title: Joint Effects of Intraocular Pressure and Myopia on Risk of Primary Open-Angle Glaucoma: The Singapore Epidemiology of Eye Diseases Study.
abstract: We examined the joint effects of intraocular pressure (IOP) and myopia on the risk of primary open angle glaucoma (POAG) in a multi-ethnic Asian population. A total of 9,422 participants (18,469 eyes) in the Singapore Epidemiology of Eye Diseases Study were included. Of them, 213 subjects (273 eyes) had POAG. All participants underwent standardised examinations. The independent and joint effects of IOP and myopia on POAG were examined using logistic regression models. Generalised estimating equation models were used to account for correlation between eyes. Higher IOP, longer axial length, and more negative spherical equivalent were independently associated with POAG, after adjusting for relevant covariates (all P ≤ 0.005). Significant interaction between IOP and myopia on POAG was observed (P interaction = 0.025). Eyes with moderate-to-high myopia (<-3.0 dioptres) with high IOP (≥20 mmHg) were 4.27 times (95% CI, 2.10-8.69) likely to have POAG, compared to eyes without myopia (>-0.5 dioptres) and with IOP <20 mmHg. Eyes with AL of ≥25.5 mm and high IOP (≥20 mmHg) were 16.22 times (95% CI, 7.73 to 34.03) likely to have POAG, compared to eyes with shorter AL (<23.5 mm) and lower IOP (<20 mmHg). These findings may provide additional insights into the pathophysiology of POAG and are particularly relevant for Asian populations.
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.|Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
authors.forename: Yih-Chung
authors.initials: YC
authors.lastname: Tham
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.|Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.|Duke-NUS Medical School, Singapore.
authors.forename: Tin
authors.initials: T
authors.lastname: Aung
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.
authors.forename: Qiao
authors.initials: Q
authors.lastname: Fan
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.
authors.forename: Seang-Mei
authors.initials: SM
authors.lastname: Saw
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.|Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.|National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore.
authors.forename: Rosalynn Grace
authors.initials: RG
authors.lastname: Siantar
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.|Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.|Duke-NUS Medical School, Singapore.
authors.forename: Tien Y
authors.initials: TY
authors.lastname: Wong
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.|Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.|Duke-NUS Medical School, Singapore.
authors.forename: Ching-Yu
authors.initials: CY
authors.lastname: Cheng
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000150:complications*; D016017:Odds Ratio; D011159:Population Surveillance; D012306:Risk; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology / Q000208:ethnology; D014794:Visual Fields