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Ophthalmology. 2018 Oct;125(10):1526-1536. doi: 10.1016/j.ophtha.2018.03.026. Epub 2018 Apr 30.

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

Author information

1
Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department of Ophthalmology, University of Bonn, Bonn, Germany.
2
Department of Ophthalmology, Erasmus MC, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.
3
Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
4
Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany; Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany.
5
Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany; Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts.
6
Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.
7
Department of Ophthalmology, Erasmus MC, Rotterdam, The Netherlands.
8
Section of Academic Ophthalmology, School of Life Course Sciences, FoLSM, King's College London, London, United Kingdom.
9
Department of Ophthalmology, University Hospital Dijon, Dijon, France; Eye and Nutrition Research Group, University of Bourgogne Franche Comté, Dijon, France.
10
Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Institute for Biomedical Imaging and Life Sciences, Coimbra, Portugal; Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.
11
Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.
12
University of Bordeaux, Inserm, Bordeaux Population Health Research Center, Team LEHA, Bordeaux, France.
13
Department of Ophthalmology, University of Bonn, Bonn, Germany.
14
Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Bonn, Germany.
15
Department of Ophthalmology, University of Bonn, Bonn, Germany. Electronic address: robert.finger@ukbonn.de.

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.

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