Retinal Nerve Fiber Layer Defect is Associated With Cerebral Small Vessel Diseases in Korean Population: Assessment by Magnetic Resonance Imaging

Abstract

Purpose: : To investigate whether retinal nerve fiber layer bundle defect (RNFLD) is associated with cerebral small vessel diseases (SVDs) in Korean population and to evaluate the risk factors for RNFLD.

Methods: : We examined 4,416 subjects who visited the Healthcare system Gangnam center in Seoul for periodic medical check-up between January 2008 and October 2009. Subjects underwent fundus photography, detailed questionnaires and brain magnetic resonance imaging (MRI). One examiner assessed the RNFLD in fundus photography according to the definition that RNFLD is a marked thinning or an absent of retinal nerve fiber layer bundles. Subjects with normal variants, such as a split RNFL, superior segment optic hypoplasia and nonspecific slit-like defects, were excluded.

Results: : RNFLD was detected in 231 out of 4,416 subjects, and the estimated prevalence was 5.23%. Cerebral SVDs were significantly frequent in subjects with RNFLD (p<.001). Hypertension (p<.001), diabetes mellitus (p=.005) and male sex (p=.002) were also significant risk factors for RNFLD. Multivariate analyses showed that the prevalence of RNFLD was significantly higher in hypertensive subjects (OR, 1.920; 95% CI, 1.435-2.569; p<.001), those who have SVDs in brain MRI (OR, 1.635; 95% CI, 1.220-2.191; p=.001) and male (OR, 1.549; 95% CI, 1.153-2.083; p=.004).

Conclusions: : These results suggest that the presence of SVDs might be related with RNFLD. The male subjects and those who have hypertension show an increased risk for RNFLD.

Keywords: clinical (human) or epidemiologic studies: prevalence/incidence • nerve fiber layer • imaging/image analysis: clinical