Abstract
Purpose:
The pathogenesis of Primary Open-Angle Glaucoma (POAG) remains obscure. To test the hypothesis that the mechanical and vascular factors are implicated concurrently in glaucomatous optic nerve head(ONH) damage,we performed a population-based study to assess whether Intraocular pressure(IOP) related pressure and retinal vessel diameter are associated with neuroretinal rim area.
Methods:
The population-based Handan Eye Study included 6830 individuals with aged 30 years and older. The participants underwent physical examinations and comprehensive eye examinations including measurement of retinal vessel diameter and optic disc. Based on a previous study with lumbar cerebrospinal fluid pressure (CSFP) measurements, Trans-lamina cribrosa pressure difference (TLCPD) and CSFP were estimated by a formula based on body mass index (BMI), blood pressure and age. The ocular and systemic parameters associated with neuroretinal rim area were analyzed by univariate and multivariate analyses.
Results:
4234 (66.4%) individuals (1882 (44.4%) men) with gradable retinal photographs and HRTII images of acceptable quality were available for analysis.In univariate analysis, rim area was significantly associated with age, gender, BMI, waist-to-hip-ratio, hypertension, TLCPD, CSFP , disc area , central retinal arteriolar equivalent (CRAE) ,central retinal venular equivalent (CRVE), high density lipoprotein cholesterol , low density lipoprotein , high sensitive C-reactive protein , serum albumin , total iron-binding capacity , total cholesterols and urea nitrogen (p＜0.05).In multivariate analysis, reduced rim area was significantly associated with narrow CRVE(p＜0.001; beta: 0.09; B: 0.001; 95%CI: 0.444～0.281) ,higher TLCPD(p =0.026; beta: -0.03; B: -0.003; 95%CI:- 0.005～-0.001) ,higher prevalence of POAG (p＜0.001; beta: -0.112; B: -0.363; 95%CI: 0.016～0.003), older age (p＜0.001; beta:- 0.103; B: -0.003; 95%CI: -0.004～-0.002) , lower disc area (p＜0.001; beta: 0.662; B: 0.453; 95%CI: 0.436～0.470)when adjust other confounders including IOP.
Conclusions:
Narrower retinal vessel diameter and higher TLCPD are associated with reduced rim area in univariate and multivariate analysis in the adult Chinese population. As rim area an important marker of glaucomatous optic nerve damage, it may supports the notion that the mechanical and vascular factors are implicated concurrently in glaucomatous ONH damage.