Association between serum lipid parameters and retinal layer thicknesses in the macula

Abstract

Purpose : The blood high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol levels act as biomarkers for the risk of heart disease. We analyzed the relationship between HDL/LDL level and macular layer thickness generated from spectral-domain optical coherence tomography (SD-OCT) in a large population-based study.

Methods : From the population-based, sex and age-stratified (age range: 20 to 80 years) LIFE Adult study, we selected all eyes of the participants with HDL/LDL data and SD-OCT (Spectralis, Heidelberg Engineering) volume scans available. The inclusion criteria were: 1) OCT B-scan signal to noise ratio ≥20 dB; 2) 97 horizontal B-scans per eye with 512 A-scans each; 3) no reported cholesterol medication taken. Macular segmentation was exported from the OCT machine into ten layers (Fig 1A): retinal pigment epithelium (RPE), outer segment (OS), inner-outer segment junction (IS-OS), inner segment (IS), outer nuclear layer (ONL), out plexiform layer (OPL), inner nuclear layer (INL), inner plexiform layer (IPL), ganglion cell layer (GCL), and retinal nerve fiber layer (RNFL). Within each layer, we performed partial Pearson correlations between HDL/LDL level and thickness at each of the 49,644 A-scan locations with age effect removed.

Results : A total of 15,377 eyes of 7,760 participants were selected. Fig. 1B/C shows the HDL/LDL histograms. Partial correlations with age effect removed are detailed in Fig. 2. Significant (P<0.05) correlations could be found for almost all layers for both HDL and LDL. HDL level is negatively correlated with the thickness of the parafoveal area of RNFL, GCL, IPL, INL, and ONL. Most notably, HDL exhibited positive correlations on 94% of the area of the IS layer and negative correlations on 77.8% of the IS-OS layer. LDL correlations were typically in the opposite direction and occurred most notably on 87.2%/76.2%/62.2% of the areas of the GCL/IPL/IS, respectively. The most distinct flips of the correlation sign between HDL and LDL occurred for IS-OS and IS layers.

Conclusions : Serum lipid parameters are significantly correlated with thicknesses of most macular layers. The correlations exhibit layer-specific spatial patterns that are roughly antagonistic between HDL and LDL. These findings suggest that the systemic health effects assessed by the serum lipid profile might additionally specifically be reflected in the layer structure of the retina.

This is a 2020 Imaging in the Eye Conference abstract.

 

Fig. 1

 

Fig. 2