Zones of circumpapillary retinal never fiber layer thickness (cpRNFLT) (in-)vulnerability to aging and life style

Abstract

Purpose : To identify the relationship between patterns of cpRNFLT and aging/life style characteristics.

Methods : cpRNFLT scans (768 samples at diameter of 12°) of spectral domain optical coherence tomography (OCT) were selected from all participants of the age and sex stratified population-based LIFE Adult study without clinically significant findings on fundus and/or OCT images and with reliable B-scans (quality ≥20 dB, ≤5% missing A-scans). Linear regression was used to relate RNFLT at the 768 retinal locations to age as well as parameters related to life style (waist-to-hip ratio [WHR], systolic/diastolic blood pressure [SBP/DBP], self-reported alcohol consumption, HDL/LDL cholesterol, and socio-economical status [SES; index calculated from education, income, and profession]). P-values were adjusted for multiple comparisons, and only the proportion of variance unexplained by age, sex, and an estimation of real scanning diameter based on scanning focus (to adjust for eye anatomy and lens effects) was analyzed (Fig. 1A).

Results : 11,879 eyes of 6,917 subjects were selected (53.8% female; age range: 20-79 yrs.). For all parameters apart from DBP and HDL cholesterol, there were retinal locations with significant associations to RNFLT (red in Fig. 2), ranging from 12.4% (SBP) to 91.8% (age) significant locations. With the exception of WHR, the nasal area was widely unrelated to all parameters. Across all parameters other than LDL cholesterol, values associated with unhealthier life style were related to thinner RNFLT at two isolated supero/infero-temporal areas (“vulnerability zones”, magenta in Fig. 1A and 2) that coincide with the locations of strongest thinning by age. This effect was strongest for SES and generally more pronounced on the inferior retina. Furthermore, at superior/inferior areas with weak aging effects (“invulnerability zones”, blue in Fig. 1A and 2), for most parameters, values associated with unhealthier life style were related to thicker RNFLT. This effect was strongest for LDL cholesterol and generally more pronounced on the inferior retina.

Conclusions : Parameter values related to unhealthier life style are associated with RNFLT on specific circumpapillary locations. Separate zones of vulnerability/invulnerability on the inferior and superior retina can be distinguished that coincide with the local maxima/minima of age related RNFLT thinning, respectively.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Fig.1

 

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