June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Body Mass Index and Fuchs’ Endothelial Corneal Dystrophy (FECD)
Author Affiliations & Notes
  • Yihua Yue
    Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York, United States
  • Sangita P Patel
    Department of Ophthalmology, University at Buffalo, Buffalo, New York, United States
  • Jing Nie
    Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York, United States
  • Chris A. Andrews
    Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States
  • Jean Wactawski-Wende
    Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York, United States
  • Aladdin Shadyab
    Herbert Wertheim School of Public Health and Human Longevity Science, University of California SanDiego, La Jolla, California, United States
  • Robert Wallace
    Department of Epidemiology, University of Iowa, Lowa City, Iowa, United States
  • Amy E Millen
    Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York, United States
  • Footnotes
    Commercial Relationships   Yihua Yue None; Sangita Patel None; Jing Nie None; Chris Andrews None; Jean Wactawski-Wende None; Aladdin Shadyab None; Robert Wallace None; Amy Millen None
  • Footnotes
    Support  NIH- NEI R21 EY032544-01
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 623. doi:
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      Yihua Yue, Sangita P Patel, Jing Nie, Chris A. Andrews, Jean Wactawski-Wende, Aladdin Shadyab, Robert Wallace, Amy E Millen; Body Mass Index and Fuchs’ Endothelial Corneal Dystrophy (FECD). Invest. Ophthalmol. Vis. Sci. 2023;64(8):623.

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

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Abstract

Purpose : FECD results in the death of the non-proliferative endothelial cells of the posterior corneal surface leading to corneal swelling, clouding, and potential blindness. Previous data shows higher prevalence of FECD in women compared to men, with this disparity becoming evident after menopause in women. We hypothesized that estrogen exposure protects the corneal endothelium. Previous studies have observed increased prevalence of FECD in those with lower compared to higher body mass indices (BMIs). Using data from the Women’s Health Initiative Observational Study (WHI-OS) of postmenopausal women, we examined whether higher compared to lower BMI exposure (as a proxy for estrogen exposure in postmenopausal women) was associated with a lower risk of FECD.

Methods : We utilized a sample of 27,863 women enrolled in the WHI-OS with available claims data from Medicare at WHI-OS baseline (1993-1998). Height measured at WHI baseline was used to calculate BMI with weight at multiple time points. At baseline, weight was measured, and women were asked to recall their weight at ages 18, 35, and 50. At follow-up years 3-8, women were asked to self-report their weight. FECD incidence was determined from Medicare claims data reports from 1-year post-baseline through 2019. We used Cox proportional hazard models to estimate the hazard ratio (HR) and 95% Confidence Intervals (CI) for incident FECD with historic BMI (aged 18, 35, and 50), BMI at baseline, and time-dependent BMI (baseline, years 3-8) during WHI-OS follow-up. BMI was parameterized as a continuous and categorical variable in analyses. Models were adjusted for age, race, education, smoking status, the healthy eating index-2015, and hormone therapy use.

Results : No statistically significant HRs for incident FECD were found with continuous BMI or categorical BMI at the ages of 18, 35, and 50. Women categorized as obesity II (35.0 - 39.9 kg/m2) at baseline had a lower hazard for incident FECD (HR [95% CI]=0.68 [0.52-0.89]) compared to those underweight/normal weight (BMI<25kg/m2). Using time-dependent BMI measures during WHI-OS visits, the hazard of incident FECD was lower in women with extreme obesity III (BMI>40 kg/m2; HR [95% CI]=0.53 [0.32-0.88]) compared to women who were underweight/normal weight.

Conclusions : In this cohort of postmenopausal women, obesity II or III (BMI of ≥ 35 kg/m2) was associated with a lower risk of FECD.

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

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