April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Systemic Medication and Intraocular Pressure in a British Population: The EPIC-Norfolk Eye Study
Author Affiliations & Notes
  • Anthony P Khawaja
    Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, London, United Kingdom
  • Michelle P Chan
    Division of Genetics and Epidemiology, UCL Institute of Ophthalmology, London, United Kingdom
  • David C Broadway
    Department of Ophthalmology, Norfolk & Norwich University Hospital, Norwich, United Kingdom
  • David F Garway-Heath
    NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • Robert N Luben
    Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, London, United Kingdom
  • Jennifer L Y Yip
    Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, London, United Kingdom
  • Shabina Hayat
    Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, London, United Kingdom
  • Kay-Tee Khaw
    Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, London, United Kingdom
  • Paul J Foster
    Division of Genetics and Epidemiology, UCL Institute of Ophthalmology, London, United Kingdom
    NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • Footnotes
    Commercial Relationships Anthony Khawaja, None; Michelle Chan, None; David Broadway, None; David Garway-Heath, None; Robert Luben, None; Jennifer Yip, None; Shabina Hayat, None; Kay-Tee Khaw, None; Paul Foster, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 4314. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Anthony P Khawaja, Michelle P Chan, David C Broadway, David F Garway-Heath, Robert N Luben, Jennifer L Y Yip, Shabina Hayat, Kay-Tee Khaw, Paul J Foster; Systemic Medication and Intraocular Pressure in a British Population: The EPIC-Norfolk Eye Study. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4314.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract
 
Purpose
 

To determine the association between systemic medication use and intraocular pressure (IOP) in a population of older British men and women.

 
Methods
 

The EPIC-Norfolk Eye Study is a cross-sectional population-based study in the UK. IOP was measured using the Ocular Response Analyser. Three readings were taken per eye and the single best value of the Goldmann-correlated IOP considered. Participants were asked to bring their medication and related documentation to the examination, and these were recorded by a research nurse. The medication classes examined in the current analysis were α-blockers, angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), β-blockers, calcium channel blockers (CCB), diabetic medication, diuretics, nitrates, statins, aspirin and other non-steroidal anti-inflammatory drugs (NSAID). We excluded participants with a history of glaucoma therapy or IOP asymmetry between eyes of >5 mmHg. We examined associations between medication use and mean IOP of both eyes using linear regression models adjusted for age, sex and body mass index. We further adjusted for other medication use, one at a time, to determine if associations were independent of other concurrent medication use.

 
Results
 

There were complete data from 7093 participants with a mean age of 68 years (range 48-92); 56% were women. The figure presents the associations between medication use and IOP. Use of systemic β-blockers (-1.04 mmHg, 95% CI [-1.30, -0.79], p<0.001) and nitrates (-1.04 mmHg, 95% CI [-1.51, -0.58], p<0.001) were associated with lower IOP. Use of diabetic medication was associated with higher IOP (0.44 mmHg, 95% CI [0.02, 0.85], p=0.038). The observed associations between statin or aspirin use with IOP were no longer significant following adjustment for β-blocker use (Table).

 
Conclusions
 

This is the first population-based study to have demonstrated and quantified clinically significant differences in IOP among participants using systemic β-blockers or nitrates. The study findings may have implications for the management of glaucoma patients with co-morbidity, and may provide insight into the pathophysiological processes underlying IOP.

 
 
Figure: β coefficients with 95% CI. Adjusted for age, sex and body mass index.
 
Figure: β coefficients with 95% CI. Adjusted for age, sex and body mass index.
 
 
Table: Results from regression models further adjusted for systemic β-blocker use.
 
Table: Results from regression models further adjusted for systemic β-blocker use.
 
Keywords: 568 intraocular pressure • 503 drug toxicity/drug effects • 459 clinical (human) or epidemiologic studies: biostatistics/epidemiology methodology  
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×