Dataset Information

Associations with intraocular pressure across Europe: The European Eye Epidemiology (E³) Consortium.

ABSTRACT: Raised intraocular pressure (IOP) is the most important risk factor for developing glaucoma, the second commonest cause of blindness globally. Understanding associations with IOP and variations in IOP between countries may teach us about mechanisms underlying glaucoma. We examined cross-sectional associations with IOP in 43,500 European adults from 12 cohort studies belonging to the European Eye Epidemiology (E³) consortium. Each study conducted multivariable linear regression with IOP as the outcome variable and results were pooled using random effects meta-analysis. The association of standardized study IOP with latitude was tested using meta-regression. Higher IOP was observed in men (0.18 mmHg; 95 % CI 0.06, 0.31; P = 0.004) and with higher body mass index (0.21 mmHg per 5 kg/m²; 95 % CI 0.14, 0.28; P < 0.001), shorter height (-0.17 mmHg per 10 cm; 95 % CI -0.25, -0.08; P < 0.001), higher systolic blood pressure (0.17 mmHg per 10 mmHg; 95 % CI 0.12, 0.22; P < 0.001) and more myopic refraction (0.06 mmHg per Dioptre; 95 % CI 0.03, 0.09; P < 0.001). An inverted U-shaped trend was observed between age and IOP, with IOP increasing up to the age of 60 and decreasing in participants older than 70 years. We found no significant association between standardized IOP and study location latitude (P = 0.76). Novel findings of our study include the association of lower IOP in taller people and an inverted-U shaped association of IOP with age. We found no evidence of significant variation in IOP across Europe. Despite the limited range of latitude amongst included studies, this finding is in favour of collaborative pooling of data from studies examining environmental and genetic determinants of IOP in Europeans.

SUBMITTER: Khawaja AP

PROVIDER: S-EPMC5206267 | biostudies-literature | 2016 Nov

REPOSITORIES: biostudies-literature

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Associations with intraocular pressure across Europe: The European Eye Epidemiology (E<sup>3</sup>) Consortium.

Khawaja Anthony P AP Springelkamp Henriët H Creuzot-Garcher Catherine C Delcourt Cécile C Hofman Albert A Höhn René R Iglesias Adriana I AI Wolfs Roger C W RC Korobelnik Jean-François JF Silva Rufino R Topouzis Fotis F Williams Katie M KM Bron Alain M AM Buitendijk Gabriëlle H S GH Cachulo Maria da Luz MD Cougnard-Grégoire Audrey A Dartigues Jean-François JF Hammond Christopher J CJ Pfeiffer Norbert N Salonikiou Angeliki A van Duijn Cornelia M CM Vingerling Johannes R JR Luben Robert N RN Mirshahi Alireza A Lamparter Julia J Klaver Caroline C W CC Jansonius Nomdo M NM Foster Paul J PJ

European journal of epidemiology 20160909 11

Raised intraocular pressure (IOP) is the most important risk factor for developing glaucoma, the second commonest cause of blindness globally. Understanding associations with IOP and variations in IOP between countries may teach us about mechanisms underlying glaucoma. We examined cross-sectional associations with IOP in 43,500 European adults from 12 cohort studies belonging to the European Eye Epidemiology (E<sup>3</sup>) consortium. Each study conducted multivariable linear regression with IO ...[more]

PMID: 27613171

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Project description:To determine the association between systemic medication use and intraocular pressure (IOP) in a population of older British men and women.Population-based, cross-sectional study.We included 7093 participants from the European Prospective Investigation into Cancer-Norfolk Eye Study. Exclusion criteria were a history of glaucoma therapy (medical, laser, or surgical), IOP asymmetry between eyes of >5 mmHg, and missing data for any covariables. The mean age of participants was 68 years (range, 48-92) and 56% were women.We measured IOP using the Ocular Response Analyzer. Three readings were taken per eye and the best signal value of the Goldmann-correlated IOP value considered. Participants were asked to bring all their medications and related documentation to the health examination, and these were recorded by the research nurse using an electronic case record form. The medication classes examined were angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, ?-blockers, ?-blockers, calcium channel blockers, diuretics, nitrates, statins, insulin, biguanides, sulfonylureas, aspirin, and other nonsteroidal anti-inflammatory drugs. We examined associations between medication use and IOP using multivariable linear regression models adjusted for age, sex, and body mass index. Models containing diabetic medication were further adjusted for glycosylated hemoglobin levels.Mean IOP of the right and left eyes.Use of systemic ?-blockers (-0.92 mmHg; 95% CI, -1.19, -0.65; P<0.001) and nitrates (-0.63 mmHg; 95% CI, -1.12, -0.14; P = 0.011) were independently associated with lower IOP. The observed associations between statin or aspirin use with IOP were no longer significant after adjustment for ?-blocker use.This is the first population-based study to demonstrate and quantify clinically significant differences in IOP among participants using systemic ?-blockers or nitrates. Lower IOP observed in participants using statins or aspirin was explained by concurrent systemic ?-blocker use. The study findings may have implications for the management of glaucoma patients with comorbidity, and may provide insight into the pathophysiologic processes underlying IOP.

Project description:PurposeTo describe the associations of physical and demographic factors with Goldmann-correlated intraocular pressure (IOPg) and corneal-compensated intraocular pressure (IOPcc) in a British cohort.DesignCross-sectional study within the UK Biobank, a large-scale multisite cohort study in the United Kingdom.ParticipantsWe included 110 573 participants from the UK Biobank with intraocular pressure (IOP) measurements available. Their mean age was 57 years (range, 40-69 years); 54% were women, and 90% were white.MethodsParticipants had 1 IOP measurement made on each eye using the Ocular Response Analyzer noncontact tonometer. Linear regression models were used to assess the associations of IOP with physical and demographic factors.Main outcome measuresThe IOPg and IOPcc.ResultsThe mean IOPg was 15.72 mmHg (95% confidence interval [CI], 15.70-15.74 mmHg), and the mean IOPcc was 15.95 mmHg (15.92-15.97 mmHg). After adjusting for covariates, IOPg and IOPcc were both significantly associated with older age, male sex, higher systolic blood pressure (SBP), faster heart rate, greater myopia, self-reported glaucoma, and colder season (all P < 0.001). The strongest determinants of both IOPg and IOPcc were SBP (partial R(2): IOPg 2.30%, IOPcc 2.26%), followed by refractive error (IOPg 0.60%, IOPcc 1.04%). The following variables had different directions of association with IOPg and IOPcc: height (-0.77 mmHg/m IOPg; 1.03 mmHg/m IOPcc), smoking (0.19 mmHg IOPg, -0.35 mmHg IOPcc), self-reported diabetes (0.41 mmHg IOPg, -0.05 mmHg IOPcc), and black ethnicity (-0.80 mmHg IOPg, 0.77 mmHg IOPcc). This suggests that height, smoking, diabetes, and ethnicity are related to corneal biomechanical properties. The increase in both IOPg and IOPcc with age was greatest among those of mixed ethnicities, followed by blacks and whites. The same set of covariates explained 7.4% of the variability of IOPcc but only 5.3% of the variability of IOPg.ConclusionsThis analysis of associations with IOP in a large cohort demonstrated that some variables clearly have different associations with IOPg and IOPcc, and that these 2 measurements may reflect different biological characteristics.

Project description:PurposeTo characterize the relationship between angle configuration measured by anterior segment optical coherence tomography (AS-OCT) and intraocular pressure (IOP).DesignCross-sectional study.ParticipantsSubjects aged 50 years or older were identified from the Chinese American Eye Study (CHES), a population-based epidemiological study in Los Angeles, CA.MethodsEach subject underwent a complete ocular exam including Goldmann applanation tonometry, gonioscopy, and AS-OCT imaging. Four AS-OCT images were analyzed per eye and parameters describing angle configuration were measured, including angle opening distance (AOD), angle recess area (ARA), trabecular iris space area (TISA), trabecular iris angle (TIA), and scleral spur angle (SSA). The relationship between AS-OCT measurements and IOP was assessed using locally-weighted scatterplot smoothing (LOWESS) regression and change-point analyses.Main outcome measuresCorrelation between AS-OCT measurements and IOP.Results702 eyes (382 closed angle and 320 open angle) from 555 subjects were analyzed. Mean IOP for angle closure eyes was 16.3 ± 3.9 mmHg and open angle eyes was 15.3 ± 2.7 mmHg. Mean IOP increased as AS-OCT measurements decreased for all parameters except TIA750. Once measurement values dropped below parameter-specific threshold values, AS-OCT measurements and IOP were significantly correlated (p < 0.05) for AOD500 (r = -0.416), AOD750 (r = -0.213), ARA500 (r = -0.669), ARA750 (r = -0.680), TISA500 (r = -0.655), TISA750 (r = -0.641), SSA500 (r = -0.538), and SSA750 (r = -0.208). There was no correlation between AS-OCT measurements and IOP in open angle eyes (p > 0.40).ConclusionsThere is an anatomic threshold for angle configuration below which IOP is strongly related to the degree of angle closure. This finding suggests reconsideration of current definitions of angle closure and may be relevant for developing new OCT-based methods to identify patients at higher risk for elevated IOP and glaucoma.

Dataset Information

Associations with intraocular pressure across Europe: The European Eye Epidemiology (E3) Consortium.

Publications

Associations with intraocular pressure across Europe: The European Eye Epidemiology (E<sup>3</sup>) Consortium.

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Associations with intraocular pressure across Europe: The European Eye Epidemiology (E³) Consortium.