RT Journal Article A1 Xie, Yuan A1 Yang, Yiquan A1 Han, Ying A1 Yang, Diya A1 Sun, Yunxiao A1 Wang, Xinmao A1 Nguyen, Anh Hong A1 Chen, Yihan A1 Tian, Jiaxin A1 Zhang, Qing A1 Xin, Chen A1 Cao, Kai A1 Wang, Huaizhou A1 Liu, Xiaofang A1 Wang, Guozhong A1 Wang, Ningli T1 Association Between Arterial Blood Gas Variation and Intraocular Pressure in Healthy Subjects Exposed to Acute Short-Term Hypobaric Hypoxia JF Translational Vision Science & Technology JO Trans. Vis. Sci. Tech. YR 2019 DO 10.1167/tvst.8.6.22 VO 8 IS 6 SP 22 OP 22 SN 2164-2591 AB To investigate the association between changes in arterial blood gases and intraocular pressure (IOP) after acute, short-term exposure to simulated elevation of 4000 m above sea level. Twenty-five healthy young lowlanders participated in this prospective study. IOP was measured in both eyes with an Accupen tonometer. Arterial blood gas parameters (partial oxygen pressure [PaO2], partial carbon dioxide pressure [PaCO2], pH, and bicarbonate ion [HCO3−]) were checked using a blood gas analyzer. Measurements were taken at sea level (T1), at 15-minute (T2) and at 2-hour (T3) exposure times to simulated 4000 m above sea level in a hypobaric chamber, and upon return to sea level (T4). Associations between arterial blood gas parameters and IOP were evaluated using multivariate linear regression. PaO2 significantly decreased at T2 and T3, resolving at T4 (P < 0.001). pH significantly increased at T2 and returned to baseline at T3 (P = 0.004). Actual and standard bicarbonate ion both dropped with IOP at T3 and T4. IOP significantly decreased from 16.4 ± 3.4 mm Hg at T1 to 15.1 ± 2.1 mm Hg (P = 0.041) at T3 and remained lower (14.9 ± 2.4 mm Hg; P = 0.029) at T4. IOP was not correlated with pH. Multivariate linear regression showed that lower IOP was associated with lower standard bicarbonate ion (beta = −1.061; 95% confidence interval, −0.049 to −2.074; P = 0.04) when adjusted for actual bicarbonate and diastolic blood pressure. Hypobaric hypoxia triggers plasma bicarbonate ion reduction which, rather than pH, may decrease aqueous humor formation and subsequently cause IOP reduction. These findings may shed light on the mechanism of IOP regulation at high altitude. Hypoxia-triggered reduction in plasma bicarbonate ion may decrease aqueous humor production, leading to IOP reduction at high altitude. These findings may provide new insight into a potential mechanism of IOP regulation. Hypobaric hypoxia at high altitude is an environmental factor that can reduce IOP and, therefore, deserves further study. RD 3/2/2021 UL https://doi.org/10.1167/tvst.8.6.22