Manny Ruth E, Mitchell G Lynn, Cotter Susan A, Jones-Jordan Lisa A, Kleinstein Robert N, Mutti Donald O, Twelker J Daniel, Zadnik Karla
University of Houston College of Optometry, Houston, Texas 77204-2020, USA.
Optom Vis Sci. 2011 Dec;88(12):1445-53. doi: 10.1097/OPX.0b013e318230f559.
The ethnically diverse Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study cohort provides a unique opportunity to explore associations among intraocular pressure (IOP), ethnicity, and refractive error while adjusting for potential confounding variables.
Mixed linear models were used to examine the effect of age, refractive error (cycloplegic auto-refraction), ethnicity, sex, and measurement protocol on IOP (Tono-pen) in 3777 children, aged 6 to 14 years at their first CLEERE visit (1995-2009). Children who became myopic during follow-up were used to examine the relationship between time since myopia onset and IOP. Clinically meaningful differences in IOP were preset at >2 mm Hg.
IOP differed among refractive error categories with higher IOP in children with low/moderate myopia than those with high hyperopia (differences <1 mm Hg). There was a statistically significant relationship between age and IOP that depended on ethnicity (interaction p < 0.0001) and measurement protocol (interaction p < 0.0001). The relationship between sex and IOP depended on measurement protocol (interaction p = 0.0004). For children who became myopic during follow-up, the adjusted mean IOP showed a significant decline for only Asian (p = 0.024) and white children (p = 0.004). As with other statistically significant results, these changes in mean adjusted IOPs from 2 years before to 2 years after myopia onset were <2 mm Hg.
Small but significant differences in IOP by refractive error category were found in this ethnically diverse cohort of children. Relationships between IOP and age, ethnicity, sex, and measurement protocol were complicated by significant interactions between these parameters. Longitudinal analysis of children before and after myopia onset showed changes in IOP over time that varied by ethnicity. Higher IOPs before and at myopia onset were not present in all ethnic groups, with differences before and after onset too small to suggest a role for IOP in the onset of myopia.
种族多样化的种族与屈光不正纵向协作评估（CLEERE）研究队列提供了一个独特的机会，可在调整潜在混杂变量的同时，探索眼压（IOP）、种族和屈光不正之间的关联。
采用混合线性模型，研究年龄、屈光不正（睫状肌麻痹自动验光）、种族、性别和测量方案对3777名6至14岁儿童（首次CLEERE访视时间为1995 - 2009年）眼压（眼压计测量）的影响。对随访期间近视的儿童，用于研究近视发病时间与眼压之间的关系。临床上有意义的眼压差异预设为>2 mmHg。
不同屈光不正类别之间眼压存在差异，中低度近视儿童的眼压高于高度远视儿童（差异<1 mmHg）。年龄与眼压之间存在统计学显著关系，这取决于种族（交互作用p<0.0001）和测量方案（交互作用p<0.0001）。性别与眼压之间的关系取决于测量方案（交互作用p = 0.0004）。对于随访期间近视的儿童，调整后的平均眼压仅在亚洲儿童（p = 0.024）和白人儿童（p = 0.004）中显示出显著下降。与其他统计学显著结果一样，近视发病前2年至发病后2年调整后的平均眼压变化<2 mmHg。
在这个种族多样化的儿童队列中，发现不同屈光不正类别之间眼压存在微小但显著的差异。眼压与年龄、种族、性别和测量方案之间的关系因这些参数之间的显著交互作用而变得复杂。对近视发病前后儿童的纵向分析表明，眼压随时间的变化因种族而异。并非所有种族在近视发病前和发病时眼压都较高，发病前后的差异太小，无法表明眼压在近视发病中起作用。
