Principal Investigator: Professor Paul Foster
Department: Glaucoma Research, Moorfields Eye Hospital
Moorfields Eye Hospital, Glaucoma Research, 162 City Road, EC1V 2PDTags: 5608, epidemiology, glaucoma, intraocular pressure, risk factors
Intraocular pressure (IOP) is an important ocular physiological variable. Higher
IOP is linked with increased risk of glaucoma (a chronic, irreversible
degenerative optic neuropathy), retinal vein occlusions (blockages in blood
vessels that often cause loss of vision). Elevated IOP is a common cause of
referral to Hospital Eye Services. NICE guidelines make specific
recommendations on referral from opticians to HES on the basis of IOP
measurements. Eye disease accounts for 7% of all NHS out patient service
episodes.Glaucoma is the commonest cause of irreversible blindness
worldwide, and ranks second in causes of registered blindness in the UK (12%
of total). IOP currently the only proven modifiable risk factor for glaucoma, and
therefore is the focus of all glaucoma therapy- medication, laser and surgery.
We plan to use UKBB data to explore the distribution and determinants of IOP
in the UK, with the aim of gaining a clearer understanding of factors that
influence the aetiology of glaucoma.
Glaucoma is the second commonest cause of blindness worldwide, and the leading cause of medically and surgically irreversible blindness. In the UK, it is the second commonest cause of severe sight impairment registration. Prevalence of glaucoma increases exponentially with age, with no clear upper limit to the increase in prevalence with age. As a chronic, age-related disease, current care strategies require regular monitoring of established cases and high-risk suspects. The increase in life expectancy in the UK, together with increasing referral of early cases and suspects has seen 7-8% per year growth in demand for glaucoma service appointments at Moorfields Eye Hospital. National Institute for Health and Care Excellence (NICE) guidelines for the diagnosis and management of chronic open angle glaucoma and ocular hypertension in 2009 (NICE, 2009) led to significant increases in referral numbers across the NHS.
In conjunction with our analysis of the determinants of intraocular pressure (IOP, UKBB project 5608)), we wish to explore the factors associated with self-reported glaucoma. We assume that IOP is related to a diagnosis of glaucoma, and this would be an interesting opportunity to compare the relationship between the two measures of IOP (IOPg & IOPcc) and also corneal biomechanics (hysteresis). Other important associations we anticipate are with age (increased risk in older people), race (higher risk in black participants), refractive error (higher risk among more myopic people) and sex (greater risk in men).
One novel aspect of the analysis would be to explore the effect of socio-economic status (SES- deprivation) across the full range of income and Townsend DI scores. It is well recognised that lower SES is a risk factor for late presentation with more advanced disease, but we will seek a spectrum of risk across the entire population, which my help to clarify if there is an underlying biological basis to previous reports of an SES association with glaucoma.