Distribution of intraocular pressure. The Barbados Eye Study.
OBJECTIVE
To provide data on the distribution of intraocular pressure (IOP) in a predominantly black population, which has a high prevalence of open-angle glaucoma.


METHODS
Population-based prevalence study.


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


METHODS
A standardized protocol included applanation tonometry and other ocular measurements, fundus photography, demographic data, and an interview.


METHODS
The average of 3 IOP measurements at the Barbados Eye Study visit was used to compare IOP by self-reported race. Descriptive data on IOP by age, sex, glaucoma status, and cup-disc ratio were examined in the black population.


RESULTS
The IOP was highest in the population of African origin. The mean (+/-SD) IOP values for black, mixed, and white participants were 18.7 +/- 5.2, 18.2 +/- 3.8, and 16.5 +/- 3.0 mm Hg, respectively. An IOP greater than 21 mm Hg was present in 18.4%, 13.6%, and 4.6% of the black, mixed, and white participants, respectively. In analyses that were adjusted for age, sex, and glaucoma status, such values were 5 times as likely in black than white participants and 3.5 times as likely in mixed race participants (P < .01). Among the black participants, the mean IOP increased approximately 1 mm Hg for every increase in 10 years of age. After excluding persons with any type of glaucoma, suspected glaucoma, or a history of glaucoma treatment, women had significantly (P < .01) higher IOP values; however, no significant IOP trends by sex were evident in the group with glaucoma. The IOP was also positively associated (P < .05) with vertical cup-disc ratios. After 2 visits, the IOP remained 21 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 white participants. The IOP was also associated with age and cup-disc ratios. The results showed that open-angle glaucoma and a high IOP alone have a different distribution by sex; although open-angle glaucoma was more frequent in men, ocular hypertension was more frequent in women. These data have implications for the detection and causation of open-angle glaucoma in this high-risk population.
Leske
M C
MC
Department of Preventive Medicine, University Medical Center at Stony Brook, NY, USA.
Connell
A M
AM
Wu
S Y
SY
Hyman
L
L
Schachat
A P
AP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001460:Barbados / Q000453:epidemiology; D044383:Black People; D005260:Female; D005902:Glaucoma, Open-Angle / Q000208:ethnology*; D006306:Health Surveys; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000208:ethnology*; D015995:Prevalence; D012650:Self Disclosure; D017678:Sex Distribution; D014065:Tonometry, Ocular; D044465:White People