Markers of non-alcoholic fatty liver disease (NAFLD) are inversely associated with macular optical coherence tomography (OCT)-derived retinal layer thicknesses in a large population-based study

Abstract

Purpose : To investigate the relationship between macular retinal thicknesses and indices of non-alcoholic fatty liver disease (NAFLD) in a large population-based study.

Methods : The Leipzig Research Centre for Civilization Diseases (LIFE)-Adult Study randomly selected 10,000 sex- and age-stratified participants from the population registry of Leipzig, Germany. Macular volume scans (97 B-scans by 512 A-scans) with high quality (≥20 dB) were obtained by Spectral-domain optical coherence tomography (SD-OCT, Spectralis, Heidelberg Engineering, Germany) and segmented into 10 layers and 9 Early Treatment Diabetic Retinopathy Study (ETDRS) sectors (Figure 1A-B). Global and ETDRS sector-specific retinal layer thicknesses were calculated and their relationship with NAFLD indices was identified by linear regression analyses. The p values were adjusted for multiple comparisons with respect of the 10 layers (significance level: adjusted p value<0.05).

Results : We randomly selected one eye from 7,384 participants (3,451 males and 3,933 females) with healthy retinal status. The global thicknesses of ONL and MZ were strongly associated with NAFLD indices, including fatty liver index, hepatic steatosis index (HSI), and NAFLD fat percentage (Figure 1C). Figure 2 depicts the relationship between the ETDRS sector-specific thickness for each layer and fatty liver index, HSI, and NAFLD fat percentage. In these analyses, fatty liver index, HSI, and NAFLD fat percentage were also inversely associated with the thicknesses of all ETDRS sectors for ONL and MZ. The inner-ring sectors also presented negative associations in RNFL, GCL, and IPL and positive associations in the IZ with NAFLD indices.

Conclusions : In our large population-based cohort, indices of NAFLD inversely associate with macular ONL and MZ retinal thicknesses. Future pathophysiological studies need to elucidate the causal relationship between NAFLD and retinal layer thinning.

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