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      Age-Related Changes of Intraocular Pressure in Elderly People in Southern China: Lingtou Eye Cohort Study

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          Abstract

          Purpose

          To study age-related changes of intraocular pressure (IOP) and assess the cohort effect in both cross-sectional and longitudinal settings among elderly Chinese adults.

          Methods

          Participants were enrolled from the Lingtou Eye Cohort Study with Chinese government officials aged 40 years and older at baseline and received physical check-up and ocular examinations from 2010 to 2012. IOP was measured using a non-contact tonometer according to standardized protocols, as well as systolic blood pressure (SBP), diastolic blood pressure (DBP) and body mass index (BMI). Participants who had attended IOP measurements in both 2010 and 2012 were included in this study. Cross-sectional association of IOP with age was assessed using multivariate liner regression analyses and based on the data of 2010. Longitudinal changes in IOP were assessed by paired t-test.

          Results

          A total of 3372 subjects were enrolled in the current analysis (2010 mean [SD] age, 61.9 [7.1] years; 60.2% men). The mean IOP in 2010 was 15.4±2.3 mmHg for women and 15.2±2.3 mmHg for men with an intersex difference (P = 0.029). Cross-sectional analysis showed that IOP was negatively associated with age (P = 0.003, β = -0.033 for women and P<0.001, β = -0.061 for men) adjusted for baseline SBP, DBP and BMI. Paired t-test suggested that IOP was higher in the year 2012 than 2010 in women (P = 0.006) but did not change significantly in men within 2 years (P = 0.345). In addition, the 2-year changes of IOP were not associated with age adjusted for baseline IOP in 2010 (P = 0.249).

          Conclusion

          Cross-sectional data suggests that IOP is lower in people with older age. Longitudinal data does not support such findings and thus the identified decreasing pattern with age in cross-sectional analysis is likely caused by cohort effects.

          Related collections

          Most cited references 25

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          Intraocular pressure in an American community. The Beaver Dam Eye Study.

          The Beaver Dam Eye Study is a population-based study of age-related eye diseases in persons 43-86 yr of age. Applanation tonometry was done on all study subjects. Mean intraocular pressure (IOP) increased significantly with age. Mean IOP differed little between the sexes and was not significantly different after age adjustment (in right eyes of 2721 women, it was 15.5 mm Hg, and in right eyes of 2135 men, it was 15.3 mm Hg). There was an association of IOP with systolic and diastolic blood pressures, body mass index, hematocrit, serum glucose, glycohemoglobin, cholesterol level, pulse, nuclear sclerosis, season, and time of day of measurement. These data confirm that, in a general population, IOP is associated with important systemic and ocular characteristics. Those characteristics should be considered in further research on determinants of IOP.
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            Nocturnal elevation of intraocular pressure in young adults.

            To distinguish 24-hour (circadian) and postural effects on intraocular pressure (IOP) in healthy young adults. Thirty-three volunteers were housed in a sleep laboratory for 1 day under a strictly controlled 16-hour light and 8-hour dark environment. Sleep was encouraged in the dark period. Intraocular pressure was measured in each eye every 2 hours using a pneumatonometer. Researchers used night-vision goggles to perform IOP measurements in the dark, while the subject's light exposure was minimized. In the first group of 12 subjects, measurements were taken with subjects in the sitting position during the light-wake period and supine during the dark period. In the second group of 21 subjects, all IOP measurements were taken with the subjects supine. Average IOP was significantly higher in the dark period than in the light-wake period in both groups. The lowest IOP occurred in the last light-wake measurement, and the peak IOP occurred in the last dark measurement. The trough-peak difference in IOP was 8.2+/-1.4 mm Hg (mean +/- SEM) in the first group. Intraocular pressure changed sharply at the transitions between light and dark. In the second group, the trough-peak IOP difference was 3.8+/-0.9 mm Hg. Intraocular pressure changed gradually throughout the 24-hour period. In comparison with the sitting IOP in the first group, the supine IOP in the second group was significantly higher during the light-wake period. Circadian rhythms of IOP were shown in young adults, with the peaks occurring in the late dark period. A nocturnal IOP elevation can appear independent of body position change, but change of posture from upright to recumbent may contribute to the relative nocturnal IOP elevation.
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              Associations with intraocular pressure in Latinos: the Los Angeles Latino Eye Study.

              To evaluate the association of biologic factors with intraocular pressure (IOP) in a Latino population. Population-based cross-sectional study. Latinos 40 years and older (n = 5,958) from the Los Angeles Latino Eye Study without a history of ocular hypotensive treatment underwent an interviewer-administered questionnaire and a complete ocular and clinical examination. IOP was obtained by applanation tonometry and was based on the mean of three measurements. Multivariable regression models were used to evaluate the independent association of biological factors with IOP. Higher systolic blood pressure, higher central corneal thickness, and diabetes mellitus were the major factors associated with elevated IOP. Other positively correlated variables included age, female gender, higher diastolic blood pressure, larger body mass index, darker colored irides, and nuclear sclerosis. Axial length and family history of glaucoma had no association with IOP. Several systemic and ocular characteristics are associated with elevated IOP in Latinos. By identifying and recognizing these risk factors, we can define subgroups of the population that may be most at risk of having elevated IOP.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                17 March 2016
                2016
                : 11
                : 3
                Affiliations
                [1 ]State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
                [2 ]Guangzhou No.11 People’s Hospital, Guangzhou, China
                [3 ]Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
                National Eye Institute, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: XH MH. Performed the experiments: YN XH XG. Analyzed the data: XH XG YH. Contributed reagents/materials/analysis tools: YN MH. Wrote the paper: XH XG YH WY.

                Article
                PONE-D-15-53384
                10.1371/journal.pone.0151766
                4795753
                26986222
                © 2016 Han et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                Page count
                Figures: 3, Tables: 2, Pages: 10
                Product
                Funding
                The study was supported by the Fundamental Research Funds of the State Key Laboratory in Ophthalmology, and the National Natural Science Foundation of China (81125007) and a research grant from the Brien Holden Vision Institute. The sponsors had no role in study design, data collection, analysis or decision to publish or prepare of the manuscript.
                Categories
                Research Article
                Research and Analysis Methods
                Research Design
                Cohort Studies
                Medicine and Health Sciences
                Vascular Medicine
                Blood Pressure
                Biology and Life Sciences
                Anatomy
                Ocular System
                Intraocular Pressure
                Medicine and Health Sciences
                Anatomy
                Ocular System
                Intraocular Pressure
                Biology and Life Sciences
                Anatomy
                Head
                Eyes
                Medicine and Health Sciences
                Anatomy
                Head
                Eyes
                Biology and Life Sciences
                Anatomy
                Ocular System
                Eyes
                Medicine and Health Sciences
                Anatomy
                Ocular System
                Eyes
                Research and Analysis Methods
                Research Design
                Longitudinal Studies
                People and Places
                Population Groupings
                Age Groups
                Elderly
                People and Places
                Population Groupings
                Age Groups
                Adults
                Biology and Life Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Body Mass Index
                Medicine and Health Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Body Mass Index
                Custom metadata
                All relevant data are within the paper and its Supporting Information files.

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