Distribution of Intraocular Pressure: The Barbados Eye Study

doi:10.1001/archopht.1997.01100160221012

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Vol. 115 No. 8, August 1997

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Distribution of Intraocular Pressure

The Barbados Eye Study

M. Cristina Leske, MD, MPH; Anthea M. S. Connell, FRCS, FRCOphth; Suh-Yuh Wu, MA; Leslie Hyman, PhD; Andrew P. Schachat, MD; Barbados Eye Study Group

Arch Ophthalmol. 1997;115(8):1051-1057.

Abstract

Objective
To provide data on the distribution of intraocular pressure(IOP) in a predominantly black population, which has a highprevalence of open-angle glaucoma.

Design
Population-based prevalence study.

Setting and Participants
Participants (N=4601) (age range, 40-84 years) who had undergoneapplanation tonometry measurements in the Barbados Eye Study.Self-reported race was 93% black, 4% mixed (black and white),and 3% white or other.

Data Collection
A standardized protocol included applanation tonometry and otherocular measurements, fundus photography, demographic data, andan interview.

Main Outcome Measures
The average of 3 IOP measurements at the Barbados Eye Studyvisit was used to compare IOP by self-reported race. Descriptivedata on IOP by age, sex, glaucoma status, and cup-disc ratiowere examined in the black population.

Results
The IOP was highest in the population of African origin. Themean (±SD) IOP values for black, mixed, and white participantswere 18.7±5.2, 18.2±3.8, and 16.5±3.0 mmHg, respectively. An IOP greater than 21 mm Hg was present in18.4%, 13.6%, and 4.6% of the black, mixed, and white participants,respectively. In analyses that were adjusted for age, sex, andglaucoma status, such values were 5 times as likely in blackthan white participants and 3.5 times as likely in mixed raceparticipants (P<.01). Among the black participants, the meanIOP increased approximately 1 mm Hg for every increase in 10years of age. After excluding persons with any type of glaucoma,suspected glaucoma, or a history of glaucoma treatment, womenhad significantly (P<.01) higher IOP values; however, nosignificant IOP trends by sex were evident in the group withglaucoma. The IOP was also positively associated (P<.05)with vertical cup-disc ratios. After 2 visits, the IOP remained21 mm Hg or less in 21% of the persons with glaucoma vs 64%of those without glaucoma.

Conclusions
In the black participants, the IOP was higher than in the whiteparticipants. The IOP was also associated with age and cup-discratios. The results showed that open-angle glaucoma and a highIOP alone have a different distribution by sex; although open-angleglaucoma was more frequent in men, ocular hypertension was morefrequent in women. These data have implications for the detectionand causation of open-angle glaucoma in this high-risk population.

Author Affiliations

From the Department of Preventive Medicine, University Medical Center at Stony Brook, Stony Brook, NY (Drs Leske and Hyman and Ms Wu), the Ministry of Health, Barbados, West Indies (Dr Connell), and the Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Md (Dr Schachat).

Footnotes

A complete list of the members of the Barbados Eye Study Groupappears on page 1052.

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