Circumpapillary retinal nerve fiber layer thickness (cpRNFLT) and medication related to the cardiovascular system

Abstract

Purpose : To compare cpRNFLT between subjects taking or not taking medication related to the cardiovascular system.

Methods : Reliable (quality ≥20 dB, ≥50 B-scan repetitions) spectral domain optical coherence tomography (OCT) cpRNFLT scans (768 A-scans, schematically illustrated on Fig. 1A) were selected from all participants without clinically significant findings on fundus and/or OCT of the age- and sex-stratified, population-based Leipzig Research Centre for Civilization Diseases - LIFE Adult study. Participants were instructed to bring all medications they were presently taking as part of their routine clinical care at the time of their study assignments. Among all ATC code subgroups from C01 to C10, i.e. all medication groups related to the cardiovascular system, separately for all 768 A-scan locations, logistic regressions were calculated with intake of medication as outcome and cpRNFLT, age, and the true scanning radius estimated from scan focus as regressors, if at least 100 study participants took medication from the respective ATC code subgroup. P values were adjusted for multiple comparisons by false discovery rate.

Results : 11,124 eyes of 6,471 subjects (53.1% female) were selected. 3 ATC code groups were excluded because fewer than 100 participants took respective medications. The 7 included groups were C01: Cardiac therapy, C02: Antihypertensives, C03: Diuretics, C07: Beta blocking agents, C08: Calcium channel blockers, C09: Agents acting on the renin-angiotensin system, C10: Lipid modifying agents. For groups C02, C03, C08, and C10, cpRNFLT was not significantly associated with medication at any of the 768 retinal locations. For C01 and C07, cpRNFLT at 16% and 21% of the retinal locations was significantly associated with medication, respectively, where thinner cpRNFL in nasal areas was associated with intake of medication (Fig. 1B). For C01, additional significantly thicker (superior region) and thinner (superotemporal region) locations were observed. A separate analysis for male (Fig. 2A) and female subjects (Fig. 2B) revealed that all significant findings were restricted to female participants, for whom also significantly thinner nasal cpRNFL could be observed for group C09.

Conclusions : In women, taking cardiac therapy medication, beta-blocking agents and agents acting on the renin-angiotensin system is associated with thinner nasal cpRNFL.

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

 

Fig. 1

 

Fig. 2