Periodontal disease and outer retinal morphology: A cross-sectional analysis of the UK Biobank cohort

Abstract

Purpose : To investigate whether periodontal disease (PD), a chronic disorder of the gums and bones that surround the teeth, is associated with early features of age-related macular degeneration (AMD) in individuals with no eye disease.

Methods : A cross-sectional analysis of the UK Biobank, a prospective cohort of UK residents aged 40-69 years recruited between 2006-2010 where 67,311 individuals underwent retinal imaging. PD was defined through self-report. Photoreceptor segment layer (PSL) and retinal pigment epithelium-Bruch’s membrane (RPE-BM) thicknesses were extracted from macular-centered optical coherence tomography through automated segmentation. Linear mixed effects modeled the association between PD and retinal sublayer thicknesses adjusting for age, sex, ethnicity, socioeconomic status, alcohol consumption, smoking status, diabetes mellitus, hypertension and refractive error.

Results : Among 35,142 participants included in the analysis, 1,233 (3.5%) had PD. Individuals with PD were older, lived in areas of greater socioeconomic deprivation and were more likely to be male, hypertensive, diabetic and currently smoking (all p<0.001). On adjusted analysis, PD was associated with reduced thickness of the PSL (-0.90 μm, 95% CI: -1.49, -0.30, p=0.003) and increased thickness of the RPE-BM (0.89 μm, 95% CI: 0.33, 1.46, p=0.002). Stratifying individuals by age, PSL thickness was reduced among those aged 60-69 years (-1.40 μm, 95% CI: -2.25, -0.55, p=0.001) but not those under 60 years.

Conclusions : PD is associated with outer retinal features consistent with early AMD among those with no known eye disease. Further investigations should examine whether individuals with PD have accelerated PSL thinning and RPE-BM thickening. The role of enhanced dental hygiene in high-risk and affected individuals warrants further investigation.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.