Association between metabolic risk factors and optic disc cupping identified by deep learning method

Abstract

This study aims to investigate correlation between metabolic risk factors and optic disc cupping and the development of glaucoma. Methods This study is a retrospective, cross-sectional study with over 20-year-old patients that underwent health screening examinations. Intraocular pressure (IOP), fundus photographs, Body Mass Index (BMI), waist circumference (WC), serum triglycerides, serum HDL cholesterol (HDL-C), serum LDL cholesterol (LDL-C), systolic blood pressure (BP), diastolic BP, and serum HbA1c were obtained to analyse correlation between metabolic risk factors and glaucoma. Eye with glaucomatous optic neuropathy(GON) was defined as having an optic disc with either vertical cup-to-disc ratio(VCDR) � 0.7 or a VCDR difference � 0.2 between the right and left eyes by measuring VCDR with deep learning approach. Results The study comprised 15,585 subjects and 877 subjects were diagnosed as GON. In univariate analyses, age, BMI, systolic BP, diastolic BP, WC, triglyceride, LDL-C, HbA1c, and IOP were significantly and positively correlated with VCDR in the optic nerve head. In linear regression analysis as independent variables, stepwise multiple regression analyses revealed that age, BMI, systolic BP, HbA1c, and IOP showed positive correlation with VCDR. In multivariate logistic analyses of risk factors and GON, higher age (odds ratio [OR], 1.054; 95% confidence interval [CI], 1.046-1.063), male gender (OR, 0.730; 95% CI, 0.609-0.876), more obese (OR, 1.267; 95% CI, 1.065-1.507), and diabetes (OR, 1.575; 95% CI, 1.214-2.043) remained statistically significant correlation with GON.

Big Data Analysis of Glaucoma Prevalence in Israel

“…Previous reports described higher mean CDR values of 0.3–0.5 18–20 . Some other studies found that a greater vertical CDR or glaucomatous optic neuropathy was related to age and male sex, 18,21 supporting our current findings.…”

Glaucoma Prediction Models Based on Ocular and Systemic Findings

“…Ophthalmic Res 2024;67:29-38 DOI: 10.1159/000535879 duration. Vascular factors previously found to be associated with glaucoma, such as hypertension, diabetes, cardiovascular disease, and hyperlipidemia, were not predictive of glaucoma progression [24][25][26].…”

“…First, not all studies support an association of these vascular factors with glaucoma and report contrasting results. For instance, several of them demonstrated that both high and low BPs were associated with an increased risk of glaucoma, and that low nighttime BP or excessive dipping reportedly could affect glaucoma progression [24,27,28], while others did not find any correlation or they suggested that extremes in BP tend to overwhelm or disrupt the autoregulatory mechanisms [26,29]. Although many studies propose diabetes as a POAG risk factor, that issue remains controversial [26,30].…”

“…For instance, several of them demonstrated that both high and low BPs were associated with an increased risk of glaucoma, and that low nighttime BP or excessive dipping reportedly could affect glaucoma progression [24,27,28], while others did not find any correlation or they suggested that extremes in BP tend to overwhelm or disrupt the autoregulatory mechanisms [26,29]. Although many studies propose diabetes as a POAG risk factor, that issue remains controversial [26,30]. Similarly, some suggest a positive association between glaucoma and hyperlipidemia [31], whereas others do not [26].…”

Risk Factors Associated With a Large Vertical Cup-to-Disc Ratio: Korean National Health and Nutritional Examination Survey

“…According to a study conducted by Kim et al,6 higher DBP was associated with greater CDR in nonglaucoma group. Shin et al13 concluded by deep learning approach that vCDR had a positive correlation with SBP. In contrast, the Singapore Malay Eye Study (SiMES) of 3280 Malay people aged 40 to 80 years in Singapore concluded that greater CDR is related to lower DBP 14.…”