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Intraocular pressure changes over 21 years: a longitudinal age-cohort study in northern Sweden
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
2014 (English)In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 92, no 5, 417-420 p.Article in journal (Refereed) Published
Abstract [en]

Purpose:  To follow intraocular pressure (IOP) and the influence of pseudoexfoliation (PEX) and cataract extraction in an age-cohort in northern Sweden; patients were followed prospectively for 21 years from age 66 to 87 years.

Methods:  Three Hundred and thirty-nine individuals, randomly selected from an age-cohort born in 1915 underwent ophthalmological examination including measurement of IOP with Goldmann applanation tonometry, screening for PEX and glaucoma. Follow-up examinations were performed three times with 7-year intervals. Medical records were reviewed for dates of cataract surgery and glaucoma treatment. A linear mixed model was used to analyse the impact of sex, eye (right/left), PEX, cataract extraction and time on IOP.

Results:  Without cataract surgery, the IOP from age of 66 to 87 years, increased by 0.05 mmHg/year (p < 0.001). If cataract surgery was included in the model, no significant change in IOP over time was found. The estimated contribution of PEX to IOP was +2.05 mmHg (p < 0.001), and the contribution of cataract surgery was −2.13 mmHg (p < 0.001). The mean IOP in women was 1.22 mmHg higher than in men (p = 0.001).

Conclusion:  A small but statistically significant increase in IOP with age was detected when excluding eyes that had undergone cataract surgery. PEX was associated with a higher IOP and cataract extraction with a lower.

Place, publisher, year, edition, pages
John Wiley & Sons, 2014. Vol. 92, no 5, 417-420 p.
Keyword [en]
cataract surgery, intraocular pressure, longitudinal, long-term, pseudoexfoliation
National Category
URN: urn:nbn:se:umu:diva-64308DOI: 10.1111/aos.12232ISI: 000339482700027OAI: diva2:599930
Available from: 2013-01-22 Created: 2013-01-22 Last updated: 2014-09-19Bibliographically approved
In thesis
1. Long-term follow-up of pseudoexfoliation, intraocular pressure and glaucoma: epidemiological studies in northern Sweden
Open this publication in new window or tab >>Long-term follow-up of pseudoexfoliation, intraocular pressure and glaucoma: epidemiological studies in northern Sweden
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Purpose An age-cohort was studied with long-term follow-up. The population was born in 1915, living in the municipality of Skellefteå in 1981. The purpose was to investigate the prevalence and incidence of pseudoexfoliation (PEX), its influence on intraocular pressure (IOP) and development of open-angle glaucoma (OAG). Another purpose was to estimate the value of screening for glaucoma by comparing the screened group within the cohort with the remaining unscreened group.

Methods In 1981, 339 (40%) of the 856 individuals in the cohort underwent an eye examination. This screened group was re-examined at seven-year intervals until 2002. At each visit the presence of PEX was registered, IOP was measured and the presence of glaucoma was assessed. After the 21-year follow-up period, glaucoma cases were also searched for in the medical records of the remaining unscreened individuals in the cohort. Proportions of glaucoma were compared between the two groups.

Results The prevalence of PEX was 23% (95% confidence interval (CI): 20-26%) at the age of 66 and increased to 61% (CI: 50-71%) at the age of 87. The annual incidence of PEX was 1.8% (CI: 1.3-2.4%). The prevalence of OAG increased from 2.1% (CI: 0.8-4.3%) at the age of 66 years to 25 % (CI: 16-35%) at 87 years. The overall annual incidence of OAG was 0.9% (CI: 0.6-1.3%) and for OAG with PEX 2.1% (CI: 1.2-3.3%). PEX increased the risk of developing glaucoma at least four-fold. The incidence of diagnosed OAG in women was higher in the screened group than in the unscreened group (incidence rate ratio (IRR)=1.94, p=0.035). A corresponding difference could not be verified for men (p=0.58). The mean, agedependent, increase in IOP during the 21-year observation period was 0.05 mmHg/year.

Conclusion The prevalence of PEX in this study population was the highest reported, and it increased with age. The presence of PEX increased the risk of developing OAG four times. In this study a higher proportion of OAG was revealed by screening among women but not among men. The age-related IOP increase was clinically insignificant.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 2013. 33 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 1548
Pseudoexfoliation, glaucoma, intraocular pressure, age cohort, screening, long-term follow-up
National Category
urn:nbn:se:umu:diva-64301 (URN)978-91-7459-551-2 (ISBN)
Public defence
2013-02-22, Sal E04, Biomedicinhuset, suterrängplan, by 6E, Norrlands universitetssjukhus, Umeå, 09:00 (Swedish)
Available from: 2013-01-23 Created: 2013-01-22 Last updated: 2013-01-23Bibliographically approved

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