development; otherwise, observations were censored in October 2018. Cox regression was used to obtain hazard ratios (HR) to evaluate baseline variables (CH, central corneal thickness, gender, age IOP and glaucoma family history) as risk factors for perimetric glaucoma progression. A likelihood ratio test for interaction was performed in order to assess the effect of the combination of CH and CCT on the risk of progression. RESULTS: Of the cohort of 1573 patients, 11.38% developed early-stage POAG progression during the follow-up. The mean follow-up time was 3.28 ± 1.92 years. Patients without progression had a higher CH (11.35 ± 1.43 vs 9.07 ± 1.69 mmHg; p < 0.001) and CCT (570.75 ± 17.71 vs 554.51 ± 23.20; p < 0.001). In the multivariate analysis, each 1 mmHg of lower CH was associated with an increase of 2.13 times in the HR of progression (95% CI: 1.92-2.32; p < 0.001). CH hazard ratio was modified by CCT, with higher values of CCT and CH resulting in a higher HR of early glaucoma progression (p < 0.001). CONCLUSIONS: CH can be considered as a risk factor of progression in early-stage POAG. The risk associated with CH changed depending on CCT values, acting synergistically slowing the risk of glaucoma progression with higher values.
Asunto(s)
Glaucoma de Ángulo Abierto , Estudios de Cohortes , Córnea , Glaucoma de Ángulo Abierto/diagnóstico , Humanos , Presión Intraocular , Estudios Prospectivos , Tonometría OcularRESUMEN
AIMS: The aim of this study was to assess the prevalence of anxiety and depression in groups of obese and normal-weight individuals with type 2 diabetes. Also, to analyze the severity of depression in type 2 diabetics by taking into account the body mass index in people with this condition. METHODS: This study included 702 patients with type 2 diabetes, 236 with normal weight, and 231 with obesity. All participants completed a demographic questionnaire, the Hamilton Anxiety Rating Scale and the Hamilton Depression Rating Scale. RESULTS: In patients with obesity, 48.48% (95% CI: 41.82-55.14) were positive for anxiety and 49.78% (95% CI: 43.11-56.44) for depression. A significant correlation existed between the Hamilton Depression Rating Scale and body mass index with a correlation coefficient of 0.11 (p = 0.003). Also, a significant correlation coefficient equal to 0.107 (p = 0.005) between the Hamilton Anxiety Rating Scale and body mass index was found. In addition, when we analyzed depression scores, significant differences were encountered for gender between normal-weight and obesity groups in the range of severe (p = 0.01) and very severe (p = 0.04) cases. CONCLUSION: In view of the existing relationships observed among obesity, depression, anxiety, and gender in type 2 diabetics, we consider that a psychological intervention is necessary for an integral management of these patients.
