Association between Moyamoya Disease and Open-Angle Glaucoma: A Nationwide Cohort Study in Korea

Abstract This nationwide population-based retrospective cohort study aims to investigate the association between Moyamoya disease (MMD) and open-angle glaucoma (OAG). In this study using the Korean National Health Insurance Service database, a total of 40,253 patients having diagnostic code with MMD between 2002 and 2022, and their age-, sex-matched non-MMD controls (n = 400,033) were included. For the primary outcome, logistic regression analysis was performed to determine the association between MMD and OAG. For the secondary outcome, we used a Cox proportional hazard model after excluding cases with preexisting diagnosis of MMD for the initial 2-year. Kaplan-Meier survival analyses with log-rank test were performed to compare the incidence probability of OAG based on the MMD diagnosis. Logistic regression analysis revealed a significant association between MMD and OAG (OR, 1.45; 95% CI, 1.36–1.54; P < 0.001), consistent across adjusted model (OR, 1.15; 95% CI, 1.07–1.23; P < 0.001). Cox regression analysis showed that the diagnosis of MMD was associated with increased risk of subsequent diagnosis of OAG (adjusted HR, 1.26; 95% CI, 1.14–1.39; P < 0.001). The cumulative incidence probability of OAG was 3.7% in MMD group and 2.9% in control group at the end of the study period, and was significantly higher among MMD patients than controls consistently during the study period (P < 0.001). In conclusion, the nationwide longitudinal data of Korean population revealed a significant association between MMD and OAG. Presence of MMD may increase the risk of developing OAG.