Age, systemic factors linked to longitudinal trends in IOP levels
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A combination of age and systemic factors, including gender and various serum values, were significantly associated with a longitudinal change in IOP, according to a study published in Investigative Ophthalmology & Visual Science.
“The current results suggested that IOP might be suppressed by changing life habitat, such as increasing the intake of foods containing [calcium] and maintaining good biliary tract functions,” Ryo Asaoka, MD, PhD, of the department of ophthalmology at the University of Tokyo, and colleagues wrote. “However, these are not the results of intervention. A further study would be needed to investigate the effect of changing life habitat on IOP trend.”
In a longitudinal study investigating the effects of systemic factors on change in IOP, Asaoka and colleagues analyzed 20,909 eyes from 10,471 participants (mean age, 52.7 years; 65.9% men) without glaucoma from a large-scale health screening cohort at Seirei Center for Health Promotion and Prevention Medicine in Japan.
Participants were examined based on several systemic factors including age, sex, BMI, systolic blood pressure, diastolic blood pressure, smoking, red and white blood cell counts, hemoglobin, hematocrit, platelet count, total protein, aspartate aminotransferase, alkaline phosphatase, alanine aminotransferase, triglyceride, LDL-C, HDL-C, HbA1c, blood urea nitrogen, creatinine, calcium, uric acid, C-reactive protein and IOP. Data from the health examinations were collected from May 2012 to March 2021.
Researchers reported a decrease in IOP by –0.084 mm Hg per year. In addition, older age and higher aspartate aminotransferase, hemoglobin, platelet and calcium values were associated with a significant decrease in IOP (P < .05). Conversely, alanine aminotransferase, white blood cell count, red blood cell count and female sex were associated with a significant increase in IOP (P < .05).
After acknowledging the limitations of their study, which included noncontact tonometry readings and lack of diversity in the study population, Asaoka and colleagues wrote that “further investigation is expected in the future, as evoked by this study.”
Perspective
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It is common for patients to inquire what they can do to lower their IOP, often in the form of lifestyle changes such as reducing blood pressure, weight loss or other intrinsic changes the patient could implement. At this point, I inform them that although we do not know all the variables that influence IOP, the most effective way of lowering it often requires medication or surgery.
This study by Asaoka and colleagues in non-glaucomatous subjects is a critical first step in our knowledge gap regarding which systemic parameters are relevant to long-term IOP trends. The analysis of 27 different parameters and IOP identified 10 items with direct or inverse correlations with IOP.
While it may not all be directly applicable to glaucoma care, this research lends itself to predictive algorithms. Many of the variables evaluated are components of routine laboratory studies and could be utilized to predict future IOP trends, should these correlations hold across all populations. To determine the direct relevance of these parameters in IOP control for patients with glaucoma, future research should focus on establishing the existence of these associations and determine if modification of these parameters would have a meaningful effect on IOP.
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