The effect of caffeine on intraocular pressure: a systematic review and meta-analysis
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Caffeine is widely consumed, and its effect on intraocular pressure (IOP) has been reported in conflicting data. The aim of this meta-analysis was to quantitatively summarize the effect of caffeine on IOP in normal individuals and in patients with glaucoma or ocular hypertension (OHT).
A comprehensive literature search was performed using the Cochrane Collaboration methodology to identify pertinent randomized controlled trials (RCTs) from the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed and EMBASE. A systematic review and meta-analysis was performed. IOP at 0.5 hour (h), 1 h and 1.5 h after caffeine ingestion was the main outcome measurement.
Six RCTs (two parallel-designed and four crossover-designed) evaluating 144 participants fulfilled inclusion criteria. The risk of bias for these studies was uncertain. Among the participants, 103 were normal individuals and 41 were patients with glaucoma or OHT. In normal individuals, the IOPs measured at 0.5 h, 1 h and 1.5 h post-intervention were not affected by ingestion of caffeine. The weighted mean difference (WMD) with 95% confidence intervals (95%CI) for each measurement point were −0.740 (–2.454, 0.974), 0.522 (–0.568, 1.613) and 0.580 (–1.524, 2.684). However, in patients with glaucoma or OHT, IOP increased at each measurement point, with the WMD and 95%CI being 0.347 (0.078, 0.616), 2.395 (1.741,3.049) and 1.998 (1.522,2.474) respectively. No publication bias was detected by either Begg’s or Egger’s test.
Available evidences showed that caffeine had different effects on IOP in different groups of individuals. For normal individuals, IOP was not changed by ingestion of caffeine, while for patients with glaucoma or OHT, IOP increased significantly. More high-quality RCTs are warranted to confirm this. The mechanisms underlying this phenomenon and the clinical significance are to be explored.
KeywordsCaffeine Intraocular pressure Glaucoma Ocular hypertension Meta-analysis
- 1.Wikipedia c (2009) Caffeine. Wikipedia, The Free Encyclopedia. available from http://en.wikipedia.org/w/index.php?title=Caffeine&oldid=320136971 Accessed July 31,2009
- 12.Gordon MO, Beiser JA, Brandt JD, Heuer DK, Higginbotham EJ, Johnson CA, Keltner JL, Miller JP, Parrish RK 2nd, Wilson MR, Kass MA (2002) The Ocular Hypertension Treatment Study: baseline factors that predict the onset of primary open-angle glaucoma. Arch Ophthalmol 120:714–720, discussion 829-730PubMedGoogle Scholar
- 14.AGIS Investigators (2000) The Advanced Glaucoma Intervention Study (AGIS): 7. The relationship between control of intraocular pressure and visual field deterioration. Am J Ophthalmol 130:429–440Google Scholar
- 17.Lefebvre C, Manheimer M, Glanville J (2009) Chapter 6:Searching for studies. In: Higgins J, Green S (eds) Cochrane handbook for systematic reviews of interventions. The Cochrane Collaboration. Available from www.cochranehandbook.org. Accessed July 31,2009
- 18.Higgins JPT, Altman DG (2008) Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Altman DG (eds) Cochrane handbook for systematic reviews of interventions. The Cochrane Collaboration.Available from www.cochrane-handbook.org. Accessed July 31,2009
- 19.Higgins JPT, Deeks JJ, Altman DG (2009) Chapter 16: Special topics in statistics. In: Higgins J, Green S (eds) Cochrane handbook for systematic reviews of interventions. The Ccochrane Collaboration.Available from www.cochranehandbook.org. Accessed July 31,2009
- 23.Deeks JJ, Higgins JPT, Altman DG (2008.) Chapter 9: Analysing data and undertaking meta-analyses. In: Higgins JPT, Green S (eds) Cochrane handbook for systematic reviews of interventions version 501 (updated September 2008). The Cochrane Collaboration. Available from www.cochrane-handbook.org. Accessed July 31,2009
- 30.Alekseev BN, Ziangirova GG, Pisetskaia SF, Malakhova LA (1983) [M. M. Krasnov's caffeine therapy in treating ciliochoroidal detachment (an experimental-clinical study)]. Vestn Oftalmol: 11–14Google Scholar
- 31.Lotfi K, Grunwald JE (1991) The effect of caffeine on the human macular circulation. Investig Ophthalmol Vis Sci 32:3028–3032Google Scholar
- 43.De Venecia G, Davis MD (1963) Diurnal variation of intraocular pressure in the normal eye. Arch Ophthalmol 69:752–757Google Scholar
- 46.Tonnu PA, Ho T, Newson T, El Sheikh A, Sharma K, White E, Bunce C, Garway-Heath D (2005) The influence of central corneal thickness and age on intraocular pressure measured by pneumotonometry, non-contact tonometry, the Tono-Pen XL, and Goldmann applanation tonometry. Br J Ophthalmol 89:851–854PubMedCrossRefGoogle Scholar