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Associations between elevated intraocular pressure and glaucoma, use of glaucoma medications, and 5-year incident cataract: the Blue Mountains Eye Study.

Abstract

PURPOSE

To examine incident relationships between elevated intraocular pressure (IOP), open-angle glaucoma (OAG), and use of glaucoma medications with 5-year incident cataract.

DESIGN

Population-based cohort study.

PARTICIPANTS

The Australian Blue Mountains Eye Study examined 3654 participants > or =50 years old at baseline (82.4% response; 1992-1994); 2335 eligible participants were reexamined after 5 years (75.1% response; 1997-1999).

METHODS

A detailed medical and ocular history, including current medications, was taken, and a comprehensive eye examination, including applanation tonometry, automated perimetry, and lens photography, was performed at each examination. The Wisconsin system was used to grade lens photographs in assessing incident nuclear, cortical, and posterior subcapsular cataract (PSC). Data from both eyes were assessed using generalized estimating equation analyses.

MAIN OUTCOME MEASURES

Elevated IOP was defined as > or =21 mmHg. Open-angle glaucoma was diagnosed from typical glaucomatous field loss with matching optic disc cupping, without reference to IOP. Subjects without OAG or secondary or angle-closure glaucoma with IOP > 21 mmHg in either eye were classified as having ocular hypertension (OH), as were non-OAG subjects with IOP < 22 mmHg using glaucoma medications. Wisconsin levels 4 to 5 were graded as nuclear cataract, at least 5% lens involvement was graded as cortical cataract, and any PSC defined its presence.

RESULTS

The 5-year incidence of nuclear cataract was 23.4% (592/2532), or 23.1% (574/2486) after excluding subjects using glaucoma medication. A marginally significant association was found for elevated IOP or OH at baseline and incident nuclear cataract (odds ratio [OR], 1.93 [95% confidence interval (CI), 0.97-3.89], and OR, 1.83 [95% CI, 0.96-3.48], respectively) in subjects not using glaucoma medications, after multivariate adjustment. Age- and gender-adjusted analyses showed similar but statistically significant associations. The association between elevated IOP or OH and nuclear cataract was significant in multivariate analyses (OR, 2.07 [95% CI, 1.04-3.12], and OR, 1.78 [95% CI, 1.05-3.01], respectively). Use of glaucoma medications was associated with nonsignificantly increased adjusted odds for incident nuclear cataract (OR, 1.90 [95% CI, 0.92-3.92]). No associations, however, were found with incident cortical cataract or PSC.

CONCLUSIONS

Elevated IOP may increase the risk of nuclear cataract, but not that of other types. The use of glaucoma medications could magnify this risk.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Westmead, Australia.

    , ,

    Source

    Ophthalmology 113:3 2006 Mar pg 417-24

    MeSH

    Aged
    Australia
    Cataract
    Cohort Studies
    Female
    Glaucoma, Open-Angle
    Humans
    Incidence
    Intraocular Pressure
    Male
    Middle Aged
    Ocular Hypertension
    Risk Factors

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    16458969

    Citation

    Chandrasekaran, Sujatha, et al. "Associations Between Elevated Intraocular Pressure and Glaucoma, Use of Glaucoma Medications, and 5-year Incident Cataract: the Blue Mountains Eye Study." Ophthalmology, vol. 113, no. 3, 2006, pp. 417-24.
    Chandrasekaran S, Cumming RG, Rochtchina E, et al. Associations between elevated intraocular pressure and glaucoma, use of glaucoma medications, and 5-year incident cataract: the Blue Mountains Eye Study. Ophthalmology. 2006;113(3):417-24.
    Chandrasekaran, S., Cumming, R. G., Rochtchina, E., & Mitchell, P. (2006). Associations between elevated intraocular pressure and glaucoma, use of glaucoma medications, and 5-year incident cataract: the Blue Mountains Eye Study. Ophthalmology, 113(3), pp. 417-24.
    Chandrasekaran S, et al. Associations Between Elevated Intraocular Pressure and Glaucoma, Use of Glaucoma Medications, and 5-year Incident Cataract: the Blue Mountains Eye Study. Ophthalmology. 2006;113(3):417-24. PubMed PMID: 16458969.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Associations between elevated intraocular pressure and glaucoma, use of glaucoma medications, and 5-year incident cataract: the Blue Mountains Eye Study. AU - Chandrasekaran,Sujatha, AU - Cumming,Robert G, AU - Rochtchina,Elena, AU - Mitchell,Paul, Y1 - 2006/02/03/ PY - 2005/08/26/received PY - 2005/10/09/revised PY - 2005/10/15/accepted PY - 2006/2/7/pubmed PY - 2006/3/22/medline PY - 2006/2/7/entrez SP - 417 EP - 24 JF - Ophthalmology JO - Ophthalmology VL - 113 IS - 3 N2 - PURPOSE: To examine incident relationships between elevated intraocular pressure (IOP), open-angle glaucoma (OAG), and use of glaucoma medications with 5-year incident cataract. DESIGN: Population-based cohort study. PARTICIPANTS: The Australian Blue Mountains Eye Study examined 3654 participants > or =50 years old at baseline (82.4% response; 1992-1994); 2335 eligible participants were reexamined after 5 years (75.1% response; 1997-1999). METHODS: A detailed medical and ocular history, including current medications, was taken, and a comprehensive eye examination, including applanation tonometry, automated perimetry, and lens photography, was performed at each examination. The Wisconsin system was used to grade lens photographs in assessing incident nuclear, cortical, and posterior subcapsular cataract (PSC). Data from both eyes were assessed using generalized estimating equation analyses. MAIN OUTCOME MEASURES: Elevated IOP was defined as > or =21 mmHg. Open-angle glaucoma was diagnosed from typical glaucomatous field loss with matching optic disc cupping, without reference to IOP. Subjects without OAG or secondary or angle-closure glaucoma with IOP > 21 mmHg in either eye were classified as having ocular hypertension (OH), as were non-OAG subjects with IOP < 22 mmHg using glaucoma medications. Wisconsin levels 4 to 5 were graded as nuclear cataract, at least 5% lens involvement was graded as cortical cataract, and any PSC defined its presence. RESULTS: The 5-year incidence of nuclear cataract was 23.4% (592/2532), or 23.1% (574/2486) after excluding subjects using glaucoma medication. A marginally significant association was found for elevated IOP or OH at baseline and incident nuclear cataract (odds ratio [OR], 1.93 [95% confidence interval (CI), 0.97-3.89], and OR, 1.83 [95% CI, 0.96-3.48], respectively) in subjects not using glaucoma medications, after multivariate adjustment. Age- and gender-adjusted analyses showed similar but statistically significant associations. The association between elevated IOP or OH and nuclear cataract was significant in multivariate analyses (OR, 2.07 [95% CI, 1.04-3.12], and OR, 1.78 [95% CI, 1.05-3.01], respectively). Use of glaucoma medications was associated with nonsignificantly increased adjusted odds for incident nuclear cataract (OR, 1.90 [95% CI, 0.92-3.92]). No associations, however, were found with incident cortical cataract or PSC. CONCLUSIONS: Elevated IOP may increase the risk of nuclear cataract, but not that of other types. The use of glaucoma medications could magnify this risk. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/16458969/Associations_between_elevated_intraocular_pressure_and_glaucoma_use_of_glaucoma_medications_and_5_year_incident_cataract:_the_Blue_Mountains_Eye_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(05)01369-2 DB - PRIME DP - Unbound Medicine ER -