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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Published in:Frontiers in medicine Vol. 10; p. 1235309
Main Authors: 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
Language:English
Published: Lausanne Frontiers Media SA 19.10.2023
Frontiers Media S.A
Subjects:
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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Summary: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.
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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
ISSN:2296-858X
2296-858X
DOI:10.3389/fmed.2023.1235309