Objective:
To assess whether ambient temperature is independently associated with intraocular pressure (IOP) in medically treated patients with stable primary open-angle glaucoma (POAG).
Approach:
- Study design: Retrospective longitudinal analysis of patients treated at a hospital in Kyoto, Japan, from 2012 to 2023.
- Participants and measurements: The dataset included 2,655 Goldmann applanation tonometry measurements from 154 eyes of 77 patients, followed for an average of 5.2 years. Participants had stable glaucoma medication regimens.
- Analysis: Mixed-effects models assessed associations between IOP and hourly or daily meteorological data, accounting for potential ophthalmic, systemic, and environmental confounders.
Key Findings:
- Mean IOP was 12.5 mmHg.
- Each 1°C increase in hourly ambient temperature was associated with an estimated 0.029 mmHg decrease in IOP; the daily-temperature estimate was −0.030 mmHg per 1°C.
- Mean blood pressure was independently and positively associated with IOP. Glaucoma type, number of eye drops, and time of day also significantly influenced measurements.
- Temperature associations were significant in eyes with severe-stage glaucoma, patients using three or four glaucoma medications, and the normal-tension glaucoma subgroup. The association was not significant in the smaller high-tension glaucoma subgroup.
Interpretation:
The authors report that ambient temperature was independently associated with IOP after adjustment for blood pressure and other factors. They suggest cold-related sympathetic nervous system activity as one possible explanation, while noting that the mechanism was not established.
Limitations:
- The study was retrospective and could not account for factors including exercise, obesity, and blood biochemistry.
- The analysis was restricted to patients with stable medication regimens, so findings may not apply to people with poorly controlled IOP.
- The authors noted that the nonsignificant result in the high-tension glaucoma subgroup may reflect limited statistical power.
Conclusion:
The authors conclude that ambient temperature should be considered as an independent factor when interpreting IOP measurements and developing a comprehensive approach to POAG management.
Sources:
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