Effects of caffeinated coffee consumption on intraocular pressure, ocular perfusion pressure, and ocular pulse amplitude: a randomized controlled trial

Abstract

Purpose To examine the effects of caffeinated coffee consumption on intraocular pressure (IOP), ocular perfusion pressure (OPP), and ocular pulse amplitude (OPA) in those with or at risk for primary open-angle glaucoma (POAG). Methods We conducted a prospective, double-masked, crossover, randomized controlled trial with 106 subjects: 22 with high tension POAG, 18 with normal tension POAG, 20 with ocular hypertension, 21 POAG suspects, and 25 healthy participants. Subjects ingested either 237 ml of caffeinated (182 mg caffeine) or decaffeinated (4 mg caffeine) coffee for the first visit and the alternate beverage for the second visit. Blood pressure (BP) and pascal dynamic contour tonometer measurements of IOP, OPA, and heart rate were measured before and at 60 and 90 min after coffee ingestion per visit. OPP was calculated from BP and IOP measurements. Results were analysed using paired t-tests. Multivariable models assessed determinants of IOP, OPP, and OPA changes. Results There were no significant differences in baseline IOP, OPP, and OPA between the caffeinated and decaffeinated visits. After caffeinated as compared with decaffeinated coffee ingestion, mean mm Hg changes ( ± SD) in IOP, OPP, and OPA were as follows: 0.99 ( ± 1.52, Po0.0001), 1.57 ( ± 6.40, P ¼ 0.0129), and 0.23 ( ± 0.52, Po0.0001) at 60 min, respectively; and 1.06 (±1.67, Po0.0001), 1.26 (±6.23, P ¼ 0.0398), and 0.18 (±0.52, P ¼ 0.0006) at 90 min, respectively. Regression analyses revealed sporadic and inconsistent associations with IOP, OPP, and OPA changes. Conclusion Consuming one cup of caffeinated coffee (182 mg caffeine) statistically increases, but likely does not clinically impact, IOP and OPP in those with or at risk for POAG.

Rise of intraocular pressure in a caffeine test versus the water drinking test in patients with glaucoma

“…Although our study has a limited sample size of 14 patients, there was a significant difference between baseline IOP and mean maximum IOP demonstrating IOP fluctuation of 1.8 ± 1.9 mmHg with caffeine ( P = 0.004). We acknowledge the limited sample size is insufficient to reach adequate conclusions; however, this small rise in IOP is consistent with previous studies . Both Jiwani et al .…”

“…Many studies have not shown an increase in IOP from caffeine; however, this was examined in normal healthy subjects . On the other hand, with respect to glaucomatous eyes, most studies have reported increases in IOP …”

“…However, in some patients, the WDT may not be tolerated or appropriate, such as in renal impairment or congestive heart failure. On the other hand, caffeine has also been reported to transiently increase IOP . A recent meta‐analysis showed a significant transient rise in IOP of approximately 2 mmHg in those with glaucoma or ocular hypertension (OHT), and called for further randomized control studies to assess the effect of caffeine on IOP in these subjects …”

Therapeutic Opportunities for Caffeine and A_2A Receptor Antagonists in Retinal Diseases

“…It is still a matter of debate whether or not to recommend the consumption of products containing caffeine among patients with glaucoma. Some studies have reported that caffeine consumption may increase IOP in nonglaucomatous patients, which remains elevated over a 3-hour period after consumption [51], and in glaucoma patients [52,53,54]. The mechanism by which caffeine contributes to IOP elevation is not fully understood.…”

“…It was demonstrated that caffeine increases aqueous humor formation without inhibiting the aqueous humor drainage through the trabecular meshwork [57]. However, these reported alterations in IOP are unlikely to be clinically significant [53,54]. Moreover, topical administration of 1% caffeine does not affect IOP in patients with glaucoma [58].…”