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Intraocular pressure and associated factors in children: the Shandong children eye study

Wen Jun Jiang¹, Jian Feng Wu², Yuan Yuan Hu³

¹Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.

Investigative Ophthalmology & Visual Science

|May 31, 2014

Insights

Intraocular pressure (IOP) in children aged 4-18 shows an M-shaped curve with age. Higher IOP is linked to female sex, higher BMI, younger age, maternal myopia, indoor activities, longer axial length, and smaller corneal diameter.

Area of Science:

Ophthalmology
Pediatric Health
Public Health

Background:

Intraocular pressure (IOP) is a critical factor in eye health.
Understanding IOP distribution in children is essential for early detection of potential vision problems.
Previous studies have not fully elucidated the age-related IOP patterns and associated factors in pediatric populations.

Purpose of the Study:

To investigate the distribution and determinants of intraocular pressure (IOP) in a large cohort of children.
To identify non-ocular and ocular factors associated with elevated IOP in the pediatric age group.

Main Methods:

A school-based, cross-sectional study was conducted in Shandong Province, China, involving children aged 4 to 18 years.
Random cluster sampling was employed across various school levels.
Comprehensive ocular examinations included ocular biometry, cycloplegic refractometry, and noncontact tonometry.

Main Results:

The mean intraocular pressure (IOP) was 17.6 ± 2.7 mm Hg.
IOP exhibited an M-shaped association with age, increasing up to age 10 and then decreasing.
Higher IOP was significantly associated with female sex, higher body mass index, younger age, maternal myopia, increased indoor reading/writing time, longer axial length, and smaller corneal horizontal diameter.

Conclusions:

The study reveals a distinct M-shaped age-IOP relationship in children.
Key factors influencing IOP in children include sex, BMI, age, parental myopia, lifestyle, and specific ocular parameters.
These findings highlight the importance of considering multiple factors when assessing IOP in pediatric eye care.

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Abstract

Purpose:

We examined the distribution of intraocular pressure (IOP) and its associated factors in children.

Methods:

Using a random cluster sampling from kindergartens, primary schools, and junior and senior high schools from rural Guanxian County and the city of Weihai, the school-based cross-sectional Shandong Children Eye Study included children aged 4 to 18 years. All participants underwent an ocular examination, including ocular biometry, cycloplegic refractometry, and noncontact tonometry.

Results:

Mean IOP was 17.6 ± 2.7 mm Hg (range, 10-28 mm Hg). The IOP increased up to an age of 10 years and subsequently decreased with older age. In multivariate regression analysis, higher IOP was associated with female sex (P < 0.001; standardized correlation coefficient β, 0.06; regression coefficient β, 0.34; 95% confidence interval [CI], 0.18, 0.50), higher body mass index (P < 0.001; correlation coefficient β, 0.09; regression coefficient β, 0.07; 95% CI, 0.04,0.09), younger age (P < 0.001; correlation coefficient β, -0.15; regression coefficient β, -0.13; 95% CI, -0.17,-0.10), maternal myopia (P < 0.001; correlation coefficient β, 0.05; regression coefficient β, 0.34; 95% CI, 0.15,0.53), and more time spent indoors with reading/writing (P = 0.002; correlation coefficient β, 0.05; regression coefficient β, 0.07; 95% CI, 0.03,0.11), and with the ocular parameters of longer axial length (P < 0.001; correlation coefficient β, 0.14; regression coefficient β, 0.29; 95% CI, 0.21,0.37) and smaller corneal horizontal diameter (P < 0.001; correlation coefficient β, -0.06; regression coefficient β, -0.31; 95% CI, -0.46,-0.15).

Conclusions:

In children aged 4 to 18 years, IOP showed an M-shaped association with age. Higher IOP was associated with the nonocular parameters of female sex (P < 0.001), higher body mass index (P < 0.001), younger age (P < 0.001), maternal myopia (P < 0.001), and more time spent indoors with reading/writing (P = 0.002), and with the ocular parameters of longer axial length (P < 0.001) and smaller corneal horizontal diameter (P < 0.001).

Keywords:

epidemiology intraocular pressure ocular hypertension population-based study shandong children eye study

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