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Henry Marshall, Sean Mullany, Ayub Qassim, Xikun Han, Mark Hassall, Thi Nguyen, Paul R Healey, Ashish Agar, Alex W Hewitt, Stuart MacGregor, Stuart L Graham, Robert Casson, Owen Siggs, Jamie E Craig; Hypercholestolaemia predicts disease progression in primary open-angle glaucoma. Invest. Ophthalmol. Vis. Sci. 2021;62(8):2365.
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To investigate the association of serum cholesterol with baseline and longitudinal glaucomatous disease progression.
A Prospective longitudinal cohort study of 2056 eyes from 1026 pre-perimetric and perimetric glaucoma cases drawn from the Progression Risk of Glaucoma: Relevant SNPs with Significant Association (PROGRESSA) study.Lipid profiles were measured on serum samples obtained at study enrolment. Mixed effects multivariable linear regression compared lipid parameters to baseline and longitudinal SD-OCT peripapillary retinal nerve fibre layer (pRNFL) and macular ganglion cell-inner plexiform layer (mGCIPL) thickness data, and with longitudinal Humphrey Visual Field data.
After accounting or age, sex, IOP and lipid lowering therapy, a higher serum total cholesterol was associated with a thinner average mGCIPL thickness (Beta: -0.98 [-1.59, -0.37] P<0.001), thinner worst mGCIPL hemisphere (Beta -1.11um/SD [-1.86, -0.36] P=0.004), and thinner worst pRNFL quadrant thickness (Beta: -1.92um/SD [-3.41, -0.44] P=0.011) at study enrolment. A higher serum LDL-cholesterol concentration was associated with a thinner average mGCIPL thickness (Beta: -0.81um/SD [-1.4, -0.22] P=0.007), a thinner worst mGCIPL hemisphere (Beta: -1.02um/SD [-1.8, -0.29] P=0.006), and a thinner worst pRNFL quadrant (Beta: -1.81um/SD [-3.25, -0.36] P=0.014).Review of longitudinal progression data (mean follow up: 6.6±1.8years) showed that a higher total cholesterol was associated with a greater risk of visual field progression (HR:1.13/SD, [1.02, 1.26] P=0.023). A higher LDL cholesterol was associated with a faster rate of average mGCIPL thinning (Beta:-0.06um/year/SD [-0.11, -0.001] P=0.045), a faster rate of mGCIPL thinning in the faster progressing hemisphere (Beta: -0.073um/year/SD [-0.14, -0.001] P=0.046), a faster rate of average pRNFL progression (Beta: -0.06um/year/SD, [-0.12, -0.01] P=0.018), and a faster rate of pRNFL thinning in the faster progressing quadrant (Beta: -0.11um/year/SD, [-0.21, -0.002] P=0.045). Further evaluation identified that a higher genetic risk score for LDL-cholesterol was associated with a thinner average mGCIPL thickness(Beta:-0.95um/SD [-1.75, -0.15] P=0.020), and a thinner worst affected pRNFL quadrant (Beta:-1.87um/SD [-0.02, -3.72] P=0.049).
Hyperlipidaemia is an important risk factor for disease progression in glaucoma.
This is a 2021 ARVO Annual Meeting abstract.
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