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Abstract

Background / Aims
The aims of this study were to identify normative values in vertical cup-to-disc ratio (CDR) and intraocular pressure (IOP) measurements in a unique sample of competitors and non-competitors at London 2012 according to continents and geographical sub-regions and find a suitable tool for mapping results across the world.

Methods
Data from all patients seen in the eye clinic for the London 2012 Olympic and Paralympic Games were used in this study. Patients were categorized into countries using the United Nations Geographical Sub-regions classification. All patients underwent a full optometric eye examination and clinical details including cup-to-disc ratio were recorded. Intraocular pressures were also recorded via non contact methods using the Topcon TRK-1P. Data was analyzed using R statistical software and SPSS. Continent and sub-continent level choropleth maps were produced using GGPlot2 package.

Results
Our study used a sample of 2,077 patients for analysis. The mean age across all the continents ranged from 43.44 years in the Americas to 47.11 years in Europe with an overall mean age of 45.12 (SD = 13.62 years). A CDR was recorded in 1,566 right eyes (OD). A Games-Howell post-hoc test revealed that Africa had statistically significantly larger CDRs (0.34 +/- 0.16) than both Europe (0.29 +/- 0.12, p = 0.00) and Asia (0.31, 0.15, p = 0.04) in this unique sample. In addition, within geographical sub-regions, Western Africa had statistically larger CDRs (0.36 +/- 0.18) than Western Asia (0.27 +/- 0.14, p = 0.02), Eastern Europe (0.29 +/- 0.12, p = 0.01) and Northern Europe (0.29 +/- 0.13, p = 0.03). A total of 1,621 IOP measurements were recorded for the right eye (OD). A Tukey post-hoc test revealed that Oceania had statistically lower IOPs (15.45 +/- 2.57) than Europe (16.93 +/- 2.98, p = 0.01), Asia (16.95 +/- 2.80, p = 0.01), the Americas (16.53 +/- 2.73, p = 0.02) and Africa (16.41 +/- 3.17, p = 0.05).Within geographical sub-regions, Northern Africa had statistically significantly lower IOPs (15.85 +/- 2.92) than Western Africa (17.18 +/- 2.97, p = 0.02), Western Asia (17.58 +/- 2.83, p = 0.04) and Eastern Europe (17.10 +/- 3.06, p = 0.02). Finally, our study found that competitors had significantly smaller CDRs (U = 66583.50, p = 0.01).and lower IOPs than noncompetitors (U = 79544.50, p = 0.01).

Conclusions
This is the first study to map out cup-to-disc ratio and intraocular pressure in a unique sample of competitors and non-competitors at London 2012 by continent and geographical sub-regions. The authors hope that this data may have benefits globally and that data from future Olympic and Paralympic Games can be added to this information to produce larger, more comprehensive data sets in the future.

Publication Type:	Article
Departments:	School of Health & Psychological Sciences > Optometry & Visual Sciences
SWORD Depositor:	Symplectic Administrator

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