Abstract
Purpose :
Visual field loss (VFL) has been linked with decreased physical activity and increased falls. However, the association of VFL and bone density has not been well-characterized. We investigated bone mineral density and rates of osteoporosis among adults with VFL.
Methods :
We analyzed the 2005-2008 National Health and Nutrition Examination Survey, a representative sample of US adults. VFL was assessed by the 2-2-1 algorithm based on frequency doubling technology. Osteoporosis was determined using previously validated thresholds of total femur, femoral neck, and trochanter bone mineral density (BMD) on DEXA scan. Multivariable regression models were adjusted for age, sex, race, insurance, and chronic comorbidities. Statistical analyses were performed using SAS version 9.4.
Results :
Of the 4704 adults in the NHANES who underwent VF testing and DEXA scan, 66 (0.7%) had unilateral and 148 (2.2%) had bilateral VFL. Bilateral VFL was associated with decreased total femur (P=0.02) and trochanter BMD (P=0.02), and similar femoral neck BMD (P=0.19). Unilateral VFL was not associated with BMD (all P≥0.15).
Using validated BMD thresholds for osteoporosis, persons with bilateral VFL had higher rates of osteoporosis in the femur (adjusted OR [95% CI]: 2.46 [1.10-5.50], P=0.03) and trochanter (2.72 [1.19-6.23], P=0.02), and similar rates in the femoral neck (2.26 [0.90-5.66], P=0.08). Unilateral VFL was associated with greater odds of osteoporosis in the total femur (2.95 [1.40-6.18], P=0.006) and femoral neck (2.57 [1.04-6.37], P=0.04), and not in the trochanter (2.70 [0.78-9.34], P=0.11).
Conclusions :
In this representative US cohort, adults with visual field loss had decreased bone mineral density and higher rates of osteoporosis. Patients with VFL may benefit from osteoporosis screening and multidisciplinary interventions to mitigate bone loss and fracture risk. Further studies are needed to investigate the underlying mechanisms and determine the optimal strategies to reduce osteoporosis among patients with VFL.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.