Systemic and Ocular Determinants of Peripapillary Retinal Nerve Fiber Layer Thickness Measurements in the European Eye Epidemiology (E3) Population

European Eye Epidemiology (E³) Consortium

Research output: Contribution to journalReview article

15 Citations (Scopus)

Abstract

PURPOSE: To investigate systemic and ocular determinants of peripapillary retinal nerve fiber layer thickness (pRNFLT) in the European population.

DESIGN: Cross-sectional meta-analysis.

PARTICIPANTS: A total of 16 084 European adults from 8 cohort studies (mean age range, 56.9±12.3-82.1±4.2 years) of the European Eye Epidemiology (E3) consortium.

METHODS: We examined associations with pRNFLT measured by spectral-domain OCT in each study using multivariable linear regression and pooled results using random effects meta-analysis.

MAIN OUTCOME MEASURES: Determinants of pRNFLT.

RESULTS: Mean pRNFLT ranged from 86.8±21.4 μm in the Rotterdam Study I to 104.7±12.5 μm in the Rotterdam Study III. We found the following factors to be associated with reduced pRNFLT: Older age (β = -0.38 μm/year; 95% confidence interval [CI], -0.57 to -0.18), higher intraocular pressure (IOP) (β = -0.36 μm/mmHg; 95% CI, -0.56 to -0.15), visual impairment (β = -5.50 μm; 95% CI, -9.37 to -1.64), and history of systemic hypertension (β = -0.54 μm; 95% CI, -1.01 to -0.07) and stroke (β = -1.94 μm; 95% CI, -3.17 to -0.72). A suggestive, albeit nonsignificant, association was observed for dementia (β = -3.11 μm; 95% CI, -6.22 to 0.01). Higher pRNFLT was associated with more hyperopic spherical equivalent (β = 1.39 μm/diopter; 95% CI, 1.19-1.59) and smoking (β = 1.53 μm; 95% CI, 1.00-2.06 for current smokers compared with never-smokers).

CONCLUSIONS: In addition to previously described determinants such as age and refraction, we found that systemic vascular and neurovascular diseases were associated with reduced pRNFLT. These may be of clinical relevance, especially in glaucoma monitoring of patients with newly occurring vascular comorbidities.

Original languageEnglish
Pages (from-to)1526-1536
Number of pages11
JournalOphthalmology: Journal of The American Academy of Ophthalmology
Volume125
Issue number10
DOIs
Publication statusPublished - Oct 2018
Externally publishedYes

Bibliographical note

Copyright © 2018 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Keywords

  • Cross-Sectional Studies
  • Disease Progression
  • Europe/epidemiology
  • Glaucoma/diagnosis
  • Humans
  • Intraocular Pressure/physiology
  • Nerve Fibers/pathology
  • Optic Disk/pathology
  • Population Surveillance/methods
  • Retinal Ganglion Cells/pathology
  • Tomography, Optical Coherence/methods

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