Biomedical subjects

Elena Rochtchina

Publications and source records attributed to Elena Rochtchina.

At least 55 records · Page 3Linked to original sources

PubMed2005

Vision and self-rated health: longitudinal findings from an older Australian population.

PURPOSE: To assess temporal associations between vision and self-rated health. METHODS: We examined 3654 Australian residents (82.4% response) aged 49+ years in the Blue Mountains Eye Study, during 1992 to 1994, and re-examined 2334 in 1997 to 1999. Change in vision was defined if baseline and 5-year visual acuity (VA) changed by > or =10 letters (2 lines). Change in self-rated health was defined if overall health ranking (excellent, good, fair, poor) changed by > or =1 step. RESULTS: Of 2285 participants with data from both examinations, 59.8%, 23.9%, and 16.3% reported unchanged, declined, and improved self-rated health, respectively. Among persons whose self-rated health declined, the proportions with a decline in presenting VA, no change, or improvement were similar (25.2%, 23.8% and 22.5%, respectively, p for trend = 0.5). Among participants with decline, no change, or improvement in self-rated health, a similar magnitude in the age-sex adjusted mean VA decline (-1.0 to -2.7 letters) was observed. After adjusting for age, sex, hospitalizations, and incident chronic conditions, declining VA was not associated with increased decline in 5-year self-rated health (multivariate-adjusted odds ratio 0.99, 95% CI 0.75-1.30). CONCLUSION: There were no parallel 5-year changes in self-rated health and vision in this population.

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PubMed2005

Effects of caffeine on intraocular pressure: the Blue Mountains Eye Study.

PURPOSE: To examine the relationship between coffee and caffeine intakes and intraocular pressure (IOP). MATERIALS AND METHODS: The Blue Mountains Eye Study examined 3654 participants aged 49+ years in an area west of Sydney, Australia. A detailed medical history questionnaire included average daily intakes of coffee and tea. The eye examination included Goldmann applanation tonometry and automated perimetry. Participants using glaucoma medications or who had previous cataract or glaucoma surgery or signs of pigmentary glaucoma/pigment dispersion, were excluded. Mean and maximum IOP calculations were used. RESULTS: Participants with open-angle glaucoma (OAG) who reported regular coffee drinking had significantly higher mean IOP (19.63 mm Hg) than participants who said that they did not drink coffee (16.84 mm Hg), after multivariate adjustment, P = 0.03. Participants consuming > or = 200 mg caffeine per day had higher mean IOP (19.47 mm Hg) than those consuming < 200 mg caffeine per day (17.11 mm Hg), after adjusting for age, sex, and systolic blood pressure (SBP), P = 0.06. This association did not reach statistical significance after multivariate adjustment. No association between coffee or caffeine consumption and higher IOP was found in participants with ocular hypertension (OH) and those without open-angle glaucoma. CONCLUSIONS: In participants with open-angle glaucoma, this study identified a positive cross-sectional association between coffee consumption/higher caffeine intakes and elevated intraocular pressure.

Blood Pressure↗

PubMed2005

Effect of stature and other anthropometric parameters on eye size and refraction in a population-based study of Australian children.

PURPOSE: To determine the effect of anthropometric parameters on refraction and ocular biometry. METHODS: Noncontact methods were used to examine ocular dimensions and cycloplegic refraction in a stratified random cluster sample of year-1 Sydney school students (mean age, 6 years; n = 1765). Height, body weight, and waist circumference were measured according to a standardized protocol. Body mass index (BMI) was subsequently calculated. The percentage of body fat was measured with leg-leg bioelectrical impedance analysis. Associations between parameters were analyzed by multiple linear regression. RESULTS: After adjustment for age in weeks, height was found to be strongly associated with axial length and corneal radius. Children in the 1st quintile for height had axial length of 22.39 +/- 0.04 mm compared with 22.76 +/- 0.04 mm in children in the 5th quintile. Other anthropometric parameters were not associated with axial length or corneal radius. Height was not associated with anterior chamber depth after adjustment for weight. Increases in weight, BMI, and waist circumference were associated with a deeper anterior chamber after adjustment for height. No associations were found between the measured anthropometric parameters and refraction or axial length-corneal radius ratio. CONCLUSIONS: This study found a strong association between height and axial length and corneal radius, but not spherical equivalent refraction. The findings may demonstrate the effectiveness of emmetropization in the presence of normal physiological influences.

Anterior Chamber↗

PubMed2004

Retinal arteriolar narrowing is associated with 5-year incident severe hypertension: the Blue Mountains Eye Study.

We assessed whether retinal arteriolar narrowing and structural abnormalities independently predicted 5-year incident severe (grade 2 or 3) hypertension in an older population-based cohort. The Blue Mountains Eye Study baseline (1992 to 1994) examined 3654 residents aged 49 and older in 2 postal code areas, west of Sydney. Of the 2335 participants (75.1% of survivors) who returned at the 5-year examinations, 1319 were normotensive or had mild (grade 1) hypertension at baseline. Baseline retinal photographs were graded for focal retinal vessel wall signs and vessel diameters were measured. Participants were classified as having normal, high-normal blood pressure [BP] (systolic BP 121 to 139 mm Hg and/or diastolic BP 81 to 89 mm Hg), mild hypertension (systolic BP 140 to 159 mm Hg and/or diastolic BP 90 to 99 mm Hg), or severe hypertension if they had a previous diagnosis of hypertension and were receiving antihypertensive medications or had systolic BP > or =160 mm Hg and/or diastolic BP > or =100 mm Hg at examination. Incident severe hypertension was defined in persons who were free of severe hypertension at baseline but classified as having severe hypertension at the 5-year examinations. Of the 1319 baseline subjects at risk, 390 (29.6%) developed severe hypertension. After adjusting for age, sex, body mass index, smoking, glucose, and total cholesterol, generalized retinal arteriolar narrowing at baseline was associated with increased risk of incident severe hypertension (odds ratio 2.6; 95% confidence interval, 1.7 to 3.9) when comparing the narrowest versus widest quintile. This association remained significant after further adjustment for baseline mean arterial BP or BP status. Our findings support the hypothesis that small vessel structural changes may precede the development of severe hypertension.

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PubMed2004

Intraocular pressure asymmetry and undiagnosed open-angle glaucoma in an older population.

PURPOSE: To quantify prevalence of asymmetric intraocular pressure (IOP) and assess associations with undiagnosed open-angle glaucoma. DESIGN: Population-based cross-sectional study. METHODS: Participants underwent applanation tonometry. Intraocular pressure asymmetry was defined for differences > or = 3 mm Hg; open-angle glaucoma was diagnosed if glaucomatous optic disk and field changes were congruous. Analyses excluded subjects using glaucoma medication, known glaucoma, pseudoexfoliation, and cataract surgery. RESULTS: Intraocular pressure asymmetry was present in 5.1% of subjects and was greater for patients older than 70 years (6.2%). Of subjects with maximum IOP > 21 mm Hg, IOP asymmetry was present in 41.1%. Undiagnosed open-angle glaucoma was more frequent among subjects with (4.8%) than without (1.2%) IOP asymmetry. This relationship remained significant for maximum IOP < or = 21 mm Hg. CONCLUSIONS: Intraocular pressure asymmetry may be a useful sign of undiagnosed glaucoma in subjects without elevated IOP.

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PubMed2004

Does refractive error influence the association of blood pressure and retinal vessel diameters? The Blue Mountains Eye Study.

PURPOSE: To determine if refractive errors influence the association of blood pressure and retinal vessel diameters. DESIGN: Population-based, cross-sectional study. METHODS: Retinal photographs from the right eyes of participants (n = 3,654, aged 49+ years) in the Blue Mountains Eye Study taken during baseline examinations (1992 to 1994) were digitized. The diameter of all retinal vessels located half to one disk diameter from the disk margin was measured using a computer-assisted imaging program. These measurements were combined to provide the average diameters of retinal arterioles and venules of that eye, and the ratio of their diameters, the arteriole-to-venule ratio (AVR). The association of blood pressure and retinal vessel diameters was analyzed before and after correction for refraction using the Bengtsson formula. RESULTS: Before correction, each 10-mm Hg increase in mean arterial blood pressure was associated with a 3.7-microm (95% confidence interval [CI], 3.2-4.3) decrease in arteriolar diameter and a 0.9-microm (95% CI, 0.3-0.9) decrease in venular diameter. After correction for refraction, each 1-mm Hg increase in mean arterial blood pressure was associated with a 3.7-microm (95% CI, 3.2-4.2) decrease in arteriolar diameter and a 0.8-microm (95% CI, 0.3-0.9) decrease in venular diameter. Refraction was not associated with the AVR and had no effect on the association of blood pressure and AVR. CONCLUSION: Refraction had no appreciable effect on the association of blood pressure and retinal vessel diameters or on the AVR. Correction for refraction is important for quantifying absolute retinal vessel caliber, but may not be particularly important in epidemiologic studies investigating the association of generalized retinal arteriolar narrowing and hypertension.

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PubMed2004

Does hormone replacement therapy influence retinal microvascular caliber?

Previous population-based data suggest that retinal arteriolar diameter is wider in women than in men. Estrogen exposures could account for this difference. To evaluate the effects of HRT on small blood vessels, we assessed the relationship between use of hormone replacement therapy (HRT) and retinal microvascular diameter in older women in the Blue Mountains Eye Study baseline population (n = 1993, age >/= 49 years). Information on HRT use was recorded by trained interviewers. A computer-assisted program measured retinal vessel diameters from digitized photographs. Average arteriolar diameter was calculated as the central retinal arteriolar equivalent (CRAE); the lowest quintile of CRAE was considered generalized arteriolar narrowing. Of the 1897 women with complete data, 79 (4%) were premenopausal and 315 (17%), 224 (12%), and 1279 (67%) were current, past, and never HRT users, respectively. Among women aged < 65 years, multivariate-adjusted mean CRAE for the four groups was 196, 198, 201, and 200 microm (P < 0.0001), respectively. Among postmenopausal women >/= 65 years, multivariate-adjusted mean CRAE was 187, 188, 191 microm (P < 0.0001), respectively, for current, past, and never users. Current HRT users were 40% more likely than never users to have generalized arteriolar narrowing (95% confidence interval 1.0-2.1). It appears that the use of HRT in older women may not have any long-term vasodilatory effects on retinal arterioles. These data do not support our hypothesis that exogenous estrogen exposures account for observed wider retinal arteriolar diameters in women.

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PubMed2004

Corneal arcus and hyperlipidemia: findings from an older population.

PURPOSE: To quantify the association between arcus and hyperlipidemia in an older population. DESIGN: Cross-sectional population-based study. METHODS: Arcus and serum lipids were measured in the Blue Mountains Eye Study (n = 3,654, aged >49 years). Arcus was graded as absent, partial (<180 degrees) or circumferential (> or =180 degrees). Associations between arcus and hyperlipidemia were assessed using logistic regression, adjusting for age and vascular risk factors. RESULTS: Arcus was strongly associated with age (P <.0001). After age adjustment, arcus was associated with male sex (P <.01) and diabetes (P <.02) but not with hypertension or smoking. Corneal arcus was significantly associated with progressively higher levels of total cholesterol over 5 mmol/l. Adjusted odds increased from 1.6 for cholesterol 6.0 to 6.9 mmol/l to 4.6 for cholesterol >8.0 mmol/l, and was 1.9 for high triglyceride >3.0 mmol/l. CONCLUSION: This population-based finding confirms that corneal arcus was associated with hypercholesterolemia and hypertriglyceridemia in older persons.

Age Factors↗

PubMed2004

Five-year incidence of cataract in older persons with diabetes and pre-diabetes.

PURPOSE: To investigate longitudinal associations between diabetes and the 5-year incidence of cataract and cataract surgery. (A population-based, cohort study of 2335 persons with baseline ages 49 years or older resident in the Blue Mountains region, west of Sydney, Australia). METHODS: Baseline information on diabetes history was collected during an interviewer-administered questionnaire. Impaired Fasting Glucose (IFG) was defined as venous plasma glucose between 6.0 and 7.0 mmol/L and newly diagnosed diabetes as plasma glucose >7.0 mmol/L, using fasting blood glucose measurements taken at baseline. Retroillumination lens photographs from the baseline and 5-year follow-up examinations were graded for presence of cortical, posterior subcapsular (PSC) and nuclear cataract. RESULTS: We found a 2-fold higher 5-year incidence of cortical cataract in participants with IFG, multivariate adjusted odds ratio (OR) 2.2, 95% confidence interval (CI) 1.1-4.1. Incident PSC cataract was more frequent among persons with diabetes, but this association was statistically significant only for those with newly diagnosed diabetes, multivariate adjusted OR 4.5 (CI 1.5-13.0). There were no statistically significant associations found between incident nuclear cataract or cataract surgery and either diabetes or IFG. CONCLUSIONS: These epidemiological data suggest that IFG, a pre-diabetic condition, may be a risk factor for the development of cortical cataract.

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PubMed2004

Open-angle glaucoma and systemic hypertension: the blue mountains eye study.

PURPOSE: To assess whether systemic hypertension is associated with open-angle glaucoma (OAG) in an older population. PATIENTS AND METHODS: The Blue Mountains Eye Study examined 3654 subjects aged 49 to 97 years. Hypertension was diagnosed from history in treated subjects or from systolic blood pressure (BP) > or=160 mm Hg or diastolic BP > or=95 mm Hg. OAG was diagnosed from congruous glaucomatous optic disc rim thinning and visual field loss, without reference to intraocular pressure (IOP) level. Ocular hypertension (OH) was defined when IOP was > 21 mm Hg in either eye, among persons without OAG. RESULTS: Hypertension was present in 45.7% of subjects, OAG in 3.0%, and OH in 5.2%. Hypertension was significantly associated with OAG, after adjustment for OAG risk factors including IOP, odds ratio (OR) 1.56, 95% confidence interval (CI) 1.01-2.40. This relation was strongest in subjects with poorly controlled treated hypertension (OAG prevalence 5.4%), compared with normotensive subjects (OAG prevalence 1.9%), independent of IOP (OR 1.88, CI 1.09-3.25). The population attributable risk for hypertension (20.4%) was higher than for other identified OAG risk factors. The prevalence of OH was 8.1% in subjects with poorly controlled treated hypertension (OR 1.81, CI 1.20-2.73) and 8.2% in untreated hypertension (OR 1.96, CI 1.31-2.95), compared with 4.2% in normotensive subjects. CONCLUSIONS: Hypertension, particularly if poorly controlled, appears related to a modest, increased risk of OAG, independent of the effect of BP on IOP and other glaucoma risk factors. However, we could not exclude nocturnal hypotensive episodes among treated subjects. Hypertension was also associated with OH, a relationship that could in part reflect the influence of BP on IOP.

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PubMed2004

Impact of current and past blood pressure on retinal arteriolar diameter in an older population.

OBJECTIVE: To examine the effects of current and past blood pressure on retinal arteriolar diameter in a general older population. DESIGN: Cross-sectional and longitudinal studies. SETTING: Population-based cohort study of older residents from an area west of Sydney, Australia. PARTICIPANTS: Two thousand three hundred and thirty-five individuals (n = 2335) (aged > or = 54 years) who attended the 5-year follow-up Blue Mountains Eye Study during 1997-99. MAIN OUTCOME MEASURES: A computer-assisted method measured vessel diameters from digitized right eye retinal photographs. The narrowest quintile of central retinal arteriolar equivalent or arteriole-to-venule ratio (AVR) defined generalized arteriolar narrowing. Blood pressure was measured using a mercury sphygmomanometer. RESULTS: After simultaneous adjustment for age, sex, body mass index, smoking and current or past blood pressure, elevated levels of both current and past blood pressure were associated with narrower retinal arterioles [Ptrend = 0.009 and 0.007 for current and past systolic blood pressure (SBP), respectively] and lower AVR [Ptrend = 0.001 and 0.0009 for current and past diastolic blood pressure (DBP), respectively]. Generalized arteriolar narrowing was associated with both current blood pressure [adjusted odds ratio (OR) 2.4, 95% confidence interval (CI) 1.5-3.8 for the highest versus lowest quintile of current DBP] and past blood pressure (adjusted OR 1.7, 95% CI 1.1-2.6, for the highest versus lowest quintile of past DBP). Hypertension duration or control status at baseline had no additional effect on arteriolar diameter after adjusting for current blood pressure. CONCLUSIONS: Our data document the independent effects of both current and past blood pressure on small vessel calibre in the retina, suggesting that retinal arteriolar narrowing may result from the cumulative effects of long-standing hypertension.

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PubMed2004

Increase in cataract surgery prevalence from 1992-1994 to 1997-2000: analysis of two population cross-sections.

BACKGROUND: Monitoring temporal changes in the demand for and provision of cataract surgery will be useful to health planners to meet resource needs and to estimate likely costs. The aim of this report was to compare the prevalence of cataract surgery in two population cross-sections of the Blue Mountains Eye Study (BMES), over an interval of around 6 years. METHODS: Cross-section I (n = 3654; mean age 66.2 years) consisted of BMES I participants (1992-1994). Cross-section II (n = 3509; mean age 66.7 years) consisted of BMES II (5-year) participants (n = 2335) plus persons who had moved into the area and age category since BMES I (n = 1174), so were newly eligible (1997-2000). Cataract surgery history was collected during interview and confirmed at examination. RESULTS: Over this 6-year period, there was a 32% increase in cataract surgery prevalence from 6.0% to 7.9%, or from 6.0% to 7.7% after age standardization. The increase in eye-specific prevalence was 43% (from 4.4% to 6.3%). It was more marked among persons aged 80+ years and for bilateral (from 12.3% to 19.9%) than unilateral surgery (from 10.7% to 11.8%). Best-corrected visual acuity (mean letters read correctly) after surgery (43 and 44 letters, respectively) was similar between cross-sections I and II. CONCLUSIONS: The findings from a representative older population confirm that prevalent cataract surgery has increased substantially over the average 6-year period, from 1992-1994 to 1997-2000.

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PubMed2004

Systemic and ocular comorbidity of cataract surgical patients in a western Sydney public hospital.

BACKGROUND: This study aimed to assess the frequency of major systemic and ocular comorbidities among cataract surgical patients attending a large general public hospital. METHODS: Consecutive patients aged 60+ years who had undergone cataract surgery at Westmead Hospital from July 2001 to December 2002 were included. Preoperative information was obtained from patient medical records. RESULTS: A total of 773 cataract surgical procedures were performed during the 18-month period, including 668 (86.4%) aged 60+ years. Complete data were available for 653 eyes (97.8%); 62.2% were women. The mean age at surgery was 74.6 (+/- 7.2) years. Frequent systemic comorbidities included: angina (20.2%), previous myocardial infarct (15.0%), diabetes (27.5%) and hypertension (56.3%); 12.5% were current smokers. Major preoperative ocular comorbidities included age-related maculopathy (12.6%), diabetic retinopathy (9.0%) and glaucoma (10.6%). Preoperatively, 21.7% of this group had severe visual impairment (visual acuity [VA] <6/60), 30.6% had moderate impairment (VA <6/24 ->or=6/60) and 30.6% had mild impairment (VA <6/12 ->or=6/24); 28.5% had presenting VA >or=6/12. CONCLUSION: The data indicate a high frequency of comorbid systemic and ocular diseases among cataract surgical patients.

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PubMed2004

Analysis of optineurin (OPTN) gene mutations in subjects with and without glaucoma: the Blue Mountains Eye Study.

BACKGROUND: The optineurin (OPTN) gene has been reported to possess both causal as well as risk-associated alleles for open-angle glaucoma. However, these findings have so far only been reported in family and clinic based studies. The aim of this study was to investigate the spectrum of mutations and gene variants in OPTN that might be present in people with glaucoma from a population-based study, the Blue Mountains Eye Study (BMES). METHODS: A total of 108 subjects of Caucasian origin were identified at baseline in the BMES as having open-angle glaucoma. Blood samples were available from 27 of these, of whom 18 had high-tension glaucoma and the remaining nine had normal-tension glaucoma. Ninety-four control subjects were chosen at random from the BMES, who satisfied the criteria of not having glaucoma at baseline and were over age 70 years. The 13 coding exons (exons 4-16 inclusive) and their intron-exon boundaries of OPTN were screened by the use of single-strand conformation polymorphism. Samples exhibiting mobility shifts were di-deoxy nucleotide sequenced. The M98K polymorphism was additionally screened using the restriction enzyme Stu1 in all cases and controls in this study. RESULTS: The M98K risk-associated alteration was identified in 2/18 (11%) subjects with high-tension glaucoma, 0/9 subjects (0%) with normal-tension glaucoma and 3/94 (3.2%) controls. However, association of this variant with disease was not significant (P = 0.2 for each phenotype) for either high-tension glaucoma or normal-tension glaucoma. A novel variant (P556P in exon 16) was found in one subject with open-angle glaucoma and a previously described variant (exon 7) was found in a further subject with open-angle glaucoma and in one control. No other OPTN variants were identified in this study cohort. CONCLUSIONS: Cross-sectional analysis from baseline observations of the BMES suggested that the M98K risk-associated allele appeared at a higher prevalence in high-tension glaucoma compared with controls, although this finding was not statistically significant.

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PubMed2004

Angiotensin-converting enzyme inhibitors (ACEIs) and age-related maculopathy (ARM): cross-sectional findings from the Blue Mountains Eye Study.

PURPOSE: To assess the relationship between the use of angiotensin-converting enzyme inhibitors (ACEIs) and prevalence of age-related maculopathy (ARM). METHODS: Eligible residents aged >/= 49 years were first examined in 1992-94 (Cross-section 1, n = 3654). Of these, 2335 were re-examined in 1997-99, together with an additional 1174 who became eligible after 1994 (Cross-section 2, n = 3509). Information regarding ACEI use was obtained and retinal photographs were graded using the Wisconsin ARM Grading System. RESULTS: In Cross-section 1, prevalence rates of late and early stage ARM were 1.3% and 4.3% among current ACEI users, and 2.0% and 4.8% among non-current users, respectively. In Cross-section 2, prevalence rates of late and early stage ARM were 2.3% and 11.3% among current ACEI users, and 1.3% and 9.3% among non-current users, respectively. After adjusting for age, sex and smoking, neither survey found any significant association between ACEI use and prevalence of either late or early ARM. CONCLUSIONS: No significant cross-sectional associations were found between ACEI use and ARM prevalence in this population.

Angiotensin-Converting Enzyme Inhibitors↗

PubMed2004

Impact of bilateral visual impairment on health-related quality of life: the Blue Mountains Eye Study.

PURPOSE: To assess the impact of visual impairment on health-related quality of life (HRQOL) in an older population and compare it with the impact of major medical conditions. METHODS: Participants of the second cross-sectional Blue Mountains Eye Study (BMES; n = 3509; mean age, 66.7 years; 57% female) were asked to complete the self-administered 36-item Short-Form health survey (SF-36), a comprehensive interview, and an eye examination. Visual impairment was defined as visual acuity less than 20/40 (better eye). RESULTS: Of 3154 (89.9%) participants with complete data, 172 (5.5%) had visual impairment due to refractive errors (correctable visual impairment) and 66 (2.1%) due to eye conditions (noncorrectable visual impairment; 49 mild, 9 moderate, 8 severe). After adjustment for demographic and medical confounders, there was a trend toward lower SF-36 scores in participants with noncorrectable impairment than in those with correctable impairment (physical component score [PCS] Ptrend = 0.01 and mental component score [MCS] Ptrend = 0.02). Increasingly severe noncorrectable visual impairment was associated with significantly poorer SF-36 scores in all but two dimensions. The impact of noncorrectable visual impairment was comparable to that from major medical conditions (e.g., stroke) and had a greater impact on mental than physical domains (mean MCS = 46.2, PCS = 41). No significant differences in HRQOL were demonstrated between visual impairment cases caused by age-related maculopathy and cataract, after adjusting for severity of visual impairment. CONCLUSIONS: Noncorrectable visual impairment was associated with reduced functional status and well-being, with a magnitude comparable to major medical conditions. These data have implications for disability weights such as those developed by the Global Burden of Disease study.

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PubMed2003

Hypertensive retinal vessel wall signs in a general older population: the Blue Mountains Eye Study.

To describe cross-sectional relations between hypertension and retinal vessel wall signs in an older white population. These signs were defined from fundus photographs in 3654 Blue Mountains Eye Study participants > or =49 years of age. Focal arteriolar narrowing and arteriovenous nicking were graded through the use of standard protocol. Photographs were digitized to measure retinal vessel diameters. Average arteriolar diameter, summarized as central retinal arteriolar equivalent and arteriole-to-venule ratio, were used as indexes of generalized arteriolar narrowing. Blood pressure was measured with the use of a mercury sphygmomanometer. Hypertension was defined through the use of antihypertensive medications, systolic blood pressure > or =160 mm Hg, or diastolic blood pressure > or =95 mm Hg. Hypertension was categorized as controlled (using medication, normal blood pressure), uncontrolled (using medication, high blood pressure), or untreated (not using medication). Hypertensive subjects had higher prevalence of all retinal microvascular signs. After adjusting for age, gender, body mass index, and smoking, persons with controlled (18.2%), uncontrolled (13.8%), or untreated hypertension (13.8%) were significantly more likely than normotensive subjects (54.2%) to have (a) lower central retinal arteriolar equivalent: adjusted odds ratios 1.5, (95% CI, 1.1 to 1.9), 2.1 (1.6 to 2.7), and 2.1 (1.6 to 2.7), respectively, and lower arteriole-to-venule ratio: 1.3 (1.0 to 1.6), 1.4 (1.1 to 1.8), and 1.7 (1.3 to 2.2), respectively; (b) focal arteriolar narrowing: 1.3 (0.9 to 1.9), 2.2 (1.5 to 3.2), and 2.5 (1.8 to 3.6), respectively; and (c) arteriovenous nicking: 1.3 (0.9 to 1.8), 2.3 (1.6 to 3.2), and 1.9 (1.3 to 2.7), respectively. Our findings demonstrate a strong relation between presence and severity of hypertension and retinal microvascular structural changes.

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PubMed2003

Iris color and intraocular pressure: the Blue Mountains Eye Study.

PURPOSE: To assess the relationship between iris color and intraocular pressure (IOP). DESIGN: Population-based, cross-sectional study. METHODS: The Blue Mountains Eye Study examined 3,654 largely Caucasian participants, aged 49 to 97 years, from 1992 to 1994. Information was collected about glaucoma risk factors, and Goldmann applanation IOP measurements were taken. Iris color was assessed by comparing the undilated appearance of each eye with three standard photographs. Participants who had previous cataract or glaucoma surgery and those using glaucoma medications were excluded. RESULTS: Mean IOP measurements increased with increasing grades of iris pigmentation. After simultaneous adjustment for variables associated with IOP, mean measurements were 15.92 mm Hg for blue iris color, 16.04 mm Hg for hazel or green, 16.11 mm Hg for tan-brown, and 16.49 mm Hg for dark brown (P for trend = .001). CONCLUSIONS: This study demonstrates a modest but statistically significant association between increasing iris color and IOP.

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