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   <ref-type name="Journal Article">17</ref-type>
   <contributors>
    <authors>
     <author>Jost B. Jonas</author>
     <author>Rahul A. Jonas</author>
     <author>Bikbov, M.M.</author>
     <author>Kazakbaeva, G.M.</author>
     <author>Iakupova, E.M.</author>
     <author>Dan Milea</author>
     <author>Alain Bron</author>
     <author>Cédric Lamirel</author>
     <author>Vinay Nangia</author>
     <author>Ya Xing Wang</author>
     <author>Songhomitra Panda-Jonas</author>
    </authors>
   </contributors>
   <titles>
    <title>Ocular and General Determinants of Intraocular Pressure: The Two-Continent Eye Study</title>
   </titles>
   <keywords>
    <keyword>intraocular pressure (IOP)</keyword>
    <keyword>glaucoma</keyword>
    <keyword>central corneal thickness (CCT)</keyword>
    <keyword>corneal&#13;
curvature</keyword>
    <keyword>axial length</keyword>
    <keyword>arterial hypertension</keyword>
    <keyword>ocular hypertension</keyword>
    <keyword>Scopus</keyword>
    <keyword>Web of Science</keyword>
    <keyword>Белый список</keyword>
   </keywords>
   <dates>
    <year>2026</year>
    <pub-dates>
     <date>2026-06-06</date>
    </pub-dates>
   </dates>
   <doi>10.1167/iovs.67.2.17</doi>
   <journal>INVESTIGATIVE OPHTHALMOLOGY AND VISUAL SCIENCE</journal>
   <abstract>PURPOSE. The purpose of this study was to assess associations of intraocular pressure&#13;
(IOP) readings.&#13;
METHODS. This was a population-based studies conducted in Russia, China, and India.&#13;
The project included the population-based investigations of the Beijing Eye Study (BES;&#13;
n = 3139 participants, age = 40+ years), Ural Eye and Medical Study (UEMS; n = 5514,&#13;
age = 40+ years), Ural Very Old Study (UVOS; n = 522, age = 85+ years), and Ural&#13;
Children Eye Study (UCES; n = 4294, age = 6+ years), and Central India Eye and Medical&#13;
Study (CIEMS; n = 4508, age = 30+ years). Pneumo-tonometry or applanation tonometry&#13;
were performed.&#13;
RESULTS. The study included 35,199 eyes (17,977 individuals, mean age = 46.9 ± 23.2&#13;
years, range = 6–100 years, axial length = 23.2 ± 1.0 mm, range = 18.22–34.20 mm). In&#13;
the test group (BES, UVOS, and UCES), higher IOP-readings were associated (r2 = 0.37)&#13;
with younger age, female sex, rural habitation region, higher prevalence of diabetes mellitus, higher systolic blood pressure, thicker central corneal thickness (CCT) and smaller&#13;
corneal curvature radius (i.e. steeper cornea), longer axial length, lower prevalence of&#13;
cataract surgery, and higher prevalence of pseudoexfoliation. IOP values, corrected for&#13;
these associations, correlated with the IOP readings in the external validation groups of&#13;
UEMS (r2 = 0.85) and CIEMS (r2 = 0.80). In Bland-Altman analysis, the mean bias was&#13;
0.80 millimeters of mercury (mm Hg; 95% confidence interval [CI] = 0.76–0.84 or 5.8%,&#13;
95% CI = 5.5–6.1) and 1.51 mm Hg (95% CI = 1.47–1.56 or 10.2%, 95% CI = 9.9–10.5),&#13;
in the UEMS and CIEMS, respectively. The corrected IOP compared to the measured IOP&#13;
was 8.1 mm Hg lower and 10.0 mm Hg higher, respectively, in 2 clinical examples. A&#13;
real IOP value of 21 mm Hg corresponded to a measured IOP readings ranging from&#13;
29.1 mm Hg to 11.0 mm Hg.&#13;
CONCLUSIONS. Among numerous ocular and systemic factors influencing IOP readings&#13;
(with a relative low correlation coefficient), corneal curvature radius was one of the main&#13;
ocular determinants. Correction of measured IOP readings led to a large interindividual&#13;
variation in the upper limit of the “normal” IOP range.</abstract>
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