Han Xiaotong, Yang Tangjian, Zhang Jian, Yu Sha, Guo Xinxing, Yan William, Hu Yin, He Mingguang
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Department of Ophthalmology, Guangzhou No. 11 People's Hospital, Guangzhou, China.
BMJ Open. 2018 Feb 14;8(2):e019416. doi: 10.1136/bmjopen-2017-019416.
To investigate the longitudinal changes in intraocular pressure (IOP) and its associations with refractive error and systemic determinants in a Chinese geriatric population.
Prospective cohort study.
Guangzhou Government Servant Physical Check-up Center, Guangzhou, China.
4413 government employees aged no less than 40 years (41.9% female) attending annual physical and eye examinations were included in this study. The inclusion criterion was having attended the 2010 follow-up examination. The exclusion criteria include glaucoma or intraocular surgery history, IOP >21 mm Hg at any visit or without available IOP data at all visits from 2010 to 2014.
The outcome measure was IOP at each follow-up visit from 2010 to 2014. Mixed-effect model was used to assess the relationship between longitudinal changes in IOP and potential risk factors.
For the 2653 participants who had available IOP data at both the 2010 and 2014 follow-up visits, the average change in IOP was an increase of 0.43 (95% CI 0.36 to 0.50) mm Hg. For the whole study population and in the optimised mixed model, there was a non-linear increase of IOP with age (P<0.001), with greater changes in younger subjects and in women (P<0.001 and P=0.002, respectively). Elevations in systolic blood pressure, diastolic blood pressure, body mass index (BMI) and fasting plasma glucose (FPG), as well as a myopic shift (all with P<0.001), during the follow-up were associated with an increasing trend of IOP, while serum lipids were found to be not significantly associated.
In this cohort of elderly Chinese adults, IOP increases non-linearly with ageing. People with increasing blood pressure, BMI, FPG and myopic progression are more likely to have IOP elevation over time.
探讨中国老年人群眼压（IOP）的纵向变化及其与屈光不正和全身因素的关系。
前瞻性队列研究。
中国广州政府公务员体检中心。
本研究纳入了4413名年龄不小于40岁的政府雇员（女性占41.9%），他们参加了年度体检和眼科检查。纳入标准为参加了2010年的随访检查。排除标准包括青光眼或眼内手术史、在任何一次就诊时眼压>21 mmHg或在2010年至2014年的所有就诊中无可用眼压数据。
观察指标为2010年至2014年每次随访时的眼压。采用混合效应模型评估眼压纵向变化与潜在危险因素之间的关系。
在2010年和2014年随访时均有可用眼压数据的2653名参与者中，眼压的平均变化为升高0.43（95%CI 0.36至0.50）mmHg。对于整个研究人群以及优化后的混合模型，眼压随年龄呈非线性升高（P<0.001），年轻受试者和女性的变化更大（分别为P<0.001和P=0.002）。随访期间收缩压、舒张压、体重指数（BMI）和空腹血糖（FPG）升高，以及近视度数增加（均P<0.001），均与眼压升高趋势相关，而血清脂质与眼压升高无显著相关性。
在这一中国老年成年人队列中，眼压随年龄增长呈非线性升高。血压、BMI、FPG升高以及近视进展的人群随着时间推移眼压升高的可能性更大。
