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Risk of selected eye diseases in people admitted to hospital for hypertension or diabetes mellitus: record linkage studies
  1. Michael J Goldacre1,
  2. Clare J Wotton1,
  3. Tiarnan D L Keenan2,3
  1. 1Department of Public Health, Unit of Health-Care Epidemiology, University of Oxford, Oxford, UK
  2. 2Fight For Sight Clinical Fellow, University of Manchester, Manchester, UK
  3. 3Manchester Royal Eye Hospital, Manchester, UK
  1. Correspondence to Tiarnan D L Keenan, Faculty of Medical and Human Sciences, University of Manchester, AV Hill Building, Oxford Road, Manchester M13 9PT, UK; tiarnan.keenan{at}


Aims 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.

Methods 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.

Results 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.

Conclusions 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.

  • Hypertension
  • diabetes mellitus
  • cataract
  • retinal artery occlusion
  • retinal vein occlusion
  • glaucoma
  • age-related macular degeneration
  • retinal detachment
  • angiogenesis
  • eye (tissue) banking
  • pathology
  • genetics
  • epidemiology

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  • Funding The Unit of Health-Care Epidemiology is funded by the English National Institute for Health Research to analyse the linked data. The views expressed in this paper do not necessarily reflect those of the funding body. TDLK is funded by Fight For Sight through a Clinical Fellowship.

  • Competing interests None.

  • Ethics approval Ethical approval for analysis of the record linkage study data was obtained from the Central and South Bristol Multi-Centre Research Ethics Committee (04/Q2006/176).

  • Provenance and peer review Not commissioned; externally peer reviewed.