Relationship Between Metabolic Syndrome and Primary Open-Angle Glaucoma: A Systematic Review and Meta-Analysis

Author(s): Hashim Sallam Almishhadany, Rita Alkhatib, Ahmed Al-Zuhairi, Mohamad Khalid Al Aswad, Donea N. Almaliti, Meryem Mohamed, Dr. Joyce Nana Yaa Obeng, Rodha Saeed AlMusallam, Shaikha Belhoul Alfalasi, Muhammad Salman Arif

Metabolic syndrome (MetS) is a constellation of disorders that, on their own or in combination, pose an increased threat to cardiovascular health, the development of type 2 diabetes, and a number of other chronic diseases. Newer research has proposed a relationship between MetS and some eye disorders, including primary open-angle glaucoma (POAG), which is one of the most common causes of blindness in the world. Yet this relationship remains ill-defined. This meta-analysis aims to evaluate studies that specifically explore the interconnection between MetS and POAG with a particular focus on what pathways MedS may use to alter the development or progression of POAG. Within this meta-analysis, a meticulous selection of the period 2023 - 2025 was used. The choice of studies was also limited to those that were registered in PubMed, Scopus, and Web of Science. The analysis included studies examining MetS components such as hypertension, hyperglycemia, dyslipidemia, and HO and their relation to POAG. Data retrieval was performed on cross-sectional and cohort studies in order to capture a broader view of phenomena from various perspectives. Study quality assessment was performed by applying bias and methodological quality tools. As revealed from this report, diabetes and hypertension appear to be the leading reasons for more chances of individuals with MetS developing POAG. Moreover, specific components of MetS, such as insulin resistance and hypertension, could be essential when it comes to the causes of POAG. Further studies are needed to understand why there are varying results from different studies and how confounding factors may impact the results obtained. This study strongly indicates a relationship between MetS and POAG. This analysis reveals the need for MetS at an early stage to prevent the onset of POAG. Larger scale studies examining more subjects are needed to determine the factors that lead to this correlation and appropriate interventions to treat them.