Cardiovascular disease and thinning of retinal nerve fiber layer in a multi-ethnic Asian population: the Singapore epidemiology of eye diseases study

IntroductionOur study aimed to examine the relationship between cardiovascular diseases (CVD) with peripapillary retinal fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thickness profiles in a large multi-ethnic Asian population study.Methods6,024 Asian subjects were analy...

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Veröffentlicht in:	Frontiers in medicine Jg. 10; S. 1235309
Hauptverfasser:	Majithia, Shivani, Quek, Debra Q. Y., Chee, Miao Li, Lim, Zhi Wei, Nusinovici, Simon, Soh, Zhi-Da, Thakur, Sahil, Rim, Tyler Hyungtaek, Sabanayagam, Charumathi, Cheng, Ching-Yu, Tham, Yih-Chung
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	Lausanne Frontiers Media SA 19.10.2023 Frontiers Media S.A
Schlagworte:	Alcohol Algorithms Angina pectoris Asian Blood pressure Body mass index Cardiovascular disease Diabetes Epidemiology Eye diseases ganglion cell-inner plexiform Glaucoma Hyperlipidemia Hypertension Kidney diseases Medical history Medicine Minority & ethnic groups Optic nerve optical coherence tomography Response rates retinal nerve fiber layer Self report Software Singapore
ISSN:	2296-858X, 2296-858X
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Abstract	IntroductionOur study aimed to examine the relationship between cardiovascular diseases (CVD) with peripapillary retinal fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thickness profiles in a large multi-ethnic Asian population study.Methods6,024 Asian subjects were analyzed in this study. All participants underwent standardized examinations, including spectral domain OCT imaging (Cirrus HD-OCT; Carl Zeiss Meditec). In total, 9,188 eyes were included for peripapillary RNFL analysis (2,417 Malays; 3,240 Indians; 3,531 Chinese), and 9,270 eyes (2,449 Malays, 3,271 Indians, 3,550 Chinese) for GCIPL analysis. History of CVD was defined as a self-reported clinical history of stroke, myocardial infarction, or angina. Multivariable linear regression models with generalized estimating equations were performed, adjusting for age, gender, ethnicity, diabetes, hypertension, hyperlipidaemia, chronic kidney disease, body mass index, current smoking status, and intraocular pressure.ResultsWe observed a significant association between CVD history and thinner average RNFL (β = −1.63; 95% CI, −2.70 to −0.56; p = 0.003). This association was consistent for superior (β = −1.79, 95% CI, −3.48 to −0.10; p = 0.038) and inferior RNFL quadrant (β = −2.14, 95% CI, −3.96 to −0.32; p = 0.021). Of the CVD types, myocardial infarction particularly showed significant association with average (β = −1.75, 95% CI, −3.08 to −0.42; p = 0.010), superior (β = −2.22, 95% CI, −4.36 to −0.09; p = 0.041) and inferior (β = −2.42, 95% CI, −4.64 to −0.20; p = 0.033) RNFL thinning. Among ethnic groups, the association between CVD and average RNFL was particularly prominent in Indian eyes (β = −1.92, 95% CI, −3.52 to −0.33; p = 0.018). CVD was not significantly associated with average GCIPL thickness, albeit a consistent negative direction of association was observed (β = −0.22, 95% CI, −1.15 to 0.71; p = 0.641).DiscussionIn this large multi-ethnic Asian population study, we observed significant association between CVD history and RNFL thinning. This finding further validates the impact of impaired systemic circulation on RNFL thickness.
AbstractList	IntroductionOur study aimed to examine the relationship between cardiovascular diseases (CVD) with peripapillary retinal fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thickness profiles in a large multi-ethnic Asian population study.Methods6,024 Asian subjects were analyzed in this study. All participants underwent standardized examinations, including spectral domain OCT imaging (Cirrus HD-OCT; Carl Zeiss Meditec). In total, 9,188 eyes were included for peripapillary RNFL analysis (2,417 Malays; 3,240 Indians; 3,531 Chinese), and 9,270 eyes (2,449 Malays, 3,271 Indians, 3,550 Chinese) for GCIPL analysis. History of CVD was defined as a self-reported clinical history of stroke, myocardial infarction, or angina. Multivariable linear regression models with generalized estimating equations were performed, adjusting for age, gender, ethnicity, diabetes, hypertension, hyperlipidaemia, chronic kidney disease, body mass index, current smoking status, and intraocular pressure.ResultsWe observed a significant association between CVD history and thinner average RNFL (β = −1.63; 95% CI, −2.70 to −0.56; p = 0.003). This association was consistent for superior (β = −1.79, 95% CI, −3.48 to −0.10; p = 0.038) and inferior RNFL quadrant (β = −2.14, 95% CI, −3.96 to −0.32; p = 0.021). Of the CVD types, myocardial infarction particularly showed significant association with average (β = −1.75, 95% CI, −3.08 to −0.42; p = 0.010), superior (β = −2.22, 95% CI, −4.36 to −0.09; p = 0.041) and inferior (β = −2.42, 95% CI, −4.64 to −0.20; p = 0.033) RNFL thinning. Among ethnic groups, the association between CVD and average RNFL was particularly prominent in Indian eyes (β = −1.92, 95% CI, −3.52 to −0.33; p = 0.018). CVD was not significantly associated with average GCIPL thickness, albeit a consistent negative direction of association was observed (β = −0.22, 95% CI, −1.15 to 0.71; p = 0.641).DiscussionIn this large multi-ethnic Asian population study, we observed significant association between CVD history and RNFL thinning. This finding further validates the impact of impaired systemic circulation on RNFL thickness. Our study aimed to examine the relationship between cardiovascular diseases (CVD) with peripapillary retinal fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thickness profiles in a large multi-ethnic Asian population study.IntroductionOur study aimed to examine the relationship between cardiovascular diseases (CVD) with peripapillary retinal fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thickness profiles in a large multi-ethnic Asian population study.6,024 Asian subjects were analyzed in this study. All participants underwent standardized examinations, including spectral domain OCT imaging (Cirrus HD-OCT; Carl Zeiss Meditec). In total, 9,188 eyes were included for peripapillary RNFL analysis (2,417 Malays; 3,240 Indians; 3,531 Chinese), and 9,270 eyes (2,449 Malays, 3,271 Indians, 3,550 Chinese) for GCIPL analysis. History of CVD was defined as a self-reported clinical history of stroke, myocardial infarction, or angina. Multivariable linear regression models with generalized estimating equations were performed, adjusting for age, gender, ethnicity, diabetes, hypertension, hyperlipidaemia, chronic kidney disease, body mass index, current smoking status, and intraocular pressure.Methods6,024 Asian subjects were analyzed in this study. All participants underwent standardized examinations, including spectral domain OCT imaging (Cirrus HD-OCT; Carl Zeiss Meditec). In total, 9,188 eyes were included for peripapillary RNFL analysis (2,417 Malays; 3,240 Indians; 3,531 Chinese), and 9,270 eyes (2,449 Malays, 3,271 Indians, 3,550 Chinese) for GCIPL analysis. History of CVD was defined as a self-reported clinical history of stroke, myocardial infarction, or angina. Multivariable linear regression models with generalized estimating equations were performed, adjusting for age, gender, ethnicity, diabetes, hypertension, hyperlipidaemia, chronic kidney disease, body mass index, current smoking status, and intraocular pressure.We observed a significant association between CVD history and thinner average RNFL (β = -1.63; 95% CI, -2.70 to -0.56; p = 0.003). This association was consistent for superior (β = -1.79, 95% CI, -3.48 to -0.10; p = 0.038) and inferior RNFL quadrant (β = -2.14, 95% CI, -3.96 to -0.32; p = 0.021). Of the CVD types, myocardial infarction particularly showed significant association with average (β = -1.75, 95% CI, -3.08 to -0.42; p = 0.010), superior (β = -2.22, 95% CI, -4.36 to -0.09; p = 0.041) and inferior (β = -2.42, 95% CI, -4.64 to -0.20; p = 0.033) RNFL thinning. Among ethnic groups, the association between CVD and average RNFL was particularly prominent in Indian eyes (β = -1.92, 95% CI, -3.52 to -0.33; p = 0.018). CVD was not significantly associated with average GCIPL thickness, albeit a consistent negative direction of association was observed (β = -0.22, 95% CI, -1.15 to 0.71; p = 0.641).ResultsWe observed a significant association between CVD history and thinner average RNFL (β = -1.63; 95% CI, -2.70 to -0.56; p = 0.003). This association was consistent for superior (β = -1.79, 95% CI, -3.48 to -0.10; p = 0.038) and inferior RNFL quadrant (β = -2.14, 95% CI, -3.96 to -0.32; p = 0.021). Of the CVD types, myocardial infarction particularly showed significant association with average (β = -1.75, 95% CI, -3.08 to -0.42; p = 0.010), superior (β = -2.22, 95% CI, -4.36 to -0.09; p = 0.041) and inferior (β = -2.42, 95% CI, -4.64 to -0.20; p = 0.033) RNFL thinning. Among ethnic groups, the association between CVD and average RNFL was particularly prominent in Indian eyes (β = -1.92, 95% CI, -3.52 to -0.33; p = 0.018). CVD was not significantly associated with average GCIPL thickness, albeit a consistent negative direction of association was observed (β = -0.22, 95% CI, -1.15 to 0.71; p = 0.641).In this large multi-ethnic Asian population study, we observed significant association between CVD history and RNFL thinning. This finding further validates the impact of impaired systemic circulation on RNFL thickness.DiscussionIn this large multi-ethnic Asian population study, we observed significant association between CVD history and RNFL thinning. This finding further validates the impact of impaired systemic circulation on RNFL thickness.
Author	Quek, Debra Q. Y. Thakur, Sahil Chee, Miao Li Cheng, Ching-Yu Tham, Yih-Chung Majithia, Shivani Sabanayagam, Charumathi Lim, Zhi Wei Soh, Zhi-Da Rim, Tyler Hyungtaek Nusinovici, Simon
AuthorAffiliation	1 Singapore Eye Research Institute, Singapore National Eye Centre , Singapore , Singapore 3 Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School , Singapore , Singapore 2 Yong Loo Lin School of Medicine, National University of Singapore , Singapore , Singapore 4 Centre for Innovation and Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore , Singapore , Singapore
AuthorAffiliation_xml	– name: 3 Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School , Singapore , Singapore – name: 4 Centre for Innovation and Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore , Singapore , Singapore – name: 1 Singapore Eye Research Institute, Singapore National Eye Centre , Singapore , Singapore – name: 2 Yong Loo Lin School of Medicine, National University of Singapore , Singapore , Singapore
Author_xml	– sequence: 1 givenname: Shivani surname: Majithia fullname: Majithia, Shivani – sequence: 2 givenname: Debra Q. Y. surname: Quek fullname: Quek, Debra Q. Y. – sequence: 3 givenname: Miao Li surname: Chee fullname: Chee, Miao Li – sequence: 4 givenname: Zhi Wei surname: Lim fullname: Lim, Zhi Wei – sequence: 5 givenname: Simon surname: Nusinovici fullname: Nusinovici, Simon – sequence: 6 givenname: Zhi-Da surname: Soh fullname: Soh, Zhi-Da – sequence: 7 givenname: Sahil surname: Thakur fullname: Thakur, Sahil – sequence: 8 givenname: Tyler Hyungtaek surname: Rim fullname: Rim, Tyler Hyungtaek – sequence: 9 givenname: Charumathi surname: Sabanayagam fullname: Sabanayagam, Charumathi – sequence: 10 givenname: Ching-Yu surname: Cheng fullname: Cheng, Ching-Yu – sequence: 11 givenname: Yih-Chung surname: Tham fullname: Tham, Yih-Chung
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Cites_doi	10.1111/ceo.12763 10.1097/IAE.0000000000002216 10.47102/annals-acadmedsg.V47N6p226 10.1167/iovs.11-7481 10.1136/bjo.84.5.473 10.1016/j.ophtha.2018.11.031 10.1016/j.ophtha.2014.05.013 10.1016/j.ophtha.2021.11.022 10.1167/iovs.63.9.16 10.1016/j.exer.2005.08.001 10.1056/NEJMra0804630 10.1016/0039-6257(94)90041-8 10.1093/ije/dyaa238 10.1016/j.ophtha.2018.03.026 10.1161/HYPERTENSIONAHA.118.11769 10.1136/bjophthalmol-2017-311359 10.1016/B978-0-12-385157-4.00171-8 10.2337/diaclin.26.2.77 10.5935/0004-2749.20210077 10.1371/journal.pone.0197682 10.1038/srep42201 10.1016/j.ophtha.2010.03.003 10.1111/j.1600-0420.2005.00468.x 10.1016/j.ophtha.2020.01.055 10.1016/j.jacc.2022.11.005 10.1167/iovs.62.12.5
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Notes	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 These authors share last authorship Edited by: Jie Hao, Capital Medical University, China These authors share first authorship Reviewed by: Yingxin Yang, Capital Medical University, China; Changzheng Chen, Renmin Hospital of Wuhan University, China; Pengfei Zhang, Dalian University of Technology, China
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Snippet	IntroductionOur study aimed to examine the relationship between cardiovascular diseases (CVD) with peripapillary retinal fiber layer (RNFL) and macular... Our study aimed to examine the relationship between cardiovascular diseases (CVD) with peripapillary retinal fiber layer (RNFL) and macular ganglion cell-inner...
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SubjectTerms	Alcohol Algorithms Angina pectoris Asian Blood pressure Body mass index Cardiovascular disease Diabetes Epidemiology Eye diseases ganglion cell-inner plexiform Glaucoma Hyperlipidemia Hypertension Kidney diseases Medical history Medicine Minority & ethnic groups Optic nerve optical coherence tomography Response rates retinal nerve fiber layer Self report Software
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Title	Cardiovascular disease and thinning of retinal nerve fiber layer in a multi-ethnic Asian population: the Singapore epidemiology of eye diseases study
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