Intraocular pressure and its determinants in a very old population. The ural very old study

Abstract

Aims/Purpose: To assess the distribution of intraocular pressure (IOP) and its determinants in a very old population.Methods: The population‐based Ural Very Old Study (UVOS) was performed in a rural and urban region of Bashkortostan/Russia and consisted of 1526 (81.1%) out of 1882 eligible individuals aged 85+ years. As part of a series of medical and ophthalmological examinations, we measured IOP by non‐contact tonometry.Results: The study included 1042 (68.3%) individuals with available IOP readings (mean age:88.1 ± 2.7 years). After excluding individuals with anti‐glaucomatous therapy, mean IOP was 14.5 ± 5.1 mmHg (median:14 mmHg; 95%CI:8,25) with a right‐sided skewed distribution. In multivariable analysis, higher IOP was associated (correlation coefficient r:0.38) with female sex (beta:0.13; p = 0.002), thinner central cornea thickness (beta:0.23; p < 0.001), higher systolic blood pressure (beta:0.13; p = 0.006), higher estimated cerebrospinal fluid pressure (CSFP) (beta:0.11; p = 0.04), longer axial length (beta:0.09; p = 0.02), and status after cataract surgery (beta:‐0.17; p < 0.001). In that model, the IOP measurements increased by 0.02 mmHg (95%CI:0.01,0.03) for each increase in systolic blood pressure by 1 mmHg, by 0.11 mmHg (95%CI:0.004,0.22) for each increase in estimated CSFP by 1 mmHg, by 0.2 mmHg (95%CI:0.1,0.3) for each central corneal thickness increase by 10 μm, and by 0.31 mmHg (95%CI:0.05,0.59) for each axial length increase by 1 mm. It decreased by 1.13 mmHg (95%CI:0.54,1.72) with cataract surgery.Conclusions: In this study population aged 85 + years, corneal thickness‐adjusted IOP‐readings increased with higher blood pressure and estimated CSFP and longer axial length, and it decreased with cataract surgery.