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Johansson LH, Kalaboukhova L, Erhag HF, Skoog I, Zetterberg M. Vision-related quality of life among 70-year-olds diagnosed with glaucoma. Acta Ophthalmol 2024; 102:201-207. [PMID: 37533157 DOI: 10.1111/aos.15737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023]
Abstract
PURPOSE To evaluate the effect of glaucoma on vision-related quality of life (VRQoL), lifestyle, physical factors and socioeconomic status in a 70-year-old population in Gothenburg, Sweden. METHODS Responses to questionnaires (N = 1182) between groups with and without self-reported glaucoma were analysed. Questionnaires included National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25), Short-Form Health Survey (SF-36), physical activity, socioeconomics, alcohol and tobacco consumption. Balance test and body mass index were also included. About half of the participants were randomized to ophthalmic examination (N = 560), variables were analysed separately according to known and confirmed glaucoma, ocular hypertension and/or cases of previously unknown glaucoma. RESULTS Both conventional and Rasch analysis of the NEI VFQ-25 showed that VRQoL was lower for individuals self-reporting glaucoma (p = 0.003/p = 0.024). Regarding general QoL, the participants did not differ apart from people self-reporting glaucoma reported worse general health (p = 0.01). Using logistic regression with lower VRQoL as the dependent variable glaucoma was not a significant predictor of poor VRQoL, odds ratio (OR) 1.83 (95% confidence interval (CI) 0.76-4.39, p = 0.18). Low household income was associated with lower VRQoL (OR 1.63, 95% CI 1.14-2.33, p = 0.01). Socioeconomics, physical activity and lifestyle factors were comparable between the groups (N = 915). Among participants who underwent ophthalmic examination no significant differences were found between glaucoma cases and non-glaucoma cases in relation to VRQoL (N = 560). CONCLUSIONS Patients with self-reported glaucoma assessed a lower VRQoL but not lower general quality of life. Poorer household income was associated with worse VRQoL. General health was reported low in the glaucoma population but lifestyle or physical factors did not diverge.
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Affiliation(s)
- Lena Havstam Johansson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Ophthalmology, Sahlgrenska University Hospital, Region Västra Götaland, Mölndal, Sweden
| | - Lada Kalaboukhova
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Ophthalmology, Sahlgrenska University Hospital, Region Västra Götaland, Mölndal, Sweden
| | - Hanna Falk Erhag
- Department of Psychiatry and Neurochemistry, Centre for Ageing and Health (AgeCap), Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Centre for Ageing and Health (AgeCap), Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Madeleine Zetterberg
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Ophthalmology, Sahlgrenska University Hospital, Region Västra Götaland, Mölndal, Sweden
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Hopf S, Tüscher O, Schuster AK. [Retinal OCT biomarkers and neurodegenerative diseases of the central nervous system beyond Alzheimer's disease]. DIE OPHTHALMOLOGIE 2024; 121:93-104. [PMID: 38263475 DOI: 10.1007/s00347-023-01974-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Optical coherence tomography (OCT) biomarkers are increasingly used by neurologists, psychiatrists, and ophthalmologists for the diagnosis, prognosis, and follow-up of neurodegenerative diseases. Long-term data on OCT biomarkers of selected primary and secondary neurodegenerative diseases of the central nervous system (CNS), such as multiple sclerosis (MS) or Parkinson's disease, are already available in part. In addition, there are rare neurodegenerative diseases with early disease onset that may show OCT abnormalities. METHODS A literature review on the association of OCT biomarkers with neurodegenerative diseases of the CNS beyond Alzheimer's disease is presented. Parkinson's disease, MS, Friedreich's ataxia, Huntington's disease, spinocerebellar ataxia, and lysosomal storage diseases are addressed. RESULTS Relevant OCT biomarkers of neurodegenerative diseases are the macular ganglion cell inner plexiform layer (GCIPL) and the peripapillary retinal nerve fiber layer (pRNFL) thickness. Different sectors may be affected depending on the disease entity in addition to global pRFNL reduction. OCT‑angiography (OCT-A) is also increasingly used as a biomarker in neurodegenerative diseases. CONCLUSION Optical coherence tomography biomarkers are used in an interdisciplinary context. Retinal pathologies should be excluded by an ophthalmologist. While OCT biomarkers are increasingly used clinically in MS, the benefit in other neurodegenerative diseases, especially the rare ones, is less well documented. Further longitudinal studies are required.
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Affiliation(s)
- Susanne Hopf
- Augenklinik und Poliklinik der Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.
| | - Oliver Tüscher
- Zentrum für seltene Erkrankungen des Nervensystems (ZSEN) Mainz und Klinik für Psychiatrie und Psychotherapie der Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Alexander K Schuster
- Augenklinik und Poliklinik der Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland
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Sano K, Terauchi R, Fukai K, Furuya Y, Nakazawa S, Kojimahara N, Hoshi K, Nakano T, Toyota A, Tatemichi M. Association Between Alcohol Consumption Patterns and Glaucoma in Japan. J Glaucoma 2023; 32:968-975. [PMID: 37748099 PMCID: PMC10621645 DOI: 10.1097/ijg.0000000000002308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 08/25/2023] [Indexed: 09/27/2023]
Abstract
PRCIS In this case-control study of the Japanese population, including 3207 glaucoma cases, alcohol consumption patterns such as frequency and quantity showed a positive association with glaucoma prevalence. PURPOSE To examine the association between alcohol consumption patterns and glaucoma. SUBJECTS AND METHODS This case-control study evaluated 3207 cases with glaucoma and 3207 matched controls. Patients over 40 years of age were included from 1,693,611 patients admitted to 34 hospitals in Japan. Detailed alcohol consumption patterns (drinking frequency, average daily drinks, and total lifetime drinks) were obtained, as well as various confounding factors, including smoking history and lifestyle-related comorbidities. Conditional logistic regression models were used to calculate odds ratios (ORs) and 95% CIs for glaucoma prevalence. RESULTS Drinking frequency showed an association with glaucoma for "a few days/week" (OR, 1.19; 95% CI, 1.03-1.38) and "almost every day/week" (OR, 1.40; 95% CI, 1.18-1.66). Average daily drinks showed an association for ">0-2 drinks/day" (OR, 1.16; 95% CI, 1.03-1.32). Total lifetime drinks showed an association for ">60-90 drink-year" (OR, 1.23; 95% CI, 1.01-1.49) and ">90 drink-year" (OR, 1.23; 95% CI, 1.05-1.44). As alcohol consumption levels differed considerably between men and women, additional analyses were conducted separately for men and women. Among men, drinking frequency of "a few days/week" and "almost every day/week," average daily drinks of ">0-2 drinks/day" and ">2-4 drinks/day," and total lifetime drinks of ">60-90 drink-year" and ">90 drink-year" had an association with glaucoma. Conversely, among women, neither drinking frequency, average daily drinks, nor total lifetime drinks were associated. CONCLUSIONS Both the frequency and quantity of alcohol consumption were associated with glaucoma. Further research on gender differences is warranted.
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Affiliation(s)
- Kei Sano
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo
| | - Ryo Terauchi
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo
| | - Kota Fukai
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara
| | - Yuko Furuya
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara
| | - Shoko Nakazawa
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara
| | - Noriko Kojimahara
- Department of Public Health, Shizuoka Graduate University of Public Health, Shizuoka
| | - Keika Hoshi
- Center for Health Informatics Policy, National Institute of Public Health, Wako
- Department of Hygiene, School of Medicine, Kitasato University, Sagamihara
| | - Tadashi Nakano
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo
| | - Akihiro Toyota
- Chugoku Rosai Hospital Research Center for the Promotion of Health and Employment Support, Japan Organization of Occupational Health and Safety, Hiroshima, Japan
| | - Masayuki Tatemichi
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara
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Majithia S, Quek DQY, Chee ML, Lim ZW, Nusinovici S, Soh ZD, Thakur S, Rim TH, Sabanayagam C, Cheng CY, Tham YC. Cardiovascular disease and thinning of retinal nerve fiber layer in a multi-ethnic Asian population: the Singapore epidemiology of eye diseases study. Front Med (Lausanne) 2023; 10:1235309. [PMID: 37928469 PMCID: PMC10620687 DOI: 10.3389/fmed.2023.1235309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/18/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction Our study aimed to examine the relationship between cardiovascular diseases (CVD) with peripapillary retinal fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thickness profiles in a large multi-ethnic Asian population study. Methods 6,024 Asian subjects were analyzed in this study. All participants underwent standardized examinations, including spectral domain OCT imaging (Cirrus HD-OCT; Carl Zeiss Meditec). In total, 9,188 eyes were included for peripapillary RNFL analysis (2,417 Malays; 3,240 Indians; 3,531 Chinese), and 9,270 eyes (2,449 Malays, 3,271 Indians, 3,550 Chinese) for GCIPL analysis. History of CVD was defined as a self-reported clinical history of stroke, myocardial infarction, or angina. Multivariable linear regression models with generalized estimating equations were performed, adjusting for age, gender, ethnicity, diabetes, hypertension, hyperlipidaemia, chronic kidney disease, body mass index, current smoking status, and intraocular pressure. Results We observed a significant association between CVD history and thinner average RNFL (β = -1.63; 95% CI, -2.70 to -0.56; p = 0.003). This association was consistent for superior (β = -1.79, 95% CI, -3.48 to -0.10; p = 0.038) and inferior RNFL quadrant (β = -2.14, 95% CI, -3.96 to -0.32; p = 0.021). Of the CVD types, myocardial infarction particularly showed significant association with average (β = -1.75, 95% CI, -3.08 to -0.42; p = 0.010), superior (β = -2.22, 95% CI, -4.36 to -0.09; p = 0.041) and inferior (β = -2.42, 95% CI, -4.64 to -0.20; p = 0.033) RNFL thinning. Among ethnic groups, the association between CVD and average RNFL was particularly prominent in Indian eyes (β = -1.92, 95% CI, -3.52 to -0.33; p = 0.018). CVD was not significantly associated with average GCIPL thickness, albeit a consistent negative direction of association was observed (β = -0.22, 95% CI, -1.15 to 0.71; p = 0.641). Discussion In this large multi-ethnic Asian population study, we observed significant association between CVD history and RNFL thinning. This finding further validates the impact of impaired systemic circulation on RNFL thickness.
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Affiliation(s)
- Shivani Majithia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Debra Q. Y. Quek
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Miao Li Chee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Zhi Wei Lim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Simon Nusinovici
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Zhi-Da Soh
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Sahil Thakur
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Tyler Hyungtaek Rim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Centre for Innovation and Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yih-Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Centre for Innovation and Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Mahmoudinezhad G, Nishida T, Weinreb RN, Baxter SL, Chang AC, Nikkhoy N, Walker E, Liebmann JM, Girkin CA, Moghimi S. Associations of smoking and alcohol consumption with the development of open angle glaucoma: a retrospective cohort study. BMJ Open 2023; 13:e072163. [PMID: 37793935 PMCID: PMC10551939 DOI: 10.1136/bmjopen-2023-072163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 06/22/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVES To investigate the associations of alcohol consumption and smoking with the development of perimetric glaucoma in patients with suspected glaucoma. DESIGN A retrospective cohort study of patients suspected to have glaucoma enrolled in the Diagnostic Innovations in Glaucoma Study (DIGS) and the African Descent and Glaucoma Evaluation Study (ADAGES). SETTING Three tertiary glaucoma centres in the USA. PARTICIPANTS 825 eyes of 610 patients with glaucoma suspect eyes with normal visual fields (VF) at baseline were followed over an average of 9 years from the DIGS and ADAGES studies. OUTCOME MEASURES Development of glaucoma was defined as occurrence of three consecutive abnormal VF tests during follow-up. Univariable and multivariable Cox regression models were used to investigate lifestyle-related factors associated with development of VF loss over time. RESULTS VF tests were abnormal three times in a row in 235 (28.5%) eyes. Alcohol consumption was associated with a higher risk of developing glaucoma (HR 1.57, 95% CI 1.03 to 2.38, p=0.037). In men, the risk of developing glaucoma in alcohol drinkers (HR 1.92, 95% CI 1.00 to 3.68, p=0.048) was greater than non-alcohol drinkers. In individuals of African descent, the risk of developing glaucoma in alcohol drinkers (HR 1.79, 95% CI 1.02 to 3.15, p=0.043) was greater than non-alcohol drinkers. Age was a modifier of the relationship between smoking and glaucomatous VF defects (p=0.048). The risk of developing glaucoma in smokers (HR 1.73, 95% CI 1.10 to 2.72, p=0.019) was greater than never smokers after adjustment for confounding factors in older patients (age >61 years). CONCLUSION Alcohol consumption was associated with an increased risk of developing glaucoma, particularly in men and individuals of African descent. The risk of developing glaucoma among smokers suspected of having glaucoma was influenced by age, with older individuals having a higher risk than younger people. TRIAL REGISTRATION NUMBER NCT00221897 and NCT00221923.
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Affiliation(s)
- Golnoush Mahmoudinezhad
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Takashi Nishida
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Robert N Weinreb
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Sally L Baxter
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
- Department of Biomedical Informatics, University of California San Diego, La Jolla, CA, USA
| | - Aimee C Chang
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Nicki Nikkhoy
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Evan Walker
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Jeffrey M Liebmann
- Department of Ophthalmology, Columbia University Medical Center, New York, New York, USA
| | - Christopher A Girkin
- Department of Ophthalmology, Bernard School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sasan Moghimi
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
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Stuart KV, Pasquale LR, Kang JH, Foster PJ, Khawaja AP. Towards modifying the genetic predisposition for glaucoma: An overview of the contribution and interaction of genetic and environmental factors. Mol Aspects Med 2023; 93:101203. [PMID: 37423164 PMCID: PMC10885335 DOI: 10.1016/j.mam.2023.101203] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/26/2023] [Accepted: 07/05/2023] [Indexed: 07/11/2023]
Abstract
Glaucoma, the leading cause of irreversible blindness worldwide, is a complex human disease, with both genetic and environmental determinants. The availability of large-scale, population-based cohorts and biobanks, combining genotyping and detailed phenotyping, has greatly accelerated research into the aetiology of glaucoma in recent years. Hypothesis-free genome-wide association studies have furthered our understanding of the complex genetic architecture underpinning the disease, while epidemiological studies have provided advances in the identification and characterisation of environmental risk factors. It is increasingly recognised that the combined effects of genetic and environmental factors may confer a disease risk that reflects a departure from the simple additive effect of the two. These gene-environment interactions have been implicated in a host of complex human diseases, including glaucoma, and have several important diagnostic and therapeutic implications for future clinical practice. Importantly, the ability to modify the risk associated with a particular genetic makeup promises to lead to personalised recommendations for glaucoma prevention, as well as novel treatment approaches in years to come. Here we provide an overview of genetic and environmental risk factors for glaucoma, as well as reviewing the evidence and discussing the implications of gene-environment interactions for the disease.
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Affiliation(s)
- Kelsey V Stuart
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jae H Kang
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Paul J Foster
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
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Delavari P, Ozturan G, Yuan L, Yilmaz Ö, Oruc I. Artificial intelligence, explainability, and the scientific method: A proof-of-concept study on novel retinal biomarker discovery. PNAS NEXUS 2023; 2:pgad290. [PMID: 37746328 PMCID: PMC10517742 DOI: 10.1093/pnasnexus/pgad290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/28/2023] [Indexed: 09/26/2023]
Abstract
We present a structured approach to combine explainability of artificial intelligence (AI) with the scientific method for scientific discovery. We demonstrate the utility of this approach in a proof-of-concept study where we uncover biomarkers from a convolutional neural network (CNN) model trained to classify patient sex in retinal images. This is a trait that is not currently recognized by diagnosticians in retinal images, yet, one successfully classified by CNNs. Our methodology consists of four phases: In Phase 1, CNN development, we train a visual geometry group (VGG) model to recognize patient sex in retinal images. In Phase 2, Inspiration, we review visualizations obtained from post hoc interpretability tools to make observations, and articulate exploratory hypotheses. Here, we listed 14 hypotheses retinal sex differences. In Phase 3, Exploration, we test all exploratory hypotheses on an independent dataset. Out of 14 exploratory hypotheses, nine revealed significant differences. In Phase 4, Verification, we re-tested the nine flagged hypotheses on a new dataset. Five were verified, revealing (i) significantly greater length, (ii) more nodes, and (iii) more branches of retinal vasculature, (iv) greater retinal area covered by the vessels in the superior temporal quadrant, and (v) darker peripapillary region in male eyes. Finally, we trained a group of ophthalmologists (N = 26 ) to recognize the novel retinal features for sex classification. While their pretraining performance was not different from chance level or the performance of a nonexpert group (N = 31 ), after training, their performance increased significantly (p < 0.001 , d = 2.63 ). These findings showcase the potential for retinal biomarker discovery through CNN applications, with the added utility of empowering medical practitioners with new diagnostic capabilities to enhance their clinical toolkit.
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Affiliation(s)
- Parsa Delavari
- Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, V5Z 0A6 BC, Canada
- Neuroscience, University of British Columbia, Djavad Mowafaghian Centre for Brain Health, Vancouver, V6T 1Z3 BC, Canada
| | - Gulcenur Ozturan
- Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, V5Z 0A6 BC, Canada
| | - Lei Yuan
- Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, V5Z 0A6 BC, Canada
| | - Özgür Yilmaz
- Mathematics, University of British Columbia, Vancouver, V6T 1Z2 BC, Canada
| | - Ipek Oruc
- Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, V5Z 0A6 BC, Canada
- Neuroscience, University of British Columbia, Djavad Mowafaghian Centre for Brain Health, Vancouver, V6T 1Z3 BC, Canada
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8
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Stuart KV, Luben RN, Warwick AN, Madjedi KM, Patel PJ, Biradar MI, Sun Z, Chia MA, Pasquale LR, Wiggs JL, Kang JH, Kim J, Aschard H, Tran JH, Lentjes MAH, Foster PJ, Khawaja AP. The Association of Alcohol Consumption with Glaucoma and Related Traits: Findings from the UK Biobank. Ophthalmol Glaucoma 2023; 6:366-379. [PMID: 36481453 PMCID: PMC10239785 DOI: 10.1016/j.ogla.2022.11.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 05/12/2023]
Abstract
PURPOSE To examine the associations of alcohol consumption with glaucoma and related traits, to assess whether a genetic predisposition to glaucoma modified these associations, and to perform Mendelian randomization (MR) experiments to probe causal effects. DESIGN Cross-sectional observational and gene-environment interaction analyses in the UK Biobank. Two-sample MR experiments using summary statistics from large genetic consortia. PARTICIPANTS UK Biobank participants with data on intraocular pressure (IOP) (n = 109 097), OCT-derived macular inner retinal layer thickness measures (n = 46 236) and glaucoma status (n = 173 407). METHODS Participants were categorized according to self-reported drinking behaviors. Quantitative estimates of alcohol intake were derived from touchscreen questionnaires and food composition tables. We performed a 2-step analysis, first comparing categories of alcohol consumption (never, infrequent, regular, and former drinkers) before assessing for a dose-response effect in regular drinkers only. Multivariable linear, logistic, and restricted cubic spline regression, adjusted for key sociodemographic, medical, anthropometric, and lifestyle factors, were used to examine associations. We assessed whether any association was modified by a multitrait glaucoma polygenic risk score. The inverse-variance weighted method was used for the main MR analyses. MAIN OUTCOME MEASURES Intraocular pressure, macular retinal nerve fiber layer (mRNFL) thickness, macular ganglion cell-inner plexiform layer (mGCIPL) thickness, and prevalent glaucoma. RESULTS Compared with infrequent drinkers, regular drinkers had higher IOP (+0.17 mmHg; P < 0.001) and thinner mGCIPL (-0.17 μm; P = 0.049), whereas former drinkers had a higher prevalence of glaucoma (odds ratio, 1.53; P = 0.002). In regular drinkers, alcohol intake was adversely associated with all outcomes in a dose-dependent manner (all P < 0.001). Restricted cubic spline regression analyses suggested nonlinear associations, with apparent threshold effects at approximately 50 g (∼6 UK or 4 US alcoholic units)/week for mRNFL and mGCIPL thickness. Significantly stronger alcohol-IOP associations were observed in participants at higher genetic susceptibility to glaucoma (Pinteraction < 0.001). Mendelian randomization analyses provided evidence for a causal association with mGCIPL thickness. CONCLUSIONS Alcohol intake was consistently and adversely associated with glaucoma and related traits, and at levels below current United Kingdom (< 112 g/week) and United States (women, < 98 g/week; men, < 196 g/week) guidelines. Although we cannot infer causality definitively, these results will be of interest to people with or at risk of glaucoma and their advising physicians. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Kelsey V Stuart
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom.
| | - Robert N Luben
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom; MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Alasdair N Warwick
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom; UCL Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Kian M Madjedi
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom; Department of Ophthalmology, University of Calgary, Calgary, Alberta, Canada
| | - Praveen J Patel
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Mahantesh I Biradar
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Zihan Sun
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Mark A Chia
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Janey L Wiggs
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Jae H Kang
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jihye Kim
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Hugues Aschard
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts; Institut Pasteur, Université Paris Cité, Department of Computational Biology, Paris, France
| | - Jessica H Tran
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Paul J Foster
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
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Washington J, Ritch R, Liu Y. Homocysteine and Glaucoma. Int J Mol Sci 2023; 24:10790. [PMID: 37445966 DOI: 10.3390/ijms241310790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 06/10/2023] [Accepted: 06/11/2023] [Indexed: 07/15/2023] Open
Abstract
Elevated levels of homocysteine (Hcy), a non-proteinogenic amino acid, may lead to a host of manifestations across the biological systems, particularly the nervous system. Defects in Hcy metabolism have been associated with many neurodegenerative diseases including glaucoma, i.e., the leading cause of blindness. However, the pathophysiology of elevated Hcy and its eligibility as a risk factor for glaucoma remain unclear. We aimed to provide a comprehensive review of the relationship between elevated Hcy levels and glaucoma. Through a systemic search of the PubMed and Google Scholar databases, we found that elevated Hcy might play an important role in the pathogenesis of glaucoma. Further research will be necessary to help clarify the specific contribution of elevated Hcy in the pathogenesis of glaucoma. A discovery and conceptual understanding of Hcy-associated glaucoma could be the keys to providing better therapeutic treatment, if not prophylactic treatment, for this disease.
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Affiliation(s)
- Joshua Washington
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Robert Ritch
- New York Eye & Ear Infirmary, New York, NY 10003, USA
| | - Yutao Liu
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- James & Jean Culver Vision Discovery Institute, 4 Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
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10
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van der Heide FCT, Mokhtar S, Khanna A, Said M, Henry RMA, Kroon AA, Dagnelie PC, Eussen SJPM, Berendschot TTJM, Schouten JSAG, Schram MT, van der Kallen CJH, van Greevenbroek MMJ, Wesselius A, Savelberg HHCM, Schaper NC, Webers CAB, Stehouwer CDA. Retinal Functional and Structural Neural Indices: Potential Biomarkers for the Monitoring of Cerebral Neurodegeneration: The Maastricht Study. J Alzheimers Dis 2023:JAD230104. [PMID: 37182886 DOI: 10.3233/jad-230104] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND If retinal indices of neurodegeneration are to be biomarkers for the monitoring of cerebral neurodegeneration, it is important to establish whether potentially modifiable risk factors for dementia are associated with retinal neurodegenerative changes. OBJECTIVE To study associations of dementia risk factors with retinal sensitivity, an index of retinal neural function, and retinal nerve fiber layer (RNFL) thickness, an index of retinal neural structure. METHODS We used cross-sectional data from The Maastricht Study (up to 5,666 participants, 50.5% men, mean age 59.7), and investigated associations with regression analyses (adjusted for potential confounders). RESULTS Most risk factors under study (i.e., hyperglycemia, unhealthy diet, lower cardiorespiratory fitness, smoking, alcohol consumption, and hypertension) were significantly associated with lower retinal sensitivity and lower RNFL thickness. CONCLUSION Findings of this population-based study support the concept that retinal neural indices may be biomarkers for the monitoring of therapeutic strategies that aim to prevent early-stage cerebral neurodegeneration and, ultimately, dementia.
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Affiliation(s)
- Frank C T van der Heide
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
- MHeNS School of Mental Health and Neuroscience, Maastricht University (UM), The Netherlands
- University Eye Clinic Maastricht, MUMC+, TheNetherlands
| | - Sara Mokhtar
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
- MHeNS School of Mental Health and Neuroscience, Maastricht University (UM), The Netherlands
- University Eye Clinic Maastricht, MUMC+, TheNetherlands
| | - Anjani Khanna
- Department of Ophthalmology, Sharpsight eye hospital, New Delhi, India
| | - Mozhda Said
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
| | - Ronald M A Henry
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
- Heart and Vascular Centre, MUMC+ Maastricht, The Netherlands
| | - Abraham A Kroon
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
| | - Pieter C Dagnelie
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
| | - Simone J P M Eussen
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Epidemiology, UM, The Netherlands
- CAPHRI Care and Public Health Research Institute, UM, The Netherlands
| | - Tos T J M Berendschot
- MHeNS School of Mental Health and Neuroscience, Maastricht University (UM), The Netherlands
- University Eye Clinic Maastricht, MUMC+, TheNetherlands
| | - Jan S A G Schouten
- University Eye Clinic Maastricht, MUMC+, TheNetherlands
- Department of Ophthalmology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Miranda T Schram
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
- MHeNS School of Mental Health and Neuroscience, Maastricht University (UM), The Netherlands
- Heart and Vascular Centre, MUMC+ Maastricht, The Netherlands
| | - Carla J H van der Kallen
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
| | - Marleen M J van Greevenbroek
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
| | - Anke Wesselius
- Department of Genetics and Cell Biology, Complex Genetics, UM, The Netherlands
- NUTRIM School for Nutrition and Translational Research in Metabolism, UM, The Netherlands
| | - Hans H C M Savelberg
- NUTRIM School for Nutrition and Translational Research in Metabolism, UM, The Netherlands
- Department of Nutrition and Movement Sciences, UM, The Netherlands
| | - Nicolaas C Schaper
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Social Medicine, MUMC+, The Netherlands
- Department of Internal Medicine, Division of Endocrinology and Metabolic Disease, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Carroll A B Webers
- MHeNS School of Mental Health and Neuroscience, Maastricht University (UM), The Netherlands
- University Eye Clinic Maastricht, MUMC+, TheNetherlands
| | - Coen D A Stehouwer
- CARIM School for Cardiovascular Diseases, Maastricht University (UM), The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), The Netherlands
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11
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Yang S, Zhu Z, Yuan Y, Chen S, Shang X, Bulloch G, He M, Wang W. Analysis of Plasma Metabolic Profile on Ganglion Cell-Inner Plexiform Layer Thickness With Mortality and Common Diseases. JAMA Netw Open 2023; 6:e2313220. [PMID: 37191963 DOI: 10.1001/jamanetworkopen.2023.13220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
Importance The neural retina is considered a unique window to systemic health, but its biological link with systemic health remains unknown. Objective To investigate the independent associations of retinal ganglion cell-inner plexiform layer thickness (GCIPLT) metabolic profiles with rates of mortality and morbidity of common diseases. Design, Setting, and Participants This cohort study evaluated UK Biobank participants enrolled between 2006 and 2010, and prospectively followed them up for multidisease diagnosis and mortality. Additional participants from the Guangzhou Diabetes Eye Study (GDES) underwent optical coherence tomography scanning and metabolomic profiling and were included for validation. Main Outcomes and Measures Systematic analysis of circulating plasma metabolites to identify GCIPLT metabolic profiles; prospective associations of these profiles with mortality and morbidity of 6 common diseases with their incremental discriminative value and clinical utility. Results Among 93 838 community-based participants (51 182 [54.5%] women), the mean (SD) age was 56.7 (8.1) years and mean (SD) follow-up was 12.3 (0.8) years. Of 249 metabolic metrics, 37 were independently associated with GCIPLT, including 8 positive and 29 negative associations, and most were associated with the rates of future mortality and common diseases. These metabolic profiles significantly improved the models for discriminating type 2 diabetes over clinical indicators (C statistic: 0.862; 95% CI, 0.852-0.872 vs clinical indicators only, 0.803; 95% CI, 0.792-0.814; P < .001), myocardial infarction (0.792; 95% CI, 0.775-0.808 vs 0.768; 95% CI, 0.751-0.786; P < .001), heart failure (0.803; 95% CI, 0.786-0.820 vs 0.790; 95% CI, 0.773-0.807; P < .001), stroke (0.739; 95% CI, 0.714-0.764 vs 0.719; 95% CI, 0.693-0.745; P < .001), all-cause mortality (0.747; 95% CI, 0.734-0.760 vs 0.724; 95% CI, 0.711-0.738; P < .001), and cardiovascular disease mortality (0.790; 95% CI, 0.767-0.812 vs 0.763; 95% CI, 0.739-0.788; P < .001). Additionally, the potential of GCIPLT metabolic profiles for risk stratification of cardiovascular diseases were further confirmed in the GDES cohort using a different metabolomic approach. Conclusions and Relevance In this prospective study of multinational participants, GCIPLT-associated metabolites demonstrated the potential to inform mortality and morbidity risks. Incorporating information on these profiles may facilitate individualized risk stratification for these health outcomes.
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Affiliation(s)
- Shaopeng Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Zhuoting Zhu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Yixiong Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Shida Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xianwen Shang
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Gabriella Bulloch
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
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12
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Hanyuda A, Rosner BA, Wiggs JL, Negishi K, Pasquale LR, Kang JH. Long-term Alcohol Consumption and Risk of Exfoliation Glaucoma or Glaucoma Suspect Status among United States Health Professionals. Ophthalmology 2023; 130:187-197. [PMID: 36041586 DOI: 10.1016/j.ophtha.2022.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/19/2022] [Accepted: 08/22/2022] [Indexed: 01/25/2023] Open
Abstract
PURPOSE To assess the association between intakes of total alcohol and individual alcoholic beverages and the incidence of exfoliation glaucoma/glaucoma suspect (XFG/XFGS) status. DESIGN Prospective cohort study. PARTICIPANTS A total of 195 408 participants in the Nurses' Health Study (1980-2018), the Health Professionals Follow-up Study (1986-2018), and the Nurses' Health Study II (1991-2019) were followed biennially. Eligible participants at each 2-year risk period were ≧ 40 years and free of XFG/XFGS status with available data on diet and ophthalmic examination findings. METHODS Cumulatively averaged total (primary exposure) and individual alcoholic beverage (beer, wine, and liquor) intakes from validated dietary information every 2-4 years. MAIN OUTCOME MEASURES Confirmed incident XFG/XFGS status using medical records. We used per-eye Cox proportional hazards models, accounting for intereye correlations, to estimate multivariate-adjusted relative risks (MVRRs) and 95% confidence intervals (CIs). RESULTS During 6 877 823 eye-years of follow-up, 705 eyes with XFG/XFGS status were documented. Greater total alcohol consumption was associated significantly with higher XFG/XFGS status risk: the MVRR for XFG/XFGS status for cumulatively averaged alcohol consumption of ≧15 g/day or more versus nondrinking was 1.55 (95% CI, 1.17-2.07; P = 0.02 for trend). Long- and short-term alcohol intake was associated significantly with XFG/XFGS status risk, with the strongest associations with cumulatively averaged alcohol intake as of 4 years before diagnosis (MVRR ≥ 15 g/day vs. nondrinking, 1.65; 95% CI, 1.25-2.18; P = 0.002 for trend). Compared with nondrinkers, consuming ≧ 3.6 drinks of beer, wine, or liquor per week was associated with the following MVRRs for XFG/XFGS status: 1.26 (95% CI, 0.89-1.77; P = 0.40 for trend), 1.30 (95% CI, 1.00-1.68; P = 0.15 for trend), and 1.46 (95% CI, 1.15-1.85; P = 0.01 for trend), respectively. We did not observe interactions by age, latitude, residential tier, or intakes of folate or vitamin A (P > 0.40 for interaction); however, the association between alcohol and XFG/XFGS status was suggestively stronger for those without a family history of glaucoma (P = 0.10 for interaction). CONCLUSIONS Long-term alcohol consumption was associated with a higher risk of XFG/XFGS status. Our findings provide further clues regarding the XFG/XFGS etiology.
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Affiliation(s)
- Akiko Hanyuda
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
| | - Bernard A Rosner
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Janey L Wiggs
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jae H Kang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Chen Y, Yuan Y, Zhang S, Yang S, Zhang J, Guo X, Huang W, Zhu Z, He M, Wang W. Retinal nerve fiber layer thinning as a novel fingerprint for cardiovascular events: results from the prospective cohorts in UK and China. BMC Med 2023; 21:24. [PMID: 36653845 PMCID: PMC9850527 DOI: 10.1186/s12916-023-02728-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 01/05/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Retinal structural abnormalities have been found to serve as biomarkers for cardiovascular disease (CVD). However, the association between retinal nerve fiber layer (RNFL) thickness and the incidence of CVD events remains inconclusive, and relevant longitudinal studies are lacking. Therefore, we aimed to examine this link in two prospective cohort studies. METHODS A total of 25,563 participants from UK Biobank who were initially free of CVD were included in the current study. Another 635 participants without retinopathy at baseline from the Chinese Guangzhou Diabetes Eye Study (GDES) were adopted as the validation set. Measurements of RNFL thickness in the macular (UK Biobank) and peripapillary (GDES) regions were obtained from optical coherence tomography (OCT). Adjusted hazard ratios (HRs), odd ratios (ORs), and 95% confidence intervals (CI) were calculated to quantify CVD risk. RESULTS Over a median follow-up period of 7.67 years, 1281 (5.01%) participants in UK Biobank developed CVD events. Each 5-μm decrease in macular RNFL thickness was associated with an 8% increase in incident CVD risk (HR = 1.08, 95% CI: 1.01-1.17, p = 0.033). Compared with participants in the highest tertile of RNFL thickness, the risk of incident CVD was significantly increased in participants in the lowest thickness tertile (HR = 1.18, 95% CI: 1.01-1.38, p = 0.036). In GDES, 29 (4.57%) patients developed CVD events within 3 years. Lower average peripapillary RNFL thickness was also associated with a higher CVD risk (OR = 1.35, 95% CI: 1.11-1.65, p = 0.003). The additive net reclassification improvement (NRI) was 21.8%, and the absolute NRI was 2.0% by addition of RNFL thickness over the Framingham risk score. Of 29 patients with incident CVD, 7 were correctly reclassified to a higher risk category while 1 was reclassified to a lower category, and 21 high risk patients were not reclassified. CONCLUSIONS RNFL thinning was independently associated with increased incident cardiovascular risk and improved reclassification capability, indicating RNFL thickness derived from the non-invasive OCT as a potential retinal fingerprint for CVD event across ethnicities and health conditions. TRIAL REGISTRATION ISRCTN 15853192.
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Affiliation(s)
- Yanping Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yixiong Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Shiran Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Shaopeng Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Junyao Zhang
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne. Level 7, 32 Gisborne Street, East Melbourne, VIC, 3002, Australia
| | - Xiao Guo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Wenyong Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Zhuoting Zhu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne. Level 7, 32 Gisborne Street, East Melbourne, VIC, 3002, Australia.
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne. Level 7, 32 Gisborne Street, East Melbourne, VIC, 3002, Australia.
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
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14
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Association Between Glycemic Traits and Primary Open-Angle Glaucoma: A Mendelian Randomization Study in the Japanese Population. Am J Ophthalmol 2023; 245:193-201. [PMID: 36162535 DOI: 10.1016/j.ajo.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 09/04/2022] [Accepted: 09/09/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE A meta-analysis suggests a relationship between abnormal glucose metabolism and primary open-angle glaucoma (POAG); however, the causal association between them remains controversial. We therefore conducted a Mendelian randomization (MR) study to assess the causal association between genetically predicted glycemic traits and the risk of POAG. DESIGN Two-sample MR design. METHODS We examined the genetically predicted measures of fasting glucose, hemoglobin A1c (HbA1c), and fasting C-peptide, in relation to POAG. For the single nucleotide polymorphism (SNP)-exposure analyses, we meta-analyzed the study-level genome-wide associations of fasting glucose levels (n = 17,289; n of SNPs = 34), HbA1c (n = 52,802; n of SNPs = 43), and fasting C-peptide levels (n=1666; n of SNPs = 17) from the Japanese Consortium of Genetic Epidemiology studies. We used summary statistics from the BioBank Japan projects (n = 3980 POAG cases and 18,815 controls) for the SNP-outcome association. RESULTS We observed no association of genetically predicted HbA1c and fasting C-peptide with POAG. The MR inverse-variance-weighted (IVW) odds ratios (ORs) were 1.44 (95% confidence interval [CI], 0.78-2.65; P = .25) for HbA1c (per 1% increment) and 0.92 (95% CI, 0.56-1.53; P = .76) for fasting C-peptide (per 2-fold increment). A significant association between fasting glucose (per 10 mg/dL-increment) and POAG was observed according to the MR IVW analysis (OR = 1.48 [95% CI, 1.10-1.79, P = .009]); however, sensitivity analyses, including MR-Egger and weighted-median methods, did not support this association (P > .10). CONCLUSIONS We did not observe strong evidence to support the association between genetically predicted glycemic traits and POAG in the Japanese population.
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Marshall H, Berry EC, Torres SD, Mullany S, Schmidt J, Thomson D, Nguyen TT, Knight LS, Hollitt G, Qassim A, Kolovos A, Ridge B, Schulz A, Lake S, Mills RA, Agar A, Galanopoulos A, Landers J, Healey PR, Graham SL, Hewitt AW, Casson RJ, MacGregor S, Siggs OM, Craig JE. Association Between Body Mass Index and Primary Open Angle Glaucoma in Three Cohorts. Am J Ophthalmol 2023; 245:126-133. [PMID: 35970205 DOI: 10.1016/j.ajo.2022.08.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/04/2022] [Accepted: 08/04/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE To evaluate the relationship between body mass index (BMI) and glaucoma progression. DESIGN Multicohort observational study. METHODS This study combined a retrospective longitudinal analysis of suspect and early manifest primary open angle glaucoma cases from the Progression Risk of Glaucoma: RElevant SNPs with Significant Association (PROGRESSA) study with 2 replication cohorts from the UK Biobank and the Canadian Longitudinal Study of Ageing (CLSA). In the PROGRESSA study, multivariate analysis correlated BMI with longitudinal visual field progression in 471 participants. The BMI was then associated with glaucoma diagnosis and cross-sectional vertical cup-disc ratio (VCDR) measurements in the UK Biobank, and finally prospectively associated with longitudinal change in VCDR in the CLSA study. RESULTS In the PROGRESSA study, a lower BMI conferred a faster rate of visual field progression (mean duration of monitoring (5.28 ± 1.80 years (10.6 ± 3.59 visits) (β 0.04 dB/year/SD95% CI [0.005, 0.069]; P = .013). In the UK Biobank, a 1 standard deviation lower BMI was associated with a worse cross-sectional VCDR (β -0.048/SD 95% CI [-0.056, 0.96]; P < .001) and a 10% greater likelihood of glaucoma diagnosis, as per specialist grading of retinal fundus imaging (OR 0.90 95% CI [0.84, 0.98]; P = .011). Similarly, a lower BMI was associated with a greater risk of glaucoma diagnosis as per International Classification of Disease data (OR 0.94/SD; 95% CI [0.91, 0.98]; P = .002). Body mass index was also positively correlated with intraocular pressure (β 0.11/SD; 95% CI [0.06, 0.15]; P < .001). Finally, a lower BMI was then associated with greater VCDR change in the CLSA (β -0.007/SD; 95% CI [-0.01, -0.001]; P = .023). CONCLUSIONS Body mass index correlated with longitudinal and cross-sectional glaucomatous outcomes. This supports previous work illustrating a correlation between BMI and glaucoma.
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Affiliation(s)
- Henry Marshall
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C).
| | - Ella C Berry
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | | | - Sean Mullany
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C); QIMR Berghofer Medical Research Institute, Herston, Australia (S.D.T, S.M)
| | - Joshua Schmidt
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Daniel Thomson
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Thi Thi Nguyen
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Lachlan Sw Knight
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Georgina Hollitt
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Ayub Qassim
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Antonia Kolovos
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Bronwyn Ridge
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Angela Schulz
- Faculty of Health and Medical Sciences, Macquarie University, Sydney, Australia (A.S, S.L.G)
| | - Stewart Lake
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Richard A Mills
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Ashish Agar
- Department of Ophthalmology, University of New South Wales, Sydney, Australia (A.A)
| | - Anna Galanopoulos
- Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, Australia (A.G, R.J.C)
| | - John Landers
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Paul R Healey
- Centre for Vision Research, University of Sydney, Sydney, Australia (P.R.H)
| | - Stuart L Graham
- Faculty of Health and Medical Sciences, Macquarie University, Sydney, Australia (A.S, S.L.G)
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia (A.W.H)
| | - Robert J Casson
- Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, Australia (A.G, R.J.C)
| | - Stuart MacGregor
- QIMR Berghofer Medical Research Institute, Herston, Australia (S.D.T, S.M)
| | - Owen M Siggs
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C); Garvan Institute of Medical Research, Sydney, Australia (O.M.S)
| | - Jamie E Craig
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
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16
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van der Heide FCT, Foreman YD, Franken IWM, Henry RMA, Kroon AA, Dagnelie PC, Eussen SJPM, Berendschot TTJM, Schouten JSAG, Webers CAB, Schram MT, van der Kallen CJH, van Greevenbroek MMJ, Wesselius A, Schalkwijk CG, Schaper NC, Brouwers MCGJ, Stehouwer CDA. (Pre)diabetes, glycemia, and daily glucose variability are associated with retinal nerve fiber layer thickness in The Maastricht Study. Sci Rep 2022; 12:17750. [PMID: 36273238 PMCID: PMC9587985 DOI: 10.1038/s41598-022-22748-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 10/19/2022] [Indexed: 01/13/2023] Open
Abstract
Retinopathy and neuropathy in type 2 diabetes are preceded by retinal nerve fibre layer (RNFL) thinning, an index of neurodegeneration. We investigated whether glucose metabolism status (GMS), measures of glycaemia, and daily glucose variability (GV) are associated with RNFL thickness over the entire range of glucose tolerance. We used cross-sectional data from The Maastricht Study (up to 5455 participants, 48.9% men, mean age 59.5 years and 22.7% with type 2 diabetes) to investigate the associations of GMS, measures of glycaemia (fasting plasma glucose [FPG], 2-h post-load glucose [2-h PG], HbA1c, advanced glycation endproducts [AGEs] assessed as skin autofluorescence [SAF]) and indices of daily GV (incremental glucose peak [IGP] and continuous glucose monitoring [CGM]-assessed standard deviation [SD]) with mean RNFL thickness. We used linear regression analyses and, for GMS, P for trend analyses. We adjusted associations for demographic, cardiovascular risk and lifestyle factors, and, only for measures of GV, for indices of mean glycaemia. After full adjustment, type 2 diabetes and prediabetes (versus normal glucose metabolism) were associated with lower RNFL thickness (standardized beta [95% CI], respectively - 0.16 [- 0.25; - 0.08]; - 0.05 [- 0.13; 0.03]; Ptrend = 0.001). Greater FPG, 2-h PG, HbA1c, SAF, IGP, but not CGM-assessed SD, were also associated with lower RNFL thickness (per SD, respectively - 0.05 [- 0.08; - 0.01]; - 0.06 [- 0.09; - 0.02]; - 0.05 [- 0.08; - 0.02]; - 0.04 [- 0.07; - 0.01]; - 0.06 [- 0.12; - 0.01]; and - 0.07 [- 0.21; 0.07]). In this population-based study, a more adverse GMS and, over the entire range of glucose tolerance, greater glycaemia and daily GV were associated with lower RNFL thickness. Hence, early identification of individuals with hyperglycaemia, early glucose-lowering treatment, and early monitoring of daily GV may contribute to the prevention of RNFL thinning, an index of neurodegeneration and precursor of retinopathy and neuropathy.
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Affiliation(s)
- Frank C. T. van der Heide
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands
| | - Yuri D. Foreman
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands
| | - Iris W. M. Franken
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands
| | - Ronald M. A. Henry
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Heart and Vascular Center, MUMC+ Maastricht, Maastricht, The Netherlands
| | - Abraham A. Kroon
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Heart and Vascular Center, MUMC+ Maastricht, Maastricht, The Netherlands
| | - Pieter C. Dagnelie
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands
| | - Simone J. P. M. Eussen
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.5012.60000 0001 0481 6099Department of Epidemiology, UM, Maastricht, The Netherlands
| | - Tos T. J. M. Berendschot
- grid.412966.e0000 0004 0480 1382University Eye Clinic Maastricht, MUMC+, Maastricht, The Netherlands
| | - Jan S. A. G. Schouten
- grid.412966.e0000 0004 0480 1382University Eye Clinic Maastricht, MUMC+, Maastricht, The Netherlands ,grid.413327.00000 0004 0444 9008Department of Ophthalmology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Carroll A. B. Webers
- grid.412966.e0000 0004 0480 1382University Eye Clinic Maastricht, MUMC+, Maastricht, The Netherlands
| | - Miranda T. Schram
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Heart and Vascular Center, MUMC+ Maastricht, Maastricht, The Netherlands
| | - Carla J. H. van der Kallen
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands
| | - Marleen M. J. van Greevenbroek
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands
| | - Anke Wesselius
- grid.5012.60000 0001 0481 6099Department of Complex Genetics and Epidemiology, NUTRIM School for Nutrition and Translational Research in Metabolism, UM, Maastricht, The Netherlands
| | - Casper G. Schalkwijk
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands
| | - Nicolaas C. Schaper
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.5012.60000 0001 0481 6099CAPHRI Care and Public Health Research Institute, UM, Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Division of Endocrinology and Metabolic Disease, Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Martijn C. G. J. Brouwers
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Division of Endocrinology and Metabolic Disease, Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Coen D. A. Stehouwer
- grid.5012.60000 0001 0481 6099CARIM School for Cardiovascular Diseases, Maastricht University (UM), Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands
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Pokora RM, Büttner M, Schulz A, Schuster AK, Merzenich H, Teifke A, Michal M, Lackner K, Münzel T, Zeissig SR, Wild PS, Singer S, Wollschläger D. Determinants of mammography screening participation-a cross-sectional analysis of the German population-based Gutenberg Health Study (GHS). PLoS One 2022; 17:e0275525. [PMID: 36197888 PMCID: PMC9534433 DOI: 10.1371/journal.pone.0275525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 09/18/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE We investigated the association between social inequality and participation in a mammography screening program (MSP). Since the German government offers mammography screening free of charge, any effect of social inequality on participation should be due to educational status and not due to the financial burden. METHODS The 'Gutenberg Health Study' is a cohort study in the Rhine-Main-region, Germany. A health check-up was performed, and questions about medical history, health behavior, including secondary prevention such as use of mammography, and social status are included. Two indicators of social inequality (equivalence income and educational status), an interaction term of these two, and different covariables were used to explore an association in different logistic regression models. RESULTS A total of 4,681 women meeting the inclusion criteria were included. Only 6.2% never participated in the MSP. A higher income was associated with higher chances of ever participating in a mammography screening (odds ratios (OR): 1.67 per €1000; 95%CI:1.26-2.25, model 3, adjusted for age, education and an interaction term of income and education). Compared to women with a low educational status, the odds ratios for ever participating in the MSP was lower for the intermediate educational status group (OR = 0.64, 95%CI:0.45-0.91) and for the high educational status group (0.53, 95%CI:0.37-0.76). Results persisted also after controlling for relevant confounders. CONCLUSIONS Despite the absence of financial barriers for participation in the MSP, socioeconomic inequalities still influence participation. It would be interesting to examine whether the educational effect is due to an informed decision.
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Affiliation(s)
- Roman M. Pokora
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany,* E-mail:
| | - Matthias Büttner
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Andreas Schulz
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K. Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Hiltrud Merzenich
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Andrea Teifke
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Matthias Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany,German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Karl Lackner
- Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sylke Ruth Zeissig
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany,Regional Centre Würzburg, Bavarian Cancer Registry, Bavarian Health and Food Safety Authority, Würzburg, Germany
| | - Philipp S. Wild
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany,German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany,Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Susanne Singer
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany,University Cancer Center Mainz, Mainz, Germany
| | - Daniel Wollschläger
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Stuart KV, Madjedi K, Luben RN, Chua SY, Warwick AN, Chia M, Pasquale LR, Wiggs JL, Kang JH, Hysi PG, Tran JH, Foster PJ, Khawaja AP. Alcohol, intraocular pressure and open-angle glaucoma: A systematic review and meta-analysis. Ophthalmology 2022; 129:637-652. [PMID: 35101531 PMCID: PMC9126073 DOI: 10.1016/j.ophtha.2022.01.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 01/11/2023] Open
Abstract
Topic This systematic review and meta-analysis summarizes the existing evidence for the association of alcohol use with intraocular pressure (IOP) and open-angle glaucoma (OAG). Clinical Relevance Understanding and quantifying these associations may aid clinical guidelines or treatment strategies and shed light on disease pathogenesis. The role of alcohol, a modifiable factor, in determining IOP and OAG risk also may be of interest from an individual or public health perspective. Methods The study protocol was preregistered in the Open Science Framework Registries (https://osf.io/z7yeg). Eligible articles (as of May 14, 2021) from 3 databases (PubMed, Embase, Scopus) were independently screened and quality assessed by 2 reviewers. All case-control, cross-sectional, and cohort studies reporting a quantitative effect estimate and 95% confidence interval (CI) for the association between alcohol use and either IOP or OAG were included. The evidence for the associations with both IOP and OAG was qualitatively summarized. Effect estimates for the association with OAG were pooled using random effects meta-analysis. Studies not meeting formal inclusion criteria for systematic review, but with pertinent results, were also appraised and discussed. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Results Thirty-four studies were included in the systematic review. Evidence from 10 studies reporting an association with IOP suggests that habitual alcohol use is associated with higher IOP and prevalence of ocular hypertension (IOP > 21 mmHg), although absolute effect sizes were small. Eleven of 26 studies, comprising 173 058 participants, that tested for an association with OAG met inclusion criteria for meta-analysis. Pooled effect estimates indicated a positive association between any use of alcohol and OAG (1.18; 95% confidence interval [CI], 1.02–1.36; P = 0.03; I2 = 40.5%), with similar estimates for both prevalent and incident OAG. The overall GRADE certainty of evidence was very low. Conclusions Although this meta-analysis suggests a harmful association between alcohol use and OAG, our results should be interpreted cautiously given the weakness and heterogeneity of the underlying evidence base, the small absolute effect size, and the borderline statistical significance. Nonetheless, these findings may be clinically relevant, and future research should focus on improving the quality of evidence.
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19
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The changes in retinal nerve fiber layer and macular thickness in Chinese patients with alcohol dependency. Drug Alcohol Depend 2021; 229:109130. [PMID: 34773776 DOI: 10.1016/j.drugalcdep.2021.109130] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/15/2021] [Accepted: 09/25/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES This study examined the changes in the retinal nerve fiber layer (RNFL) thickness and the macular thickness in Chinese patients with alcohol dependency and ascertaining the influence of optic cup volume on cognitive functioning. METHODS A total of 26 alcohol-dependent patients and 53 age- and gender-matched healthy controls were enrolled in the study. All subjects underwent Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) measurement and were scanned via spectral-domain optical coherence tomography (OCT). RESULTS Compared with the healthy controls, the alcohol-dependent patients returned lower scores across all subscales and total RBANS scores. The total thickness of the RNFL of the left eye, temporal and nasal RNFLthickness of both eyes were thinner in the alcohol-dependent patients (all p < 0.05). In terms of macular thickness, eight macular regions and the average thickness of the right eye and three of the left eye were thinner in the alcohol-dependent patients than in the healthy controls. The linear regression analysis indicated that a higher alcohol consumption was associated with thinner RNFL and macular thickness especially in temporal and inferior quadrant region after controlling for smoker status, age, BMI, cholesterol level and AKT level. CONCLUSIONS A higher alcohol consumption was significantly associated with thinner RNFL and macular thickness, indicating that alcohol is a potential risk factor affecting RNFL thickness and macular thickness. Meanwhile, the increase in optic cup volume was associated with the reduced cognitive functioning of the alcohol-dependent patients.
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20
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Majithia S, Tham YC, Chun Yuen CC, Yu M, Yim-Lui Cheung C, Bikbov MM, Kazakbaeva GM, Wang N, Hao J, Cao K, Wang YX, Sasaki M, Ito Y, Wong IY, Cheuk-Hung Chan J, Khanna R, Marmamula S, Nakano E, Mori Y, Aung T, Wong TY, Jonas JB, Miyake M, Cheng CY. Retinal Nerve Fiber Layer Thickness and Rim Area Profiles in Asians: Pooled Analysis from the Asian Eye Epidemiology Consortium. Ophthalmology 2021; 129:552-561. [PMID: 34856231 DOI: 10.1016/j.ophtha.2021.11.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To evaluate ethnic variations, ocular and systemic determinants of retinal nerve fibre layer (RNFL) thickness and neuroretinal rim area among Asians, using a large consortium of population-based eye studies. DESIGN Cross-sectional pooled-analysis. PARTICIPANTS 22436 participants (22436 eyes) from 10 population-based studies (China, Hong Kong, India, Japan, Russia and Singapore) of the Asian Eye Epidemiology Consortium. METHODS Participants aged ≥40 years without glaucoma were included. All participants underwent spectral domain optical coherence tomography (OCT) imaging, systemic and ocular examinations. Data were pooled from each study. Multivariable regression analysis was performed to evaluate inter-ethnic, inter-machine variations, ocular and systemic factors associated with RNFL thickness and rim area, adjusting for age, gender, diabetes, intraocular pressure (IOP), spherical equivalent (SE), ethnicity, OCT model, and study group. When evaluating body mass index, smoking, and hypertension as exposures, these factors were additionally adjusted in the model. MAIN OUTCOME MEASURE Average RNFL thickness (μm) and rim area (mm2) RESULTS: Indian and Japanese eyes showed thinner RNFL, compared to other Asian ethnicities (β values ranging 7.31-12.76μm, P<0.001 for all pair-wise comparisons). Compared to measurements by Cirrus HD-OCT, RNFL was on average 7.29μm thicker when measured by Spectralis, 12.85μm thicker by Nidek, and 17.48μm thicker by Optovue (all P<0.001). Additionally, older age (per decade, β=-2.70; 95% confidence interval [CI], -2.85 to -2.55), diabetes (β=-0.72; 95%CI, -1.20 to -0.24), ), higher IOP (per mmHg, β=-0.07; 95% CI, -0.10 to -0.04), more myopic SE (per dioptre, β=-1.13; 95% CI, -1.19 to -1.07), cardiovascular disease (CVD, β=-0.94; 95% CI, -1.49 to -0.40), and hypertension (β=-0.68; 95% CI, -1.04 to -0.32), were associated with thinner RNFL (all P≤0.003). Similarly, older age (β=-0.019; 95% CI, -0.028 to -0.009), higher IOP (β=-0.010; 95% CI, -0.013 to -0.008) and more myopic SE (β=-0.025; 95% CI, -0.029 to -0.021) were associated with smaller rim area (all P<0.001). CONCLUSIONS In this large pooled-analysis of multiple Asian population studies, Indian and Japanese eyes were observed to have thinner RNFL profiles. In addition to previously known determinants, hypertension and CVD were associated with thinner RNFL. These findings further suggest the need of ethnic-specific normative database to improve glaucoma detection.
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Affiliation(s)
- Shivani Majithia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Yih-Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | | | - Marco Yu
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Carol Yim-Lui Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | | | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing, China
| | - Jie Hao
- Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing, China
| | - Ya Xing Wang
- Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing, China
| | - Mariko Sasaki
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Yoshikazu Ito
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Ian Y Wong
- Department of Ophthalmology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; Department of Ophthalmology, The Hong Kong Sanatorium & Hospital, Hong Kong SAR, China
| | - Jonathan Cheuk-Hung Chan
- Department of Ophthalmology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Rohit Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India; Brien Holden Eye Research Centre, L.V. Prasad Eye Institute, Banjara Hills, Hyderabad, India; School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India; Brien Holden Eye Research Centre, L.V. Prasad Eye Institute, Banjara Hills, Hyderabad, India; School of Optometry and Vision Science, University of New South Wales, Sydney, Australia; Welcome Trust/Department of Biotechnology India Alliance Research Fellow, LV Prasad Eye Institute, Hyderabad, India
| | - Eri Nakano
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuki Mori
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Institute of Molecular and Clinical Ophthalmology Basel, Switzerland; Private Practice Professor Jonas and Dr. Panda-Jonas, Heidelberg, Germany
| | - Masahiro Miyake
- Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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21
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van der Heide FCT, Steens ILM, Geraets AFJ, Foreman YD, Henry RMA, Kroon AA, van der Kallen CJH, van Sloten TT, Dagnelie PC, van Dongen MCJM, Eussen SJPM, Berendschot TTJM, Schouten JSAG, Webers CAB, van Greevenbroek MMJ, Wesselius A, Koster A, Schaper NC, Schram MT, Köhler S, Stehouwer CDA. Association of Retinal Nerve Fiber Layer Thickness, an Index of Neurodegeneration, With Depressive Symptoms Over Time. JAMA Netw Open 2021; 4:e2134753. [PMID: 34783825 PMCID: PMC8596200 DOI: 10.1001/jamanetworkopen.2021.34753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
IMPORTANCE Whether neurodegeneration contributes to the early pathobiology of late-life depression remains incompletely understood. OBJECTIVE To investigate whether lower retinal nerve fiber layer (RNFL) thickness, a marker of neurodegeneration, is associated with the incidence of clinically relevant depressive symptoms and depressive symptoms over time. DESIGN, SETTING, AND PARTICIPANTS This is a population-based cohort study from the Netherlands (The Maastricht Study) with baseline examination between 2010 and 2020 and median (IQR) follow-up of 5.0 (3.0-6.0) years. Participants were recruited from the general population. Individuals with type 2 diabetes were oversampled by design. Data analysis was performed from September 2020 to January 2021. EXPOSURES RNFL, an index of neurodegeneration, assessed with optical coherence tomography. MAIN OUTCOMES AND MEASURES Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ)-9 (continuous score, 0-27) at baseline and over time via annual assessments. The presence of clinically relevant depressive symptoms was defined as a PHQ-9 score of 10 or higher. RESULTS We used data from 4934 participants with depressive symptoms over time (mean [SD] age, 59.7 [8.4] years; 2159 women [50.8%]; 870 had type 2 diabetes [20.5%]). Lower RNFL thickness was associated with higher incidence of clinically relevant depressive symptoms (per 1 SD, hazard ratio 1.11; 95% CI, 1.01-1.23) and more depressive symptoms over time (per 1 SD, rate ratio, 1.04; 95% CI, 1.01-1.06), after adjustment for demographic, cardiovascular, and lifestyle factors. CONCLUSIONS AND RELEVANCE The findings of this study suggest that lower RNFL thickness is associated with higher incidence of clinically relevant depressive symptoms and more depressive symptoms over time. Hence, neurodegeneration may be associated with the early pathobiology of late-life depression.
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Affiliation(s)
- Frank C. T. van der Heide
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Indra L. M. Steens
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Anouk F. J. Geraets
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center+, Maastricht, the Netherlands
- School of Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Yuri D. Foreman
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Ronald M. A. Henry
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Abraham A. Kroon
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Carla J. H. van der Kallen
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Thomas T. van Sloten
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Pieter C. Dagnelie
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Martien C. J. M. van Dongen
- Care and Public Health Research Institute, Maastricht University, the Netherlands
- Department of Epidemiology, Maastricht University, the Netherlands
| | - Simone J. P. M. Eussen
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Epidemiology, Maastricht University, the Netherlands
| | - Tos T. J. M. Berendschot
- University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Jan S. A. G. Schouten
- Department of Ophthalmology, Canisius-Wilhelmina Ziekenhuis Nijmegen, the Netherlands
| | - Carroll A. B. Webers
- University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Marleen M. J. van Greevenbroek
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Anke Wesselius
- Department of Complex Genetics and Epidemiology, School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Annemarie Koster
- Care and Public Health Research Institute, Maastricht University, the Netherlands
| | - Nicolaas C. Schaper
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
| | - Miranda T. Schram
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
- School of Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht, the Netherlands
- Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Seb Köhler
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center+, Maastricht, the Netherlands
- School of Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Coen D. A. Stehouwer
- Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, the Netherlands
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22
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Iwase A, Fujii M, Murata H, Ohno Y, Araie M. Effects of Physiologic Myopia and Aging on Visual Fields in Normal Eyes. Am J Ophthalmol 2021; 230:224-233. [PMID: 33965415 DOI: 10.1016/j.ajo.2021.04.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/22/2021] [Accepted: 04/24/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to investigate how mild-to-moderate myopia and aging affect visual field sensitivity (VF-S) in normal eyes, correcting for effects of each. DESIGN Combined cross-sectional and cohort study. METHODS Two normal groups, a cross-sectional group (n = 703; 1,051 eyes; mean age, 52.6 years) and a longitudinal group (n = 44; 83 eyes; mean age, 52.3 years; follow-up, 4.2 years; VF tests, 12) were included. In the cross-sectional group, the mean VF-S of the entire field and 3 disc portion-oriented subfields of the Humphrey Field Analyzer 24-2 program were correlated with subjects' age, axial length (AL), disc, rim and β-peripapillary area, and disc ovality and torsion, using linear mixed-regression models. Their time changes in the longitudinal group were correlated with time, subjects' ages, and AL using linear mixed-regression models. RESULTS In the cross-sectional group, the VF-S correlated negatively with age (-0.081 decibel [dB]/year; P < .001), which was more negative (P = .020) in the midperipheral than the central subfield, and with AL (P = .049) without intersubfield differences. In the longitudinal group, no changes in the ocular media were significant, and the VF-S declined by 0.074 dB/year (P = .007), which accelerated with higher age (P < .002) and baseline VF-S (P < .001) without intersubfield differences. The AL showed little effects on the VF-S longitudinal changes. CONCLUSIONS In normal eyes with mild-to-moderate myopia, the VF-S was lower subfield-independently with longer AL, whereas the AL had little effect on the aging-associated VF-S reduction. The VF-S decreased with aging with intersubfield differences. The aging-associated VF-S reduction accelerated with higher age, to which the ocular media changes were unrelated.
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23
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Non-drug interventions in glaucoma: Putative roles for lifestyle, diet and nutritional supplements. Surv Ophthalmol 2021; 67:675-696. [PMID: 34563531 DOI: 10.1016/j.survophthal.2021.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 09/15/2021] [Accepted: 09/20/2021] [Indexed: 02/06/2023]
Abstract
Glaucoma is a major ocular neurodegenerative disease characterized by progressive retinal ganglion cells degeneration and sight loss. Current treatment options have been limited to reducing intraocular pressure (IOP), known as the leading risk factor for this disease; however, glaucoma can develop even with low or normal IOP and progress despite controlling IOP values. Lifestyle, dietary habits, and supplementation may influence some of the risk factors and pathophysiological mechanisms underlying glaucoma development and progression; thus, the role of this complementary and alternative medicine in glaucoma has received great interest from both patients and ophthalmologists. We provide a summary of the current evidence concerning the relationship between lifestyle, dietary habits, and effects of supplements on the incidence and progression of glaucoma and their targets and associated mechanisms. The data suggest the existence of a therapeutic potential that needs to be further explored with both preclinical and rigorous clinical studies.
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24
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Rauscher FG, Wang M, Francke M, Wirkner K, Tönjes A, Engel C, Thiery J, Stenvinkel P, Stumvoll M, Loeffler M, Elze T, Ebert T. Renal function and lipid metabolism are major predictors of circumpapillary retinal nerve fiber layer thickness-the LIFE-Adult Study. BMC Med 2021; 19:202. [PMID: 34488766 PMCID: PMC8422631 DOI: 10.1186/s12916-021-02064-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 07/15/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Circumpapillary retinal nerve fiber layer thickness (cpRNFLT) as assessed by spectral domain optical coherence tomography (SD-OCT) is a new technique used for the detection and evaluation of glaucoma and other optic neuropathies. Before translating cpRNFLT into clinics, it is crucially important to investigate anthropometric, biochemical, and clinical parameters potentially affecting cpRNFLT in a large population-based dataset. METHODS The population-based LIFE-Adult Study randomly selected 10,000 participants from the population registry of Leipzig, Germany. All participants underwent standardized systemic assessment of various cardiometabolic risk markers and ocular imaging, including cpRNFLT measurement using SD-OCT (Spectralis, Heidelberg Engineering). After employing strict SD-OCT quality criteria, 8952 individuals were analyzed. Multivariable linear regression analyses were used to evaluate the independent associations of various cardiometabolic risk markers with sector-specific cpRNFLT. For significant markers, the relative strength of the observed associations was compared to each other to identify the most relevant factors influencing cpRNFLT. In all analyses, the false discovery rate method for multiple comparisons was applied. RESULTS In the entire cohort, female subjects had significantly thicker global and also sectoral cpRNFLT compared to male subjects (p < 0.05). Multivariable linear regression analyses revealed a significant and independent association between global and sectoral cpRNFLT with biomarkers of renal function and lipid profile. Thus, thinner cpRNFLT was associated with worse renal function as assessed by cystatin C and estimated glomerular filtration rate. Furthermore, an adverse lipid profile (i.e., low high-density lipoprotein (HDL) cholesterol, as well as high total, high non-HDL, high low-density lipoprotein cholesterol, and high apolipoprotein B) was independently and statistically significantly related to thicker cpRNFLT. In contrast, we do not observe a significant association between cpRNFLT and markers of inflammation, glucose homeostasis, liver function, blood pressure, or obesity in our sector-specific analysis and globally. CONCLUSIONS Markers of renal function and lipid metabolism are predictors of sectoral cpRNFLT in a large and deeply phenotyped population-based study independently of previously established covariates. Future studies on cpRNFLT should include these biomarkers and need to investigate whether incorporation will improve the diagnosis of early eye diseases based on cpRNFLT.
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Affiliation(s)
- Franziska G Rauscher
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
| | - Mengyu Wang
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
- Schepens Eye Research Institute, Harvard Medical School, Boston, MA, USA
| | - Mike Francke
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
| | - Kerstin Wirkner
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
| | - Anke Tönjes
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Christoph Engel
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
| | - Joachim Thiery
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University, Leipzig, Germany
| | - Peter Stenvinkel
- Department of Clinical Science, Intervention and Technology, Division of Renal Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Michael Stumvoll
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Markus Loeffler
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany
| | - Tobias Elze
- Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
- Schepens Eye Research Institute, Harvard Medical School, Boston, MA, USA
| | - Thomas Ebert
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany.
- Department of Clinical Science, Intervention and Technology, Division of Renal Medicine, Karolinska Institutet, Stockholm, Sweden.
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25
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Lee SSY, Mackey DA, Sanfilippo PG, Hewitt AW, Craig JE, Yazar S. In Utero Exposure to Smoking and Alcohol, and Passive Smoking during Childhood: Effect on the Retinal Nerve Fibre Layer in Young Adulthood. Ophthalmic Epidemiol 2021; 29:507-514. [PMID: 34486472 DOI: 10.1080/09286586.2021.1968005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE In utero exposure to cigarette smoke has been suggested to result in thinner retinal nerve fibre layer (RNFL). However, the potential cofounding effects of in utero alcohol exposure and passive smoking during childhood had not been considered. We explored RNFL thickness in young adults in relation to these early life factors. METHODS In 1989-1991, pregnant women completed questionnaires on their current smoking and alcohol drinking patterns. Following the birth of their offspring, information on household smokers was obtained between the 1- and 13-year follow-ups. At the 20-year follow-up, these offspring underwent an eye examination including optical coherence tomography imaging of the RNFL. RESULTS Participants (n = 1,287) were 19-22 years old at time of eye examination. Most participants (77%) had no in utero exposure to cigarette smoke; 1.3% were initially exposed but not after 18 weeks' gestation, while 21% had continual in utero smoking exposure. Half of the mothers never consumed alcohol or only consumed alcohol once during their pregnancies. After correcting for potential confounders, including in utero alcohel exposure and childhood passive smoking, participants who had continued in utero exposure to >10 cigarettes/day and ≤10 cigarettes/day had thinner RNFLs by 6.6 (95% confidence interval [CI] = 4.4-8.7) and 3.7 µm (95%[CI] = 2.3-5.5), respectively, than those with no exposure (p < .001). In utero alcohol exposure and childhood passive smoking were not significantly associated with RNFL thickness after accounting for in utero exposure to smoking. CONCLUSIONS In utero exposure to cigarette smoke is associated with thinner RFNL in young adulthood, independent of other early life environmental factors.
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Affiliation(s)
- Samantha Sze-Yee Lee
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), the University of Western Australia, Perth, Western Australia, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), the University of Western Australia, Perth, Western Australia, Australia.,School Of Medicine, Menzies Research Institute Tasmania, University Of Tasmania, Hobart, TAS, Australia.,Centre For Eye Research Australia, University Of Melbourne, Royal Victorian Eye And Ear Hospital, East Melbourne, VIC, Australia
| | - Paul G Sanfilippo
- Centre For Eye Research Australia, University Of Melbourne, Royal Victorian Eye And Ear Hospital, East Melbourne, VIC, Australia
| | - Alex W Hewitt
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), the University of Western Australia, Perth, Western Australia, Australia.,School Of Medicine, Menzies Research Institute Tasmania, University Of Tasmania, Hobart, TAS, Australia.,Centre For Eye Research Australia, University Of Melbourne, Royal Victorian Eye And Ear Hospital, East Melbourne, VIC, Australia
| | - Jamie E Craig
- Eye And Vision, Flinders Health And Medical Institute, Flinders University, Adelaide, South Australia, Australia
| | - Seyhan Yazar
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), the University of Western Australia, Perth, Western Australia, Australia.,Single Cell and Computational Genomics Laboratory, Garvan-Weizmann Centre For Cellular Genomics, Garvan Institute Of Medical Research, Sydney, NSW, Australia
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26
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Lee MW, Lim HB, Koo HM, Lee YH, Kim JY. Association of high myopia with peripapillary retinal nerve fiber layer in patients with hypertension. PLoS One 2021; 16:e0256131. [PMID: 34388218 PMCID: PMC8362946 DOI: 10.1371/journal.pone.0256131] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 07/29/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose To identify the impacts of hypertension (HTN), high myopia, and the combination thereof on peripapillary retinal nerve fiber layer (pRNFL) thickness. Methods All subjects were divided into four groups: control (group 1); patients with HTN without high myopia (group 2); patients with high myopia without HTN (group 3); and patients with both HTN and high myopia (group 4). The pRNFL thicknesses were compared using a one-way analysis of variance. Univariate and multivariate linear regression analyses were used to identify factors affecting pRNFL thickness in subjects with and without HTN. Results The mean pRNFL thicknesses were 93.9±8.8, 88.7±6.8, 86.4±8.1, and 82.5±9.6 μm in group 1, 2, 3, and 4, respectively, and differed significantly (P<0.001). On multivariate linear regression analyses, age (β = -0.181, P = 0.044), axial length (β = -1.491, P<0.001), and HTN (β = -4.876, P = 0.044) significantly affected pRNFL thickness. Additionally, age and axial length affected the pRNFL thickness in subjects with HTN (age, β = -0.254, P = 0.020; axial length, β = -1.608, P<0.001) much more than in subjects without HTN (age, β = -0.028, P = 0.712; axial length, β = -1.324, P<0.001). Conclusions High myopia and HTN affected pRNFL reduction and a combination of the 2 diseases exacerbated pRNFL damage. This could be a confounding factor in interpreting pRNFL thickness in patients with ophthalmic diseases affecting the pRNFL thickness when combined with the 2 diseases.
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Affiliation(s)
- Min-Woo Lee
- Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Hyung-Bin Lim
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Hyung-Moon Koo
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Young-Hoon Lee
- Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Jung-Yeul Kim
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
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In vivo corneal confocal microscopy and optical coherence tomography on eyes of participants with type 2 diabetes mellitus and obese participants without diabetes. Graefes Arch Clin Exp Ophthalmol 2021; 259:3339-3350. [PMID: 34283292 PMCID: PMC8523500 DOI: 10.1007/s00417-021-05251-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/07/2021] [Accepted: 05/19/2021] [Indexed: 11/09/2022] Open
Abstract
PURPOSES To examine corneal nerve and retinal nerve characteristics of participants with type 2 diabetes mellitus (T2DM) compared with obese participants without diabetes to discover potential nerve vulnerabilities. METHODS All participants underwent a complete medical examination including a physical examination and blood sample tests. The ophthalmologic examination included best-corrected visual acuity, intraocular pressure, Schirmer test, tear film breakup time, slit-lamp examination, dilated fundus photography, in vivo corneal confocal microscopy (IVCCM), and optical coherence tomography (OCT). RESULTS The study cohort consisted of 83 eyes of 83 individuals: a group of 44 participants with T2DM, and a control group of 39 obese participants with no history of diabetes. Comparing measurements on the two groups, participants with T2DM had lower values with statistical significance for retinal nerve fiber layer (RNFL) nasal superior thickness (p = 0.010) and three corneal nerve (CN) parameters: fiber length (p = 0.025), total branch density (p = 0.013), and fiber area (p = 0.009). There was a borderline significant difference in CN fiber width (p = 0.051) and RNFL nasal inferior thickness (p = 0.056). No other significant differences were observed in the IVCCM and OCT parameters. No statistically significant correlation was found between CN and RNFL parameters. CONCLUSIONS Progression from a pre-diabetic obese state to a T2DM condition might entail a loss or diminishment of certain corneal nerve fibers or retinal nerve fibers, but not necessarily a loss of both corneal and retinal nerve fibers simultaneously. Using IVCCM and OCT together enables monitoring of both corneal and retinal health of the eye.
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Retinal structural changes in mood disorders: The optical coherence tomography to better understand physiopathology? Prog Neuropsychopharmacol Biol Psychiatry 2021; 108:110080. [PMID: 32827610 DOI: 10.1016/j.pnpbp.2020.110080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Mood disorders are particularly common, disabling conditions. Diagnosis can be difficult as it may involve different pathophysiological assumptions. This could explain why such disorders are resistant to treatment. The retina is part of the central nervous system and shares a common embryonic origin with the brain. Optical coherence tomography (OCT) is an imaging technique for analysing the different layers of the retina. We reviewed studies that examined the retina with OCT in mood disorders. METHODS We conducted Pubmed search and additional manual research based on the bibliography in each of selected articles. We found and analysed 11 articles relevant to our subject. RESULTS This literature review confirms that it is possible to use OCT to detect neurodegeneration and neuroinflammation in mood disorders. Their impact is thought to depend on the duration and severity of the disease, and whether it is in acute or chronic stage. The differences seen in studies dealing with depression and those looking at bipolar disorder may reflect the particular characteristics of each disorder. A number of OCT parameters can be proposed as biomarkers of active or chronic inflammation and neurodegeneration. Markers of predisposition to an at-risk mental state are also suggested. LIMITATIONS The main limitation is selection bias, studies including more varied population would help to confirm and precise these results. CONCLUSION OCT is thus a particularly promising tool for evaluating some of the etiopathogenetic mechanisms involved in mood disorders. The combination with other approaches could help to find more specific biomarkers.
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Predicting sex from retinal fundus photographs using automated deep learning. Sci Rep 2021; 11:10286. [PMID: 33986429 PMCID: PMC8119673 DOI: 10.1038/s41598-021-89743-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 04/22/2021] [Indexed: 12/23/2022] Open
Abstract
Deep learning may transform health care, but model development has largely been dependent on availability of advanced technical expertise. Herein we present the development of a deep learning model by clinicians without coding, which predicts reported sex from retinal fundus photographs. A model was trained on 84,743 retinal fundus photos from the UK Biobank dataset. External validation was performed on 252 fundus photos from a tertiary ophthalmic referral center. For internal validation, the area under the receiver operating characteristic curve (AUROC) of the code free deep learning (CFDL) model was 0.93. Sensitivity, specificity, positive predictive value (PPV) and accuracy (ACC) were 88.8%, 83.6%, 87.3% and 86.5%, and for external validation were 83.9%, 72.2%, 78.2% and 78.6% respectively. Clinicians are currently unaware of distinct retinal feature variations between males and females, highlighting the importance of model explainability for this task. The model performed significantly worse when foveal pathology was present in the external validation dataset, ACC: 69.4%, compared to 85.4% in healthy eyes, suggesting the fovea is a salient region for model performance OR (95% CI): 0.36 (0.19, 0.70) p = 0.0022. Automated machine learning (AutoML) may enable clinician-driven automated discovery of novel insights and disease biomarkers.
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Paulsen AJ, Pinto A, Merten N, Chen Y, Fischer ME, Huang GH, Klein BEK, Schubert CR, Cruickshanks KJ. Factors Associated with the Macular Ganglion Cell-Inner Plexiform Layer Thickness in a Cohort of Middle-aged U.S. Adults. Optom Vis Sci 2021; 98:295-305. [PMID: 33771958 PMCID: PMC8007043 DOI: 10.1097/opx.0000000000001650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
SIGNIFICANCE The macular ganglion cell-inner plexiform layer (mGCIPL) may serve as a quick and easily obtained measure of generalized neurodegeneration. Investigating factors associated with this thickness could help to understand neurodegenerative processes. PURPOSE This study aimed to characterize and identify associated factors of the mGCIPL thickness in a Beaver Dam Offspring Study cohort of middle-aged U.S. adults. METHODS Baseline examinations occurred from 2005 to 2008, with follow-up examinations every 5 years. Included participants had baseline data and measured mGCIPL at 10-year follow-up (N = 1848). The mGCIPL was measured using the Cirrus 5000 HD-OCT Macular Cube Scan. Associations between mean mGCIPL thickness and thin mGCIPL, defined as 1 standard deviation (SD) below the population mean, and baseline risk factors were investigated using generalized estimating equations. RESULTS Participants (mean [SD] baseline age, 48.9 [9.3] years; 54.4% women) had mean (SD) mGCIPL thicknesses of 78.4 (8.1) μm in the right eye and 78.1 (8.5) μm in the left (correlation coefficient = 0.76). In multivariable models, age (-1.07 μm per 5 years; 95% confidence interval [CI], -1.28 to -0.86 μm), high alcohol consumption (-1.44 μm; 95% CI, -2.72 to -0.16 μm), higher interleukin 6 levels (50% increase in level: -0.23 μm; 95% CI, -0.45 to 0.00 μm), myopia (-2.55 μm; 95% CI, -3.17 to -1.94 μm), and glaucoma (-1.74 μm; 95% CI, -2.77 to -0.70 μm) were associated with thinner mGCIPL. Age (per 5 years: odds ratio [OR], 1.38; 95% CI, 1.24 to 1.53), diabetes (OR, 1.89, 95% CI, 1.09 to 3.27), myopia (OR, 2.11; 95% CI, 1.63 to 2.73), and increasing and long-term high C-reactive protein (ORs, 1.46 [95% CI, 1.01 to 2.11] and 1.74 [95% CI, 1.14 to 2.65], respectively) were associated with increased odds of thin mGCIPL. CONCLUSIONS Factors associated cross-sectionally with mGCIPL thickness, older age, high alcohol consumption, inflammation, diabetes, myopia, and glaucoma may be important to neural retina structure and health and neuronal health system-wide.
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Affiliation(s)
| | - Alex Pinto
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Natascha Merten
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Yanjun Chen
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Mary E Fischer
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | | | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Carla R Schubert
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
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Alcohol consumption is associated with glaucoma severity regardless of ALDH2 polymorphism. Sci Rep 2020; 10:17422. [PMID: 33060820 PMCID: PMC7566644 DOI: 10.1038/s41598-020-74470-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/28/2020] [Indexed: 12/20/2022] Open
Abstract
The present study investigated the effect of aldehyde dehydrogenase2 (ALDH2) rs671 polymorphism and alcohol consumption on the severity of primary open-angle glaucoma (POAG). The questionnaire for alcohol consumption pattern and targeted genotyping for ALDH2 rs671 polymorphism was performed from 445 Korean POAG patients. Retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) thicknesses were measured and compared according to alcohol consumption and ALDH2 rs671 genotype. Heavy drinking group eyes had thinner RNFL thickness than did abstinence group eyes (65.0 ± 10.9 vs. 70.9 ± 11.5 µm, P = 0.023). Both mild (65.8 ± 9.6 µm) and heavy (63.8 ± 8.4 µm) drinking group eyes had significantly thinner macular GCIPL thickness than did abstinence group eyes (68.1 ± 8.2 µm, P = 0.003). However, ALDH2 rs671 polymorphism did not show any significant association with RNFL or GCIPL thickness. Alcohol consumption was significantly associated with GCIPL thinning (β = –0.446, P = 0.035) after adjustment for multiple confounding factors. As excessive alcohol consumption was significantly associated with thinner GCIPL thickness while ALDH2 polymorphism had no significant effect on RNFL or GCIPL thickness, glaucoma patients should avoid excessive alcohol consumption regardless of ALDH2 polymorphism.
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Erdöl MA, Özbebek YE, Erbahçeci Timur IE, Ugurlu N, Bozkurt E. Effect of Transcatheter Aortic Valve Replacement on Retinal Layer Thickness Measured by Optical Coherence Tomography. Angiology 2020; 71:817-824. [PMID: 32672103 DOI: 10.1177/0003319720935294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Transcatheter aortic valve replacement (TAVR) is associated with clinically significant cerebral microembolism and cognitive status changes. There are no data on the impact of TAVR on retinal layers. We assessed the influence of TAVR on the retinal nerve fiber layer, ganglion cell complex (GCC), and macular thickness (MT) measured by spectral domain optical coherence tomography (SD-OCT). Elderly patients (n = 50) with severe aortic stenosis undergoing TAVR were included in this study (mean age: 78.5 ± 6.9 years). Retinal nerve fiber layer, GCC, and MT were measured with SD-OCT by an ophthalmologist before and on the first day and in the first month after TAVR. The average MT was significantly increased on the first day after TAVR compared with the basal value (P = .04). Ganglion cell complex thickness was significantly thinner on the first day after TAVR than the basal value in the inner inferior quadrant and outer temporal quadrant of the left eye (P = .03 and .04, respectively). Postoperative changes observed on the first day compared with the preoperative period returned to basal values in the first month. In conclusion, TAVR did not cause permanent changes in retinal layers.
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Affiliation(s)
| | | | | | - Nagihan Ugurlu
- Department of Ophtalmology, 442146Yildirim Beyazit University, Ankara, Turkey
| | - Engin Bozkurt
- Department of Cardiology, 442146Yildirim Beyazit University, Ankara, Turkey
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Fieß A, Nickels S, Urschitz MS, Münzel T, Wild PS, Beutel ME, Lackner KJ, Hoffmann EM, Pfeiffer N, Schuster AK. Association of Birth Weight with Peripapillary Retinal Nerve Fiber Layer Thickness in Adulthood—Results from a Population-Based Study. ACTA ACUST UNITED AC 2020; 61:4. [PMID: 35917383 PMCID: PMC7425698 DOI: 10.1167/iovs.61.8.4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Purpose Low birth weight is associated with altered retinal development in childhood, including reduced peripapillary retinal nerve fiber layer (pRNFL) thickness. However, to the best of our knowledge, no population-based study has analyzed the relationship of low birth weight to pRNFL thickness in adulthood. The purpose of this study was to investigate whether birth weight has a long-term effect on pRNFL thickness in adulthood. Methods In the German population-based Gutenberg Health Study (GHS), participants were examined with spectral-domain optical coherence tomography using a peripapillary scan and automated measurement of pRNFL thickness as a global parameter and in six sectors. The association between self-reported birth weight and the different pRNFL sectors were analyzed with multivariable linear regression, adjusted for potential confounders including sex, age, axial length, self-reported age-related macular degeneration, and glaucoma. Results In 3,028 participants, self-reported birth weight was documented and pRNFL measurements were successfully performed (1632 females, ages 54.9 ± 10.0 years). After adjustment for several confounders in the multivariable model, a positive association was observed between birth weight and pRNFL thickness in the global sector (β = 0.13 µm/100 g; 95% CI, 0.08–0.18; P < 0.001; R2 = 0.007) and especially in the inferotemporal sector (β = 0.22 µm/100 g; 95% CI, 0.15–0.29; P < 0.001; R2 = 0.008) and inferonasal sector (β = 0.28 µm/100 g; 95% CI, 0.17–0.39; P < 0.001; R2 = 0.005). Conclusions Our data show that there is a weak relationship between birth weight and pRNFL thickness in adulthood. This weak association is particularly present in the inferior part of the optic nerve head. Therefore, low birth weight may have an impact on optic nerve head development and potentially on ocular disease development.
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Affiliation(s)
- Achim Fieß
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stefan Nickels
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael S. Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Thomas Münzel
- Center for Cardiology–Cardiology I, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Philipp S. Wild
- Preventive Cardiology and Preventive Medicine/Center for Cardiology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Karl J. Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Esther M. Hoffmann
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K. Schuster
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
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Altered Macular Vasculature in Migraine Patients without Aura: Is It Associated with Ocular Vasculature and White Matter Hyperintensities? J Ophthalmol 2020; 2020:3412490. [PMID: 32351718 PMCID: PMC7174908 DOI: 10.1155/2020/3412490] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/30/2020] [Indexed: 11/17/2022] Open
Abstract
Aim We aimed to determine the alterations in macular and optic nerve vasculature in patients with migraine without aura using optical coherence tomography-angiography (OCTA). We also aimed to determine whether there were clinical differences and alterations in ocular structures in migraine cases with white matter hyperintensities (WMH) using magnetic resonance imaging (MRI). Materials and Methods. The study group comprised patients with migraine without aura and age- and sex-matched healthy controls. Detailed histories of the patients with migraine were recorded including the disease duration, number of attacks in the last month, and attack durations. Visual evoked potentials (VEP) were recorded in all migraine patients. The migraine disability assessment (MIDAS) questionnaire was administered to all patients. The patients were divided into two groups as migraine with WMHs and migraine without WMHs. All subjects underwent a complete neurological and ophthalmological examination. Only the right eyes of the patients were included in the study. Retinal imaging was performed using OCT and OCTA. Results A total of 66 migraine patients (29 with WMH and 37 without WMH) and 43 healthy controls were included in this study. Among the migraine patients, disease duration, attack frequency in the last month, attack durations, and the visual analogue scale (VAS), MIDAS, and VEP scores were all similar between those with and without WMHs. There was no significant difference between the groups regarding the ganglion cell complex, foveal, and retinal nerve fiber layer thicknesses. The superficial or deep vascular perfusion densities of the optic disc were also similar between the groups. The foveal avascular zone (FAZ) was significantly larger (P=0.034), and both superficial and deep macular vascular densities were significantly lower in the migraine groups compared with the healthy controls (P=0.001). There was no significant difference concerning the FAZ size or vascular densities between the migraine groups with and without WMHs. In the correlation analysis performed between the migraine patients, the FAZ size was correlated with age and VAS and MIDAS scores while both superficial and deep macular vascular densities were negatively correlated with age and VAS and MIDAS scores. Conclusion We suggest that for not only migraine with aura but also migraine without aura, neurovascular structures play an important role in pathogenesis, and novel studies are warranted to elucidate the alterations in these and determine the significance of WMHs in these patient groups.
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Retinal neurodegeneration in patients with end-stage renal disease assessed by spectral-domain optical coherence tomography. Sci Rep 2020; 10:5255. [PMID: 32210247 PMCID: PMC7093533 DOI: 10.1038/s41598-020-61308-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 02/04/2020] [Indexed: 11/08/2022] Open
Abstract
Spectral-domain optical coherence tomography (SD-OCT) represents a reliable tool for retinal layer volume and thickness measurement. The aim of this study was to evaluate retinal changes indicating neurodegenerative processes in patients with end-stage renal disease (ESRD) compared to healthy controls. This was a cross-sectional, single-center study comprising 32 ESRD patients and 38 controls. Sectoral retinal nerve fiber layer (RNFL) thickness and retinal layer volumes were obtained by SD-OCT. Age- and gender-adjusted retinal layer volumes such as total retinal volume (p = 0.037), ganglion cell layer volume (GCL, p = 0.003), ganglion cell layer - inner plexiform layer volume (GCL-IPL, p = 0.005) and inner retinal layer volume (IRL, p = 0.042) of the right eye were lower in ESRD patients. Inner plexiform layer volume of both eyes (IPL, right eye: p = 0.017; left eye: 0.044) was reduced, as was RNFL thickness in the temporal superior sector (right eye: p = 0.016). A subgroup analysis excluding patients with diabetes revealed that GCL (p = 0.014) and GCL-IPL volume of the right eye (p = 0.024) and temporal superior sector of the RNFL scan (p = 0.021) in ESRD patients were still significantly thinner. We observed a decrease in several retinal layer volumes and temporal RNFL thickness indicative of retinal neurodegenerative processes in patients with ESRD.
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Lee MW, Lee WH, Park GS, Lim HB, Kim JY. Longitudinal Changes in the Peripapillary Retinal Nerve Fiber Layer Thickness in Hypertension: 4-Year Prospective Observational Study. Invest Ophthalmol Vis Sci 2020; 60:3914-3919. [PMID: 31546252 DOI: 10.1167/iovs.19-27652] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine longitudinal changes in the peripapillary retinal nerve fiber layer (pRNFL) thickness in patients with hypertension (HTN). Methods Participants without any ophthalmic disease were divided into two groups: an HTN group (50 eyes) that included patients with HTN for ≥5 years and a control group. After the initial visit, pRNFL thicknesses were measured four more times at 1-year intervals using spectral-domain optical coherence tomography. The pRNFL thickness was fitted using linear mixed models. Univariate and multivariate generalized linear mixed models were used to determine factors associated with pRNFL reductions over time. Results The mean ages of the HTN and control groups were 62.9 ± 6.2 and 60.7 ± 6.1 years, respectively, and they were not significantly different (P = 0.089). The baseline mean pRNFL thicknesses were 90.50 ± 8.31 and 93.90 ± 8.77 μm; they were significantly different (P = 0.049). The mean pRNFL reduction rate was -0.99 and -0.40 μm/y in the HTN and control groups, respectively; the interaction between group and duration was significant (P < 0.001). In the linear mixed model determination of factors associated with pRNFL reduction, there was no significant factor in the control group. In the HTN group, age, and axial length showed significant results in both univariate and multivariate analyses (estimate: -0.362 and -2.618; P = 0.042 and 0.026, respectively). Conclusions Patients with HTN had a significantly greater decrease in pRNFL than normal individuals. Additionally, age and axial length significantly affected the reduction in pRNFL in HTN patients.
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Affiliation(s)
- Min-Woo Lee
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea.,Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Woo-Hyuk Lee
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Gi-Seok Park
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Hyung-Bin Lim
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Jung-Yeul Kim
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
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Chang R, Nelson AJ, LeTran V, Vu B, Burkemper B, Chu Z, Fard A, Kashani AH, Xu BY, Wang RK, Varma R, Richter GM. Systemic Determinants of Peripapillary Vessel Density in Healthy African Americans: The African American Eye Disease Study. Am J Ophthalmol 2019; 207:240-247. [PMID: 31229463 DOI: 10.1016/j.ajo.2019.06.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 06/11/2019] [Accepted: 06/12/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE To determine the relationship between systemic factors and radial peripapillary capillary (RPC) vessel density (VD) in healthy African American (AA) participants of the African American Eye Disease Study. DESIGN A population-based, cross-sectional study. METHODS A total of 4135 eyes from 2127 AA participants aged 40 years and older in Inglewood, California, were imaged for 6×6-mm optic disc scans on a spectral-domain optical coherence tomography angiography (OCTA) device. Of these, 1029 eyes from 1029 participants who met the inclusion and exclusion criteria were analyzed, including only 1 eye per participant. Custom software was used to quantify RPC VD. Multivariate linear regression was used to identify systemic factors associated with RPC VD with a significance level set at 0.05. The contribution of each variable to the final model was estimated with the magnitude of standardized regression coefficients (SRCs). The fit of the final model was measured by R2. RESULTS The average RPC VD was 0.346±0.045. Controlling for signal strength, the systemic variables in the final multivariate model associated with reduced RPC VD were older age (β = -0.0123 per decade; SRC = -0.2733; P < .0001), male sex (β = -0.0067; SRC = -0.0716; P = .0060), and longer diabetes duration (β = -0.0022 per 5 years; SRC = -0.0527; P = .0427). The model R2 was 0.3689. CONCLUSIONS Age, sex, and systemic influences, such as diabetes duration, need to be considered when assessing changes in RPC VD in glaucoma and other ocular diseases. Longitudinal studies are needed to investigate whether reduced RPC VD and the factors that affect it are associated with an increased risk of developing glaucomatous nerve damage.
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Affiliation(s)
- Ryuna Chang
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, California, USA
| | - Andrew J Nelson
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, California, USA
| | - Vivian LeTran
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, California, USA
| | - Brian Vu
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, California, USA
| | - Bruce Burkemper
- Southern California Eyecare and Vision Research Institute, Los Angeles, California, USA
| | - Zhongdi Chu
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
| | - Ali Fard
- Carl Zeiss Meditec, Inc, Dublin, California, USA
| | - Amir H Kashani
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, California, USA
| | - Benjamin Y Xu
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, California, USA
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
| | - Rohit Varma
- Southern California Eyecare and Vision Research Institute, Los Angeles, California, USA
| | - Grace M Richter
- USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, California, USA.
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OCT and IOP findings in a healthy worker cohort: results from a teleophthalmic study in occupational medicine. Graefes Arch Clin Exp Ophthalmol 2019; 257:2571-2578. [DOI: 10.1007/s00417-019-04457-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 08/26/2019] [Accepted: 08/28/2019] [Indexed: 10/26/2022] Open
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Fujiwara K, Yasuda M, Hata J, Hirakawa Y, Hashimoto S, Ueda E, Iwase A, Araie M, Yoshitomi T, Ninomiya T, Sonoda KH. Glucose Tolerance Levels and Circumpapillary Retinal Nerve Fiber Layer Thickness in a General Japanese Population: The Hisayama Study. Am J Ophthalmol 2019; 205:140-146. [PMID: 30959002 DOI: 10.1016/j.ajo.2019.03.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 03/29/2019] [Accepted: 03/30/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE To investigate the relationship between glucose tolerance levels and the circumpapillary retinal nerve fiber layer thickness (cpRNFLT) in a general Japanese population. DESIGN Population-based, cross-sectional study. METHODS In 2012 and 2013, a total of 2809 Japanese community dwellers aged 40-79 years in the Hisayama Study underwent eye examinations including cpRNFLT measurement with spectral domain optical coherence tomography. Of these, 1324 subjects (578 men and 746 women) were enrolled. Glucose tolerance levels were determined by a 75-g oral glucose tolerance test. We conducted an analysis of covariance to estimate the mean values of cpRNFLT according to the subjects' glucose intolerance status. RESULTS The subjects with prediabetes or with diabetes mellitus had significantly lower age- and sex-adjusted mean cpRNFLT values than those with normal glucose tolerance (P = .04 and P = .0004, respectively). The age- and sex-adjusted mean values of cpRNFLT decreased significantly with elevating fasting plasma glucose and 2-hour postload glucose levels (all P for trend < .05). These associations were substantially unchanged after adjustment for potential confounding factors. The coexistence of poorer glucose tolerance and higher intraocular pressure levels was additively associated with thinner cpRNFLT. CONCLUSIONS Our analyses revealed that poorer glucose tolerance was significantly associated with the reduction of cpRNFLT in a Japanese general population, suggesting that the loss of neural tissue in the eye begins at the prediabetic stage, and that hyperglycemia may play a role in the reduction of cpRNFLT.
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Affiliation(s)
- Kohta Fujiwara
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Miho Yasuda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoichiro Hirakawa
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Sawako Hashimoto
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Emi Ueda
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Makoto Araie
- Kanto Central Hospital of The Mutual Aid Association of Public School Teachers, Tokyo, Japan
| | - Takeshi Yoshitomi
- Department of Ophthalmology, Graduate School of Medical Sciences, Akita University, Akita, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koh-Hei Sonoda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Khawaja AP, Chua S, Hysi PG, Georgoulas S, Currant H, Fitzgerald TW, Birney E, Ko F, Yang Q, Reisman C, Garway-Heath DF, Hammond CJ, Khaw PT, Foster PJ, Patel PJ, Strouthidis N. Comparison of Associations with Different Macular Inner Retinal Thickness Parameters in a Large Cohort: The UK Biobank. Ophthalmology 2019; 127:62-71. [PMID: 31585827 DOI: 10.1016/j.ophtha.2019.08.015] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 08/07/2019] [Accepted: 08/13/2019] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To describe and compare associations with macular retinal nerve fiber layer (mRNFL), ganglion cell complex (GCC), and ganglion cell-inner plexiform layer (GCIPL) thicknesses in a large cohort. DESIGN Cross-sectional study. PARTICIPANTS We included 42 044 participants in the UK Biobank. The mean age was 56 years. METHODS Spectral-domain OCT macular images were segmented and analyzed. Corneal-compensated intraocular pressure (IOPcc) was measured with the Ocular Response Analyzer (Reichert, Corp., Buffalo, NY). Multivariable linear regression was used to examine associations with mean mRNFL, GCC, and GCIPL thicknesses. Factors examined were age, sex, ethnicity, height, body mass index (BMI), smoking status, alcohol intake, Townsend deprivation index, education level, diabetes status, spherical equivalent, and IOPcc. MAIN OUTCOME MEASURES Thicknesses of mRNFL, GCC, and GCIPL. RESULTS We identified several novel independent associations with thinner inner retinal thickness. Thinner inner retina was associated with alcohol intake (most significant for GCIPL: -0.46 μm for daily or almost daily intake compared with special occasion only or never [95% confidence interval (CI), 0.61-0.30]; P = 1.1×10-8), greater social deprivation (most significant for GCIPL: -0.28 μm for most deprived quartile compared with least deprived quartile [95% CI, -0.42 to -0.14]; P = 6.6×10-5), lower educational attainment (most significant for mRNFL: -0.36 μm for less than O level compared with degree level [95% CI, -0.45 to 0.26]; P = 2.3×10-14), and nonwhite ethnicity (most significant for mRNFL comparing blacks with whites: -1.65 μm [95% CI, -1.86 to -1.43]; P = 2.4×10-50). Corneal-compensated intraocular pressure was associated most significantly with GCIPL (-0.04 μm/mmHg [95% CI, -0.05 to -0.03]; P = 4.0×10-10) and was not associated significantly with mRNFL (0.00 μm/mmHg [95% CI, -0.01 to 0.01]; P = 0.77). The variables examined explained a greater proportion of the variance of GCIPL (11%) than GCC (6%) or mRNFL (7%). CONCLUSIONS The novel associations we identified may be important to consider when using inner retinal parameters as a diagnostic tool. Associations generally were strongest with GCIPL, particularly for IOP. This suggests that GCIPL may be the superior inner retinal biomarker for macular pathophysiologic processes and especially for glaucoma.
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Affiliation(s)
- Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom.
| | - Sharon Chua
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Pirro G Hysi
- Department of Ophthalmology, King's College London, St. Thomas' Hospital, London, United Kingdom; Department of Twin Research & Genetic Epidemiology, King's College London, St. Thomas' Hospital, London, United Kingdom
| | - Stelios Georgoulas
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Hannah Currant
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton, Cambridge, United Kingdom
| | - Tomas W Fitzgerald
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton, Cambridge, United Kingdom
| | - Ewan Birney
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton, Cambridge, United Kingdom
| | - Fang Ko
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Qi Yang
- Topcon Advanced Biomedical Imaging Laboratory, Oakland, New Jersey
| | - Charles Reisman
- Topcon Advanced Biomedical Imaging Laboratory, Oakland, New Jersey
| | - David F Garway-Heath
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Chris J Hammond
- Department of Ophthalmology, King's College London, St. Thomas' Hospital, London, United Kingdom
| | - Peng T Khaw
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Paul J Foster
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Praveen J Patel
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Nicholas Strouthidis
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom; Discipline of Clinical Ophthalmology and Eye Health, University of Sydney Medical School, Sydney, Australia
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Ophthalmologic evaluation of severely obese patients undergoing bariatric surgery: A pilot, monocentric, prospective, open-label study. PLoS One 2019; 14:e0216351. [PMID: 31095581 PMCID: PMC6522100 DOI: 10.1371/journal.pone.0216351] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 04/18/2019] [Indexed: 12/22/2022] Open
Abstract
Purpose The aim of this study was to investigate the pathogenic role of obesity on blinding eye diseases in a population of severely obese patients with no history of eye diseases, and to verify whether weight loss induced by bariatric surgery may have a protective effect. Methods This was a pilot, monocentric, prospective, and open label study conducted at the University Hospital of Pisa. Fifty-seven severely obese patients with a mean body mass index value of 44.1 ± 6 kg/m2 were consecutively recruited and received a complete ophthalmological evaluation and optical coherence tomography. Twenty-nine patients who underwent gastric bypass were evaluated also 3 months, and 1 year after surgery. Results At baseline, blood pressure value were directly and significantly related to intraocular pressure values (p<0.05, R = 0.35). Blood pressure values were also significantly and inversely related to retinal nerve fiber layer thickness, particularly in the temporal sector (RE p<0.05 r-0.30; LE p<0.01, R = -0.43). Moreover, minimum foveal thickness values were significantly and inversely associated with body mass index (RE p<0.02, R = -0.40; LE p<0.02, R = -0.30). A significant reduction of body mass index (p<0.05) and a significant (p<0.05) improvement of blood pressure was observed three months and one year after gastric bypass, which were significantly associated with an increase in retinal nerve fiber layer thickness and minimum foveal thickness values in both eyes (p<0.05). Conclusions The results of this study suggest that obese patients may have a greater susceptibility to develop glaucomatous optic nerve head damage and age-related macular degeneration. Moreover, weight reduction and improvement of comorbidities obtained by bariatric surgery may be effective in preventing eye disease development by improving retinal nerve fiber layer and foveal thickness.
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Abstract
PURPOSE OF REVIEW Although reducing the intraocular pressure (IOP) through medications, laser or surgery remains the primary means of glaucoma treatment, there is increasing evidence during the last decade that environmentally modifiable factors may help to prevent glaucoma or its progression through different mechanisms that may or may not involve lowering IOP. Additionally, patients are increasingly interested in maintaining a healthy lifestyle and taking an active role in the management of their disease. Therefore, the aim of this review is to summarize the current evidence regarding environmentally modifiable factors such as lifestyle, exercise, and nutrition in the pathogenesis of glaucoma. RECENT FINDINGS In the last decade, large population-based studies have helped to identify possible environmentally modifiable protective and risk factors with regard to glaucomatous disease. Smoking cessation; moderate aerobic exercise; recommended weight; and a balanced diet including green leafy vegetables, omega fatty-acids, and moderate intake of hot tea and coffee have been reported to be possibly protective against developing glaucoma or its progression. SUMMARY Modifiable environmental factors such as lifestyle, exercise, and nutrition may play a role in glaucoma pathogenesis. Large prospective studies with long-term follow-up should be encouraged to corroborate these findings, which may guide future treatments for our patients, some of which may not be limited to IOP reduction.
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Jung SH, Jeon S, Park CK, Park HYL. Associations between Retinal Nerve Fiber Layer Defect and Systemic Indices According to the KNHNES 2010–2012. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.11.1089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Suk Hoon Jung
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sooji Jeon
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chan Kee Park
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hae-Young Lopilly Park
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Ho H, Tham YC, Chee ML, Shi Y, Tan NYQ, Wong KH, Majithia S, Cheung CY, Aung T, Wong TY, Cheng CY. Retinal Nerve Fiber Layer Thickness in a Multiethnic Normal Asian Population: The Singapore Epidemiology of Eye Diseases Study. Ophthalmology 2018; 126:702-711. [PMID: 30529130 DOI: 10.1016/j.ophtha.2018.11.031] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 11/26/2018] [Accepted: 11/27/2018] [Indexed: 12/17/2022] Open
Abstract
PURPOSE To describe variations in retinal nerve fiber layer (RNFL) thickness based on spectral-domain (SD) OCT in a multiethnic Asian population. DESIGN Population-based, cross-sectional study. PARTICIPANTS Ethnic Chinese, Malay, and Indian adults older than 48 years without glaucoma who were recruited from the Singapore Epidemiology of Eye Diseases Study. METHODS All participants underwent standardized systemic and ocular examinations. Retinal nerve fiber layer thickness was measured using SD OCT. Participants with poor-quality scans were excluded. Linear regression models were used to investigate the associations of ocular and systemic factors with average RNFL thickness. Generalized estimating equation models were used to account for correlation between both eyes. MAIN OUTCOME MEASURE Average RNFL thickness. RESULTS Four thousand four hundred seventy-five participants (8178 eyes) consisting of 1371 Chinese, 1303 Malay, and 1801 Indian adults contributed to this analysis. Average RNFL thickness measured was 95.7±9.6 μm in Chinese participants, 94.9±10.6 μm in Malay participants, and 87.3±10.6 μm in Indian participants (P < 0.001). Multivariate analysis adjusted for age, gender, and ethnicity revealed a reduction in RNFL thickness with increased intraocular pressure and axial length (P < 0.001 for both), as well as a diagnosis of diabetes (P = 0.04); greater RNFL thickness was associated with increased disc area (P < 0.001), signal strength (P < 0.001), and low-density lipoprotein cholesterol (P = 0.02). When these significant variables were taken into account, the average RNFL thickness of Indian participants was significantly thinner compared with Chinese participants (7.45 μm thinner on average [95% confidence interval, 6.75-8.15 μm; P < 0.001]), whereas there was no significant difference in average RNFL thickness between Malay and Chinese participants (P = 0.15). CONCLUSIONS Average and regional RNFL thicknesses were significantly thinner in Indian eyes compared with Chinese and Malay eyes. Results of the study highlight the need to acquire more refined normative data for the comparison of individual patients with others of similar ethnic background while accounting for ocular factors that could influence RNFL thickness. This in turn may improve the sensitivity and specificity of glaucoma detection.
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Affiliation(s)
- Henrietta Ho
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore; Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom
| | - Yih-Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore
| | - Miao Li Chee
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore
| | - Yuan Shi
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore
| | - Nicholas Y Q Tan
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore
| | - Kah-Hie Wong
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore; Department of Ophthalmology, National University Hospital, Singapore, Republic of Singapore
| | - Shivani Majithia
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore; Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Carol Y Cheung
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore; Department of Ophthalmology and Visual Science, The Chinese University of Hong Kong, Hong Kong, China; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore; Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore, Republic of Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore; Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore, Republic of Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore; Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore, Republic of Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore.
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