Association of ocular, cardiovascular, morphometric and lifestyle parameters with retinal nerve fibre layer thickness

• Published in: PloS one Vol. 13; no. 5; p. e0197682
• Main Authors: Lamparter, Julia, Schmidtmann, Irene, Schuster, Alexander K, Siouli, Angeliki, Wasielica-Poslednik, Joanna, Mirshahi, Alireza, Höhn, René, Unterrainer, Josef, Wild, Philipp S, Binder, Harald, Lackner, Karl, Beutel, Manfred E, Münzel, Thomas, Pfeiffer, Norbert, Hoffmann, Esther M
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 22.05.2018; Public Library of Science (PLoS)
• Subjects: Age; Alcohol; Alcohol use; Alcoholic beverages; Alcohols; Alzheimer's disease; Alzheimers disease; Apnea; Biology and Life Sciences; Biometrics; Blood; Blood pressure; Body length; Body mass; Body weight; Cardiology; Cholesterol; Cognitive ability; Cornea; Coronary artery; Coronary artery disease; Correlation; Correlation analysis; Correlation coefficient; Correlation coefficients; Diabetes mellitus; Diabetic retinopathy; Dietary fiber; Disease susceptibility; Epidemiology; Equivalence; Evaluation; Eye (anatomy); Glaucoma; Headache; Health status indicators; Heart diseases; Homocysteine; Hypertension; Infarction; Informatics; Intraocular pressure; Laboratories; Lifestyles; Medical examination; Medical research; Medicine and Health Sciences; Migraine; Myocardial infarction; Nicotine; Ophthalmology; Optic nerve; Optical Coherence Tomography; Optics; Parameters; Preventive medicine; Regression analysis; Regression models; Research and Analysis Methods; Retina; Sex; Sleep disorders; Subgroups; Surgery; Thickness; Tinnitus; Vascular diseases; Germany
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0197682

Glaucoma is a neurodegenerative disease, leading to thinning of the retinal nerve fibre layer (RNFL). The exact influence of ocular, cardiovascular, morphometric, lifestyle and cognitive factors on RNFL thickness (RNFLT) is unknown and was analysed in a subgroup of the Gutenberg Health Study (GHS). Global peripapillary RNFLT was measured in 3224 eyes of 1973 subjects (49% female) using spectral-domain optical coherence tomography (SD-OCT). The association of age, sex, ocular, cardiovascular, morphometric, lifestyle and cognitive factors on RNFLT was analysed using Pearson correlation coefficient and fitting a linear mixed model. In the univariable analysis highest correlations were found for axial length (r = -0.27), spherical equivalent (r = 0.24), and glaucoma (r = -0.15) (p<0.0001, respectively). Other significant correlations with RNFLT were found for age, sex, intraocular pressure, systemic hypertension and systolic blood pressure, previous eye surgery, cholesterol, homocysteine, history of coronary artery disease, history of myocardial infarction, apnoea, diabetes and alcohol intake, p<0.05, respectively. Body length, body weight, BMI, diastolic blood pressure, blood glucose, HbA1c, history of apoplexy, cognitive function, peripheral artery disease, tinnitus, migraine, nicotine intake, central corneal thickness, and pseudophakia were not significantly correlated with RNFLT. The regression model revealed a significant relationship between RNFLT and age in decades (p<0.02), spherical equivalent (p<0.0001), axial length (p<0.0001), glaucoma (p<0.0001), tinnitus (p = 0.04), apnoea (p = 0.047), homocysteine (p = 0.05) and alcohol intake >10g/d for women and >20g/d for men (p = 0.02). Glaucoma, apnoea, higher homocysteine, higher alcohol intake and higher axial length as well as age were related to decreased RNFLT while higher spherical equivalent or history for tinnitus were related to thicker RNFL. RNFLT is related to age, ocular parameters and lifestyle factors. Considering these parameters in normative databases could improve the evaluation of peripapillary RNFLT. It is necessary to evaluate if a reduction of alcohol intake as well as the therapy of apnea or high homocysteine levels could positively influence RNFLT.