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Intraocular pressure and circumpapillary retinal nerve fibre layer thickness in the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA): distributions and associations
  1. Paul McCann1,
  2. Ruth Hogg1,
  3. David M Wright1,
  4. Usha Chakravarthy1,
  5. Tunde Peto1,
  6. Sharon Cruise1,
  7. Bernardette McGuinness1,
  8. Ian S Young1,
  9. Frank Kee1,
  10. Augusto Azuara-Blanco1
  1. Centre for Public Health, Queen’s University Belfast, Belfast, UK
  1. Correspondence to Augusto Azuara-Blanco, Institute of Clinical Sciences, Belfast, UK; a.azuara-blanco{at}qub.ac.uk

Abstract

Aims To describe the distributions of and associations with intraocular pressure (IOP) and circumpapillary retinal nerve fibre layer (cRNFL) thickness in a population-based study.

Methods Northern Ireland Cohort for the Longitudinal Study of Ageing participants underwent a computer-assisted personal interview, a self-completion questionnaire and a health assessment (HA). At the HA, participants underwent IOP measurement using Ocular Response Analyser and spectral-domain optical coherence tomography with Heidelberg Spectralis. Participants also underwent a range of anthropometric, ophthalmic, cardiovascular, cognition and blood tests. Participants who attended the HA and had a vertical cup-to-disc ratio (VCDR) measurement in at least one eye were eligible for the study. Participants without any IOP or cRNFL measurements were excluded from the respective analyses.

Results There were 3221 participants eligible for this study (5753 eyes included in the IOP analysis and 5461 eyes included in the cRNFL analysis). The mean (SD) Goldmann correlated IOP (IOPg) was 15.39 mm Hg (3.55 mm Hg). The mean (SD) average global cRNFL thickness was 94.39 µm (11.18 µm). Increased IOPg was associated with increased age, male sex, hypertension, refractive error (myopic decrease in spherical equivalent) and increased corneal resistance factor, while beta-blocker drug use was associated with lower IOPg in the fully adjusted multivariate analysis. Thinner average global cRNFL was associated with Alzheimer’s disease in the age-adjusted and sex-adjusted model. In the fully adjusted multivariate analysis, increased age, male sex, left eyes, hypertension, increased VCDR, refractive error (myopic decrease in spherical equivalent) and increased IOPg were associated with thinner average global cRNFL, while Parkinson’s disease and current (vs never) smoking status were associated with thicker average global cRNFL.

Conclusions Increased IOP and reduced cRNFL were associated with increased age, myopic refractive error, male sex and hypertension. Alzheimer’s disease was associated with thinner average global cRNFL, while Parkinson’s disease was associated with thicker average global cRNFL.

  • Glaucoma
  • Anatomy
  • Retina
  • Intraocular pressure
  • Diagnostic tests/Investigation

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Footnotes

  • Twitter @ruth_hogg.

  • Acknowledgements We are grateful to all the participants of the NICOLA Study, and the whole NICOLA team, which includes nursing staff, research scientists, clerical staff, computer and laboratory technicians, managers and receptionists. The authors alone are responsible for the interpretation of the data and any views or opinions presented are solely those of the authors and do not necessarily represent those of the NICOLA Study team.

  • Contributors PMcC: acquisition, design, analysis, interpretation of data, drafting the work, final approval. RH: conception, design, acquisition, analysis, interpretation of data, drafting the work, final approval. DMW: analysis, interpretation of data, final approval. TP: conception, interpretation of data, drafting the work, final approval. SC: design, analysis, drafting the work, final approval. BMcG: design, analysis, drafting the work, final approval. ISY: conception, design, interpretation of data, drafting the work, final approval. FK: conception, design, interpretation of data, drafting the work, final approval. AA-B: conception, analysis, interpretation of data, drafting the work, final approval.

  • Funding The Atlantic Philanthropies, the Economic and Social Research Council, the UKCRC Centre of Excellence for Public Health Northern Ireland, the Centre for Ageing Research and Development in Ireland, the Office of the First Minister and Deputy First Minister, the Health and Social Care Research and Development Division of the Public Health Agency, the Wellcome Trust/Wolfson Foundation and Queen’s University Belfast provide core financial support for NICOLA. Belfast Association for the Blind provided core financial support for the follow-up visit for expert glaucoma diagnosis and perimetry. The sponsors and funding organisations had no role in the design or conduct of this research.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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