The Impact of Cardiovascular Medications on the Association Between Cardiovascular Diagnoses and Circumpapillary Retinal Nerve Fiber Layer Thickness

Abstract

Purpose : To investigate the effect of cardiovascular medications on the association between cardiovascular diagnoses and the circumpapillary retinal nerve fiber layer thickness (cpRNFLT).

Methods : This study used spectral domain optical coherence tomography (OCT) scans of cpRNFLT meeting the criteria of ≥20 dB, ≥50 B-scan repetitions and 768 A-scans on a circle around the optic nerve head (Fig. 1A). These scans were drawn from participants in the Leipzig Research Centre for Civilization Diseases - LIFE Adult study, where age- and sex-stratification was applied, and individuals with clinically significant findings in fundus and/or OCT were excluded. Participants were tasked with bringing all their current or routine medications to their study sessions. All pointwise measurements were analyzed independently. Logistic regressions were performed for cardiovascular diagnoses, categorizing participants into those taking or not taking cardiovascular medications, as indicated by the group C ATC codes (Fig. 1B).

Results : The study comprised a total of 11,124 eyes from 6,471 participants (53.1% female). Among participants not using any cardiovascular medication, a significant association was observed between stroke and global thinning, particularly in 11.6% of retinal locations in the superotemporal to inferonasal areas (Fig. 2A). Similarly, individuals taking at least one cardiovascular medication displayed a significant association between stroke and global thinning of cpRNFLT, in conjunction with 18.2% of distinct retinal areas in the temporal regions (Fig. 2B). Moreover, participants taking cardiovascular medication(s) also demonstrated significant associations with angina pectoris and arrhythmia. Angina pectoris was characterized by global thinning accompanied by specific thinning in 18.4% of retinal locations consisting of non-inferior areas. Arrhythmia was found to be significantly associated with global thinning.

Conclusions : Stroke showed a significant association with cpRNFLT thinning among both subgroups. However, participants in the medication subgroup also had significantly thinner cpRNFLT with angina pectoris and arrhythmia. These findings underscore potential connections between retinal health and cardiovascular health, suggesting that cardiovascular medications may have systemic effects on overall health.

This abstract was presented at the 2024 ARVO Imaging in the Eye Conference, held in Seattle, WA, May 4, 2024.

 

Fig. 1

 

Fig. 2