Evaluation of Optic Nerve Head Changes in Diabetic and Non-Diabetic Glaucoma Patients

Open Access

Abstract

Background: Diabetes mellitus could contribute to the development of glaucoma due to vascular/metabolic mechanisms that might lead to optic nerve head and retinal nerve fiber layer damage, but this has not been sufficiently examined in Bangladesh. This study sought to compare the optic nerve head and retinal nerve fiber layer parameters among the glaucoma patients with and without diabetes mellitus. Methods & Materials: A cross-sectional comparative study was conducted on 120 glaucoma patients (60-diabetic and 60 non-diabetic) within a time span of January-Dec 2025. In this study, optic nerve head, RNFL thickness, intraocular pressure, central corneal thickness, visual field parameters were analyzed and compared among the groups using optical coherence tomography and standard automated perimetry. The IBM-SPSS statistical software was used to evaluate the collected data, where p<0.05 was considered significant. Results: Patients with diabetic glaucoma were older than those without diabetes (59.9 ± 6.4 vs. 57.0 ± 7.4 years, p=0.024). They also had larger optic discs, higher vertical cup-to-disc ratios, lower neuroretinal rim and RNFL thicknesses, and poorer visual field parameters (p≤0.019). Moderate-to-severe glaucoma was significantly more prevalent in the diabetic group than in the non-diabetic group (85.0% vs. 51.7%, p<0.001), indicating greater structural and functional glaucomatous damage, with more pronounced optic nerve changes and advanced disease severity among diabetic patients. Conclusion: Diabetes was associated with greater structural and functional glaucomatous damage and more advanced disease severity, emphasizing the need for regular comprehensive ophthalmic assessment and close glaucoma monitoring in diabetic patients to facilitate early detection of progression and appropriate management.