Renal function and lipid metabolism are major predictors of circumpapillary retinal nerve fiber layer thickness—the LIFE-Adult Study

Abstract

Background Circumpapillary retinal nerve fiber layer thickness (cpRNFLT) as assessed by spectral domain optical coherence tomography (SD-OCT) is a new technique used for the detection and evaluation of glaucoma and other optic neuropathies. Before translating cpRNFLT into clinics, it is crucially important to investigate anthropometric, biochemical, and clinical parameters potentially affecting cpRNFLT in a large population-based dataset. Methods The population-based LIFE-Adult Study randomly selected 10,000 participants from the population registry of Leipzig, Germany. All participants underwent standardized systemic assessment of various cardiometabolic risk markers and ocular imaging, including cpRNFLT measurement using SD-OCT (Spectralis, Heidelberg Engineering). After employing strict SD-OCT quality criteria, 8952 individuals were analyzed. Multivariable linear regression analyses were used to evaluate the independent associations of various cardiometabolic risk markers with sector-specific cpRNFLT. For significant markers, the relative strength of the observed associations was compared to each other to identify the most relevant factors influencing cpRNFLT. In all analyses, the false discovery rate method for multiple comparisons was applied. Results In the entire cohort, female subjects had significantly thicker global and also sectoral cpRNFLT compared to male subjects (p < 0.05). Multivariable linear regression analyses revealed a significant and independent association between global and sectoral cpRNFLT with biomarkers of renal function and lipid profile. Thus, thinner cpRNFLT was associated with worse renal function as assessed by cystatin C and estimated glomerular filtration rate. Furthermore, an adverse lipid profile (i.e., low high-density lipoprotein (HDL) cholesterol, as well as high total, high non-HDL, high low-density lipoprotein cholesterol, and high apolipoprotein B) was independently and statistically significantly related to thicker cpRNFLT. In contrast, we do not observe a significant association between cpRNFLT and markers of inflammation, glucose homeostasis, liver function, blood pressure, or obesity in our sector-specific analysis and globally. Conclusions Markers of renal function and lipid metabolism are predictors of sectoral cpRNFLT in a large and deeply phenotyped population-based study independently of previously established covariates. Future studies on cpRNFLT should include these biomarkers and need to investigate whether incorporation will improve the diagnosis of early eye diseases based on cpRNFLT.

Comparison of peripapillary retinal nerve fiber layer and macular thickness in non-diabetic chronic kidney disease and controls

“…In our subanalysis, pRNFL thickenss of superior quadrant, inferior quadrant, average pRNFL, CST, average macular thickness and GC-IPL showed significant positive correlation with eGFR. Renal dysfunction has also been correlated with decreased choroidal thickness [ 39 ] and pRNFL thickness [ 46 – 48 ]. This may partly be attributed to the sympathetic nervous system overactivation which is characteristic of CKD [ 49 ].…”

Cross-sectional and Longitudinal Impacts of Chronic Kidney Disease on Retinal Ageing: An International Multi-Country Analysis

“…Intraocular pressure was measured using an ocular response analyzer (Reichert, Depew, NY). The covariates were selected based on prior knowledge and previous literature [12,14,18].…”

“…This may be because this relationship has not been clari ed in different populations, such as healthy individuals and those with diabetes or hypertension. In addition, most studies on this topic have been cross-sectional, no longitudinal population-based studies have been conducted, but this approach is needed to unravel the causal relationship between these factors [10][11][12][13][14].…”

Analysis of Plasma Metabolic Profile on Ganglion Cell–Inner Plexiform Layer Thickness With Mortality and Common Diseases

“…[17][18][19][20] Previous studies have reported associations between circulating metabolites and alterations in neuroretinas, but these are limited to single-biomarker approaches. [21][22][23] Additionally, these studies majorly focused on the RNFL (representing axons of retinal ganglion cells [RGCs]), while growing evidence suggesting that GCIPL (representing cytosol and dendrites of RGCs) is a more sensitive and reproducible mirror for neuroretinal damage and systemic health. 6,[24][25][26] We hypothesized that circulating metabolites may underlie the links between neuroretinal changes and systemic health.…”