Exploring the Impact of Cardiovascular Medications and Diagnoses on Circumpapillary Retinal Nerve Fiber Layer Thickness

Abstract

Purpose : To assess the differences in associations between circumpapillary retinal nerve fiber layer thickness (cpRNFLT) and cardiovascular medication or cardiovascular diagnoses.

Methods : Spectral domain optical coherence tomography (OCT) scans of cpRNFLT (≥20 dB, ≥50 B-scan repetitions and 768 A-scans; Fig. 1A) were selected from participants in the age- and sex-stratified, population-based Leipzig Research Centre for Civilization Diseases - LIFE Adult study, excluding those with clinically significant findings on fundus and/or OCT. Participants were asked to bring all current or routine medications during their study assignments. Analyses were conducted separately for all 768 A-scan locations. Logistic regressions were performed for ATC code subgroups and cardiovascular diagnoses (Fig. 1B). The analyses featured either medication intake or cardiovascular diagnosis as outcomes, with cpRNFLT, age, and true scanning radius (estimated from scan focus) as regressors. P values were adjusted using false discovery rate correction.

Results : A total of 11,124 eyes from 6,471 participants (53.1% female) were chosen for the study. For C01 and C07, cpRNFLT at 16% and 21% of the retinal locations were significantly associated with medication, respectively; C09 was significantly associated with thinner cpRNFLT globally (Fig. 2A). For C01, associated thinner cpRNFL was present inferotermporally and nasally while thicker cpRNFL was found superiorly. C07 was associated with thinner nasal cpRNFLT. Of the 5 cardiovascular diagnoses investigated (Fig. 2B), significant findings presented for hypertension in 5.5% of the retinal locations. Globally thinner cpRNFLT was associated with angina pectoris and arrhythmia, plus thinner nasal areas for arrhythmia.

Distinct analyses for male and female subjects (not shown here) revealed that significant associations for medication usage were driven by female participants. For angina pectoris, male participants additionally exhibited nasal thinning. For arrhythmia, global and nasal thinning were only found in female participants, while hypertension-related global thinning was found specifically among male participants.

Conclusions : Cardiovascular medications (C01, C07, and C09) and cardiovascular diagnoses (angina pectoris, arrhythmia, and hypertension) were associated with thinner cpRNFLT globally or at distinct local areas.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Fig. 1

 

Fig. 2