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Editors Selection IGR 9-3

Intraocular Pressure: Relation between IOP and blood pressure

Comment by Paul Healey on:

21697 Associations with intraocular pressure in Latinos: The Los Angeles Latino Eye Study, Memarzadeh F; Ying-Lai M; Azen SP et al., American Journal of Ophthalmology, 2008; 146: 69-76

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Intraocular pressure (IOP) is a major modifiable risk factor for glaucoma. But what factors influence IOP? Memarzadeh et al. (913), Intraocular Pressure in the Los Angeles Latino Eye Study, address the question in a well-defined group of almost 6000 Americans of Latino ancestry. The importance of this group lies in its relatively high rates of glaucoma and population growth compared to the rest of the country. The principal findings echo that of the other large epidemiological studies. IOP rose linearly with increased systolic or diastolic blood pressure and was higher, on average, among participants with systemic hypertension. The range was almost 4 mmHg across the range of systolic blood pressure measurements. Central corneal thickness showed a very similar relationship, again with almost a 4-mmHg range from the thinnest to the thickest corneas.

The consistency of blood pressure and obesity measurements remind us that while IOP is a risk factor for glaucoma, IOP itself is under the influence of modifiable risk factors

The presence of diabetes was associated with an average 1 mmHg higher IOP. Increasing age and body mass index were also associated with IOP, but to a lesser degree, increasing only about 1.5 mmHg across the range. Other findings consistent with previous studies included slightly (~0.5 mmHg) higher IOP in participants with dark brown compared to blue irides and higher IOP in the small number of participants with nuclear lenticular sclerosis. The consistency of these findings with other similar studies in different ethnic groups provide strong evidence of generalizable associations across the world. With the exception of lens opacity, it is highly probable that these crosssectional associations reflect cause in the covariate and effect in the IOP measurement. Central corneal thickness is generally accepted as a confounder of IOP measurement. Reports of age effects on IOP vary from positive to negative across the literature suggesting the presence of unknown confounders. But the consistency of blood pressure and obesity measurements remind us that while IOP is a risk factor for glaucoma, IOP itself is under the influence of modifiable risk factors.

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