Refractive errors, intraocular pressure, and glaucoma in a white population.

PubMed ID: 12511368

Author(s): Wong TY, Klein BE, Klein R, Knudtson M, Lee KE. Refractive errors, intraocular pressure, and glaucoma in a white population. Ophthalmology. 2003 Jan;110(1):211-7. PMID 12511368

Journal: Ophthalmology, Volume 110, Issue 1, Jan 2003

OBJECTIVE To examine the relation of refractive errors to glaucoma and intraocular pressure (IOP) in a defined white population.

DESIGN Population-based cross-sectional and follow-up study.

PARTICIPANTS Persons aged 43 to 86 years living in Beaver Dam, Wisconsin (n = 4926).

METHODS All participants received a standardized assessment of refraction, IOP, and glaucoma at baseline (1988-1990), with IOP remeasured 5 years later (1993-1995). Refraction was defined at baseline as follows: myopia as spherical equivalent of -1.00 diopters (D) or less, emmetropia as -0.75 to +0.75 D, and hyperopia as +1.00 D or more.

MAIN OUTCOME MEASURES Relation of baseline refraction to prevalent glaucoma (defined from IOP, optic disc, and visual field criteria) and incident ocular hypertension (defined as IOP more than 21 mmHg at the 5-year examination in eyes with IOP of 21 mmHg or less at baseline).

RESULTS A myopic refraction was correlated with increasing IOP at baseline (P < 0.001). After controlling for age and gender, persons with myopia were 60% more likely to have prevalent glaucoma than those with emmetropia (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.1, 2.3). In contrast, controlling for age, gender, and baseline IOP, persons with hyperopia were 40% more likely to have incident ocular hypertension than those who were emmetropic at baseline (OR, 1.4; 95% CI, 1.0, 2.0). Myopia was not related to incident ocular hypertension.

CONCLUSIONS In these population-based data, there was a cross-sectional association of myopia with higher IOP and prevalent glaucoma. Similar associations have been found in previous studies. Hyperopia may be associated with 5-year risk of ocular hypertension, a finding that needs further investigation.