title: Intraocular pressure and associations in children. The Gobi Desert Children Eye Study.
abstract: OBJECTIVE
  To assess the intraocular pressure (IOP) and its association in children in a population living in an oasis in the Gobi Desert.
  
  
  METHODS
  The cross-sectional school-based study included all schools in the Ejina region. The children underwent an ophthalmic examination, non-contact tonometry and measurement of blood pressure and body height and weight.
  
  
  RESULTS
  Out of eligible 1911 children, 1565 (81.9%) children with a mean age of 11.9±3.5 years (range: 6-21 years) participated. Mean spherical refractive error was -1.58±2.00 diopters. In multivariate analysis, higher IOP (right eye) was associated with younger age (P<0.001; standardized coefficient beta: -0.13; regression coefficient B: -0.13; 95% Confidence interval (CI):-0.18, -0.07), higher diastolic blood pressure (P<0.001;beta:0.13;B:0.05;95%CI:0.03,0.07), higher corneal refractive power (P<0.001;beta:0.11;B:0.23;95%CI:0.12,0.34), more myopic refractive error (P = 0.035;beta: -0.06;B: -0.10;95%CI: -0.19, -0.001), and Han Chinese ethnicity of the father (P = 0.03;beta:0.06;B:0.42;95%CI:0.04,0.89). If age and diastolic blood pressure were dropped, higher IOP was associated with higher estimated cerebrospinal fluid pressure (CSFP) (P<0.001;beta:0.09; B:0.13;95%CI:0.06,0.21) after adjusting for higher corneal refractive power (P<0.001) and Han Chinese ethnicity of the father (P = 0.04). Correspondingly, higher IOP of the left eye was associated with younger age (P<0.001;beta: -0.15;B: -0.16;95%CI: -0.21, -0.10), female gender (P<0.001;beta:0.09;B:0.65;95%CI:0.30,1.01), higher corneal refractive power (P<0.001;beta:0.08;B:0.19;95%CI:0.06,0.32), more myopic refractive error (P = 0.03;beta: -0.06;B: -0.12;95%CI: -0.22, -0.01), and higher estimated CSFP (P<0.001;beta:0.11;B:0.17;95%CI:0.09,0.24).
  
  
  CONCLUSIONS
  In school children, higher IOP was associated with steeper corneal curvature and with younger age and higher blood pressure, or alternatively, with higher estimated CSFP. Corneal curvature radius should be included in the correction of IOP measurements. The potential association between IOP and CSFP as also assumed in adults may warrant further research.
authors.affiliation: Southern Medical University, Guangzhou, Guangdong, China; Department of Ophthalmology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
authors.forename: Da Yong
authors.initials: DY
authors.lastname: Yang
authors.affiliation: The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Guo
authors.affiliation: The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
authors.forename: Yuan Yuan
authors.initials: YY
authors.lastname: Guo
authors.affiliation: The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
authors.forename: Xian Rong
authors.initials: XR
authors.lastname: Yang
authors.affiliation: The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
authors.forename: Xin Xia
authors.initials: XX
authors.lastname: Jing
authors.affiliation: Department of Ophthalmology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
authors.forename: Hai Ke
authors.initials: HK
authors.lastname: Guo
authors.affiliation: Department of Ophthalmology, People's Hospital, Peking University, & Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Tao
authors.affiliation: The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Zhu
authors.affiliation: Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University Heidelberg, Mannheim, Germany.
authors.forename: Jost B
authors.initials: JB
authors.lastname: Jonas
mesh_terms: D000293:Adolescent; D000375:Aging / Q000502:physiology; D001794:Blood Pressure; D001827:Body Height; D001835:Body Weight; D002555:Cerebrospinal Fluid / Q000502:physiology*; D002648:Child; D002681:China; D003430:Cross-Sectional Studies; D003889:Desert Climate; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008365:Manometry; D055815:Young Adult