Association between 7-year Changes in Intraocular Pressure and Systemic Factors in Koreans: A Longitudinal Study

PURPOSE: To investigate the changes in intraocular pressure (IOP) and associated systemic factors over 7 years in a healthy Korean population. METHODS: This longitudinal study included healthy subjects with no history of ocular disease and who had been receiving health examinations seven years apart at the Konkuk University Medical Center, Healthcare Center. The participants completed lifestyle questionnaires and underwent general health examinations (blood pressure, height and weight, and blood biochemical tests) and ocular examinations including noncontact tonometry and fundus photography. Subjects with abnormal fundus photography findings and ocular hypertension were excluded. Changes in IOP and systemic factors over 7 years were analyzed. RESULTS: Of 524 possible subjects, 469 were enrolled (55 subjects were excluded: 50 due to abnormal fundus photography and 5 for missing data). The left eye was analyzed in all patients. In all subjects, initial IOP (mean 14.50 ± 3.14 mmHg) was not significantly different from final IOP (14.72 ± 3.38 mmHg) (paired t-test, p = 0.074). In male patients, the final IOP was significantly higher than the initial IOP (paired t-test, p = 0.035). Lifestyle questionnaire variables were associated with a final IOP that was significantly higher than the initial IOP (smokers, alcohol drinkers and less exercisers, paired t-test; p = 0.014, 0.010 and 0.024, respectively). A linear mixed-effects model analysis showed that the change in IOP was negatively associated with age, but this was not statistically significant. Changes in systolic blood pressure (SBP), body mass index (BMI), total cholesterol (T.Chol) and low density lipoprotein (LDL) were positively correlated with change in IOP. CONCLUSIONS: A linear mixed-model analysis showed IOP decreased with age but this was not statistically significant. Changes in SBP, BMI, T.Chol and LDL were significantly positively correlated with change in IOP.

Foveal Microvascular Changes Based on Optical Coherence Tomography Angiography in Mild Nonproliferative Diabetic Retinopathy

PURPOSE: To investigate the microvascular change in diabetic patients with no diabetic retinopathy (DR) and mild nonproliferative DR (NPDR) using optical coherence tomography angiography (OCTA). METHODS: We retrospectively reviewed the medical records of 44 eyes of 22 patients with no DR and 34 eyes of 17 patients with mild NPDR. OCTA was performed on a 3 × 3 mm region centered in the fovea and parafoveal areas. The foveal avascular zone (FAZ) and foveal and parafoveal flow density (FD) in superficial and deep vascular plexuses were analyzed using OCTA. RESULTS: The FAZ of deep capillary plexus in patients with mild NPDR was significantly larger than in patients with no DR (p = 0.008). The parafoveal deep FD, foveal and parafoveal thickness in patients with no DR was significantly larger than in patients with mild NPDR (p = 0.013, p = 0.018 and p = 0.003, respectively). Superficial FAZ, superficial foveal FD, superficial parafoveal FD and deep foveal FD were not significantly different between the patients with no DR and those with mild NPDR. CONCLUSIONS: OCTA allows detection of deep FAZ enlargement, reduction in parafoveal deep FD as well as foveal and parafoveal thickness in patients with mild NPDR compared with patients with no DR.