Abstract
Purpose :
Glaucoma is a neurodegenerative disease that leads to thinning of the retinal nerve fiber layer (RNFL). We aim to evaluate the influence of ocular, cardiovascular, anthropometric and lifestyle factors on peripapillary RNFL thickness (RNFLT) in the Gutenberg Health Study.
Methods :
The Gutenberg Health Study (GHS) is a population-based, prospective, observational, interdisciplinary cohort study with a total of 15,010 participants. In this study, global peripapillary RNFLT was measured in a subgroup of 1973 subjects (3224 eyes) using spectral-domain optical coherence tomography (SD-OCT, Heidelberg Engineering). The influence of age, sex, axial length (Lenstar LS900, Haag-Streit), spherical equivalent (auto-refraction, HARK 599, Carl Zeiss), intra-ocular pressure (non-contact tonometry, NT-2000, Nidek), central corneal thickness (Pentacam HR, Oculus), self-reported glaucoma, systemic hypertension, diabetes mellitus, and self-reported sleep apnea, tinnitus, alcohol intake (dichotomized >10g/d for women and >20g/d for men ) on RNFLT was analyzed using Pearson correlation and multivariable linear regression.
Results :
In the univariate analysis, highest correlations with RNFLT were found for axial length (r=-0.27), spherical equivalent (r=0.24), and self-reported glaucoma (r=-0.15). Other significant correlations were age, sex, intraocular pressure, systemic hypertension and systolic blood pressure, previous eye surgery, cholesterol, homocysteine, coronary artery disease, myocardial infarction, sleep apnea, diabetes mellitus and alcohol intake. The multivariable linear regression showed a significant relationship between RNFLT and age (reduction of 4-8 µm RNFLT per decade , p=0.0001), spherical equivalent (1.33 µm per diopter, p<0.0001), axial length (-1.29 µm per mm, p<0.0001), glaucoma (-7.69 µm, p<0.0001), tinnitus (1.38 µm, p=0.04), sleep apnea (-17.0 µm, p=0.047), homocysteine (-0.10 µm per mmol/L, p=0.05) and alcohol intake (-1.46 µm, p=0.02).
Conclusions :
The strong influence of age and ocular parameters on RNFLT must be considered when defining normal values and evaluating peripapillary RNFLT. Whether alcohol intake is a risk factor for RNFLT decrease needs to be confirmed by the analysis of longitudinal data.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.