Gout and open-angle glaucoma risk in a veteran population

Purpose: A history of gout, arthritis due to hyperuricemia, has been associated with decreased risk for neurodegenerative diseases such as Parkinson’s disease. We performed a population-based case-control study in the US Department of Veterans Affairs (VA) medical centers nationwide to assess if gout or hyperuricemia is similarly associated with the ocular neurodegenerative condition glaucoma. Methods: We used ICD-9 codes to identify a nationwide cohort of patients examined at VA healthcare eye clinics between 2000 and 2015 with a diagnosis of open-angle glaucoma (OAG) or of glaucoma suspect. We used incidence density matching to choose controls. We used multivariable logistic regression to examine associations between a history of gout and uric acid (UA) levels on relative risk of OAG or glaucoma suspect. Results: There were 1,144,428 OAG or glaucoma suspect cases and 1,144,428 matched controls. Veterans with a history of gout had a small significant decreased risk of OAG compared to controls (OR_{adjusted(adj)} = 0.985, 95% CI: 0.974–0.996). Treated gout was similarly associated with small decreased risk (OR_adj = 0.963, 95% CI: 0.950–0.976). A small subset of patients (11.9% of cases and 13.2% of controls) had UA labs available; veterans with the highest median UA levels (> 7.29 mg/dL) did not have statistically significant differences in relative OAG risk (OR_adj = 1.014, 95% CI: 0.991–1.036). Conclusion: Prospective research in other cohorts is needed to confirm our findings in veterans suggesting a history of gout is associated with a small decreased relative risk of glaucoma.