June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
A higher level of glycemia, high alcohol consumption, lower adherence to a healthy diet, and use of antihypertensive medication, an index of history of hypertension, are cross-sectionally associated with lower RNFL thickness in a population-based study – The Maastricht Study
Author Affiliations & Notes
  • Frank van der Heide
    CARIM, Universiteit Maastricht, Maastricht, Limburg, Netherlands
    Internal Medicine, Universiteit Maastricht, Maastricht, Limburg, Netherlands
  • Sara Mokhtar
    CARIM, Universiteit Maastricht, Maastricht, Limburg, Netherlands
    Internal Medicine, Universiteit Maastricht, Maastricht, Limburg, Netherlands
  • Anjani Khanna
    department of Ophthalmology, Sharp sight eye hospital, New Delhi, India
  • Ronald Henry
    CARIM, Universiteit Maastricht, Maastricht, Limburg, Netherlands
    Internal Medicine, Universiteit Maastricht, Maastricht, Limburg, Netherlands
  • Abraham Kroon
    CARIM, Universiteit Maastricht, Maastricht, Limburg, Netherlands
    Internal Medicine, Universiteit Maastricht, Maastricht, Limburg, Netherlands
  • Pieter Dagnelie
    CARIM, Universiteit Maastricht, Maastricht, Limburg, Netherlands
    Internal Medicine, Universiteit Maastricht, Maastricht, Limburg, Netherlands
  • Simone Eussen
    CARIM, Universiteit Maastricht, Maastricht, Limburg, Netherlands
  • Tos TJM Berendschot
    Ophthalmology, Universiteit Maastricht, Maastricht, Limburg, Netherlands
    MHeNS, Universiteit Maastricht Faculty of Health Medicine and Life Sciences, Maastricht, Limburg, Netherlands
  • Jan Schouten
    Ophthalmology, Canisius Wilhelmina Ziekenhuis, Nijmegen, Gelderland, Netherlands
  • Miranda Schram
    CARIM, Universiteit Maastricht, Maastricht, Limburg, Netherlands
    MHeNS, Universiteit Maastricht Faculty of Health Medicine and Life Sciences, Maastricht, Limburg, Netherlands
  • Carla van der Kallen
    CARIM, Universiteit Maastricht, Maastricht, Limburg, Netherlands
    Internal Medicine, Universiteit Maastricht, Maastricht, Limburg, Netherlands
  • Marleen van Greevenbroek
    CARIM, Universiteit Maastricht, Maastricht, Limburg, Netherlands
    Internal Medicine, Universiteit Maastricht, Maastricht, Limburg, Netherlands
  • Hans Savelberg
    NUTRIM, Universiteit Maastricht Faculty of Health Medicine and Life Sciences, Maastricht, Limburg, Netherlands
    Movement sciences, Universiteit Maastricht Faculty of Health Medicine and Life Sciences, Maastricht, Limburg, Netherlands
  • Nicolaas Schaper
    CARIM, Universiteit Maastricht, Maastricht, Limburg, Netherlands
    Internal Medicine, Universiteit Maastricht, Maastricht, Limburg, Netherlands
  • Carroll A. B. Webers
    Ophthalmology, Universiteit Maastricht, Maastricht, Limburg, Netherlands
    MHeNS, Universiteit Maastricht Faculty of Health Medicine and Life Sciences, Maastricht, Limburg, Netherlands
  • Coen Stehouwer
    CARIM, Universiteit Maastricht, Maastricht, Limburg, Netherlands
    Internal Medicine, Universiteit Maastricht, Maastricht, Limburg, Netherlands
  • Footnotes
    Commercial Relationships   Frank van der Heide None; Sara Mokhtar None; Anjani Khanna None; Ronald Henry None; Abraham Kroon None; Pieter Dagnelie None; Simone Eussen None; Tos TJM Berendschot None; Jan Schouten None; Miranda Schram None; Carla van der Kallen None; Marleen van Greevenbroek None; Hans Savelberg None; Nicolaas Schaper None; Carroll Webers None; Coen Stehouwer None
  • Footnotes
    Support  This study was supported by the European Regional Development Fund via OP-Zuid, the Province of Limburg, the Dutch Ministry of Economic Affairs (grant 31O.041), Stichting De Weijerhorst (Maastricht, the Netherlands), the Pearl String Initiative Diabetes (Amsterdam, the Netherlands), the Cardiovascular Centre (CVC, Maastricht, the Netherlands), CARIM School for Cardiovascular Diseases (Maastricht, the Netherlands), CAPHRI School for Public Health and Primary Care (Maastricht, the Netherlands), NUTRIM School for Nutrition and Translational Research in Metabolism (Maastricht, the Netherlands), Stichting Annadal (Maastricht, the Netherlands), Health Foundation Limburg (Maastricht, the Netherlands), Perimed (Järfälla, Sweden), Diabetesfonds grant 2016.22.1878 (Amersfoort, The Netherlands), Oogfonds (Utrecht, The Netherlands) and by unrestricted grants from Heidelberg Engineering (Heidelberg, Germany), Janssen-Cilag B.V. (Tilburg, the Netherlands), Novo Nordisk Farma B.V. (Alphen aan den Rijn, the Netherlands), and Sanofi-Aventis Netherlands B.V. (Gouda, the Netherlands).
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 569 – A0134. doi:
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      Frank van der Heide, Sara Mokhtar, Anjani Khanna, Ronald Henry, Abraham Kroon, Pieter Dagnelie, Simone Eussen, Tos TJM Berendschot, Jan Schouten, Miranda Schram, Carla van der Kallen, Marleen van Greevenbroek, Hans Savelberg, Nicolaas Schaper, Carroll A. B. Webers, Coen Stehouwer; A higher level of glycemia, high alcohol consumption, lower adherence to a healthy diet, and use of antihypertensive medication, an index of history of hypertension, are cross-sectionally associated with lower RNFL thickness in a population-based study – The Maastricht Study. Invest. Ophthalmol. Vis. Sci. 2022;63(7):569 – A0134.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Diabetic retinopathy is preceded by subtle neurodegenerative changes, including retinal nerve fiber layer (RNFL) thinning. Presently it remains unclear whether potentially modifiable risk factors may be determinants of RNFL thinning. We investigated, using prospectively-collected cross-sectional data from an observational cohort study, whether potentially modifiable risk factors were associated with RNFL thickness.

Methods : We used cross-sectional data from The Maastricht Study (up to 5,255 participants,49.0% men,mean±SD age59.5±8.7 years, and 23.3% with type 2 diabetes [T2D; T2D oversampled by design]). We assessed RNFL thickness with optical coherence tomography (i.e. mean peripapillary RNFL thickness of both eyes). We used linear regression analyses with adjustment for potential confounders; and tested for interaction by sex and T2D (yes/no).

Results : After full adjustment, greater HbA1c and lower healthy diet score were significantly associated with lower RNFL thickness (per SD, standardized beta [95% CI], -0.05 [-0.08; -0.02] and -0.03 [-0.06; -0.00], respectively); high (>2 units/ day for men or >1 unit/day for women) versus none alcohol consumption was significantly associated with lower RNFL thickness (-0.09 [-0.18; -0.00]); antihypertensive medication use was significantly associated with lower RNFL thickness (-0.12 [-0.19; -0.05]); and greater 24-hour ambulatory systolic blood pressure and greater total cholesterol were, respectively, significantly associated with lower and greater RNFL thickness in individuals with, but not in individuals without, T2D (in individuals with T2D, -0.06 [-0.13; 0.00]; 0.09 [0.03; 0.16]). Smoking,cardiorespiratory fitness, accelerometer-assessed physical activity, and waist circumference were not associated with RNFL thickness. Sex did not modify associations under study.

Conclusions : This population-based study found that a higher level of glycemia, lower adherence to a healthy diet, high alcohol consumption, and a history of hypertension, estimated from the use of antihypertensive medication, were associated with a lower RNFL thickness. Hence, early-stage prevention of these adverse factors may contribute to the prevention of RNFL thinning, and, ultimately, diabetic retinopathy.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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