Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Ophthalmol. Nov 16, 2012; 2(1): 1-5
Published online Nov 16, 2012. doi: 10.5318/wjo.v2.i1.1
Optimal screening interval for intraocular pressure measurement for Asian glaucoma patients
Daiki Kobayashi, Osamu Takahashi, Paul P Glasziou, Tsuguya Fukui
Daiki Kobayashi, Osamu Takahashi, Tsuguya Fukui, Division of General Internal Medicine, Department of Medicine, St. Luke’s International Hospital, Tokyo 1040042, Japan
Paul P Glasziou, Centre for Research in Evidence-Based Practice, Faculty of Health Sciences, Bond University, Queensland 4229, Australia
Author contributions: Kobayashi D wrote the manuscript; Takahashi O reviewed the manuscript; Glasziou PP contributed to the discussion; Fukui T contributed to the discussion and reviewed the manuscript.
Correspondence to: Daiki Kobayashi, MD, Division of General Internal Medicine, Department of Medicine, St. Luke’s International Hospital, Tokyo 1040042, Japan.
Telephone: +81-3-55502426 Fax: +81-3-55502426
Received: January 16, 2012
Revised: September 17, 2012
Accepted: October 10, 2012
Published online: November 16, 2012

AIM: To explore the optimal interval of intraocular pressure (IOP) measurement for screening glaucoma in healthy people.

METHODS: From January to December 2005, we consecutively enrolled all participants (> 20 years old) attending the Center for Preventive Medicine at St. Luke’s International Hospital in Tokyo, Japan, for the annual health check program. The program promoted the early detection of chronic diseases and their risk factors. We excluded people who had glaucoma or a high IOP (≥ 22 mmHg) at baseline. The annual health check-ups collected all demographic information and medical history with an initial evaluation, including IOP measurement. IOP was measured in both eyes with a full auto-tonometer TX-F (Canon, Tokyo, Japan). Participants with an IOP ≥ 22 mmHg in either eye were considered to require additional evaluation for glaucoma. We divided the participants into two groups based on age: under 65 years old and over 65 years old. The United States Department of Health and Human Services Centers for Medicare and Medicaid Services guideline was used as a reference.

RESULTS: From January 2005 to July 2008, 12 385 participants underwent check-ups each year. The mean ± SD IOP in the higher eye at baseline was 13.4 (2.6) in 2005, 13.2 (2.7) in 2006, 13.3 (2.6), and 12.8 (2.6) in 2008. In addition, we analyzed the differences with an analysis of variance (ANOVA), and additional analysis was performed with Bonferroni’s correction. The difference between the 4 years was significant (P < 0.01) with ANOVA. Bonferroni analysis revealed significant differences between 2005 and 2006 (P < 0.01), 2005 and 2008 (P < 0.01), 2006 and 2007 (P < 0.01), 2006 and 2008 (P < 0.01), and 2007 and 2008 (P < 0.01). Only the difference between 2005 and 2007 was not significant (P = 0.1). Logistic regression suggested that only age (P < 0.01) and baseline IOP (P < 0.01) were associated with high IOP; the presence of diabetes, HgbA1c level, gender, systolic blood pressure, diastolic blood pressure, low-density lipoprotein and family history were non-significant.

CONCLUSION: Annual IOP check-ups may be recommended for participants aged ≥ 65 years with baseline IOPs of 17-21 mmHg. A check-up every 3 years or more may be recommended for patients with IOPs < 17 mmHg.

Keywords: Glaucoma, Screening interval, Japan, Intraocular pressure, Asian