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Meta-Analysis
. 2016 Nov;31(11):1101-1111.
doi: 10.1007/s10654-016-0191-1. Epub 2016 Sep 9.

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

Anthony P Khawaja  1   2 , Henriët Springelkamp  3   4 , Catherine Creuzot-Garcher  5 , Cécile Delcourt  6   7 , Albert Hofman  4   8 , René Höhn  9   10 , Adriana I Iglesias  3   4 , Roger C W Wolfs  3 , Jean-François Korobelnik  6   7   11 , Rufino Silva  12   13   14 , Fotis Topouzis  15 , Katie M Williams  16 , Alain M Bron  5 , Gabriëlle H S Buitendijk  3   4 , Maria da Luz Cachulo  12   13   14 , Audrey Cougnard-Grégoire  6   7 , Jean-François Dartigues  6   7 , Christopher J Hammond  16 , Norbert Pfeiffer  9 , Angeliki Salonikiou  15 , Cornelia M van Duijn  4 , Johannes R Vingerling  3 , Robert N Luben  17 , Alireza Mirshahi  9   18 , Julia Lamparter  9 , Caroline C W Klaver  3   4 , Nomdo M Jansonius  4   19 , Paul J Foster  20 ; European Eye Epidemiology (E³) Consortium
Collaborators, Affiliations
Meta-Analysis

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

Anthony P Khawaja et al. Eur J Epidemiol. 2016 Nov.

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.

Keywords: Blood pressure; Body mass index; Epidemiology; Glaucoma; Intraocular pressure; Refractive errors.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Forest plots for associations with intraocular pressure (IOP). All associations were adjusted for age, sex, body mass index (BMI), systolic blood pressure (SBP), height and spherical equivalent unless otherwise indicated. Results are for phakic participants (n = 43,500) except for cataract surgery (phakic and pseudophakic, n = 46,081) and CCT (n = 21,332 with complete data). Single asterisk SBP was not measured or adjusted for in the Coimbra Eye Study. Double asterisks CCT was not measured in these studies
Fig. 2
Fig. 2
Mean intraocular pressure (IOP) and 95 % confidence intervals plotted for ordinal categories of explanatory variables
Fig. 3
Fig. 3
Forest plot of standardized intraocular pressure (IOP), stratified by latitude. Pooled associations for northern studies, southern studies, and overall were derived using random effects meta-analysis. The right column presents standardized IOP in mmHg (95 % confidence interval)
Fig. 4
Fig. 4
Meta-regression for the association between latitude and standardized intraocular pressure (IOP)
See this image and copyright information in PMC

References

    1. World Health Organization. Global data on visual impairments 2010. 2012. http://www.who.int/blindness/GLOBALDATAFINALforweb.pdf?ua=1.
    1. de Voogd S, Ikram MK, Wolfs RCW, Jansonius NM, Hofman A, de Jong PTVM. Incidence of open-angle glaucoma in a general elderly population: the Rotterdam Study. Ophthalmology. 2005;112:1487–1493. doi: 10.1016/j.ophtha.2005.04.018. - DOI - PubMed
    1. Leske MC, Heijl A, Hyman L, Bengtsson B, Dong L, Yang Z. Predictors of long-term progression in the early manifest glaucoma trial. Ophthalmology. 2007;114:1965–1972. doi: 10.1016/j.ophtha.2007.03.016. - DOI - PubMed
    1. Trichopoulou A, Orfanos P, Norat T, Bueno-de-Mesquita B, Ocké MC, Peeters PHM, et al. Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study. BMJ. 2005;330:991. doi: 10.1136/bmj.38415.644155.8F. - DOI - PMC - PubMed
    1. Hoehn R, Mirshahi A, Hoffmann EM, Kottler UB, Wild PS, Laubert-Reh D, et al. Distribution of intraocular pressure and its association with ocular features and cardiovascular risk factors: the Gutenberg health study. Ophthalmology. 2013;120:961–968. doi: 10.1016/j.ophtha.2012.10.031. - DOI - PubMed

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