Suk Hoon Jung; Sooji Jeon; Chan Kee Park; Hae-Young Lopilly Park

doi:10.3341/jkos.2019.60.11.1089

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Jung, Jeon, Park, and Park: Associations between Retinal Nerve Fiber Layer Defect and Systemic Indices According to the KNHNES 2010–2012

Original Article

Journal of the Korean Ophthalmological Society 2019; 60(11): 1089-1097.

Published online: 19 November 2019

DOI: https://doi.org/10.3341/jkos.2019.60.11.1089

Associations between Retinal Nerve Fiber Layer Defect and Systemic Indices According to the KNHNES 2010–2012

Suk Hoon Jung, MD, Sooji Jeon, MD, Chan Kee Park, MD, PhD, Hae-Young Lopilly Park, MD, PhD

Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Address reprint requests to Hae-Young Lopilly Park, MD, PhD. Department of Ophthalmology, Seoul St. Mary's Hospital, #222 Banpo-daero, Seocho-gu, Seoul 06591, Korea. Tel: 82-2-2258-6208, Fax: 82-2-599-7405, lopilly@catholic.ac.kr

Received 7 March 2019 Revised 29 April 2019 Accepted 23 October 2019

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the associations between retinal nerve fiber layer (RNFL) defects and systemic factors in the Korean population.

Methods

Based on data from the 5th Korean National Health and Nutritional Examination Survey (2010–2012), 2,999 non-glaucomatous patients and 424 glaucoma patients were included. We compared body mass index (BMI), blood pressure, and blood test values according to the presence and location of RNFL defects in the groups and analyzed whether these defects were associated with various underlying diseases.

Results

In the non-glaucomatous group, RNFL defects were significantly and linearly related with BMI (p = 0.035), systolic blood pressure (p < 0.001), diastolic blood pressure (p = 0.018), fasting blood glucose (p < 0.001), HbA1c (p < 0.001), serum ferritin (p = 0.008), and RNFL defects were also significantly associated with diabetes mellitus (p = 0.001), hypertension (p < 0.001), dyslipidemia (p = 0.003), a history of myocardial infarction or angina (p = 0.037), and migraines (p = 0.004). In the glaucoma group, patients who had superior RNFL defects had a significantly lower systolic blood pressure (p = 0.034) than patients who had inferior RNFL defects. The other systemic indices did not differ significantly between these two subgroups. Superior RNFL defects were significantly associated with diabetes mellitus (p = 0.047) and a history of cerebrovascular accident (p = 0.031).

Conclusions

RNFL defects in both the non-glaucomatous and glaucoma groups were associated with systemic factors. We could identify that the possibility of RNFL defects can be deduced from these systemic abnormalities and active treatment is needed in abnormal systemic condition.

Keywords: Blood pressure, Diabetes mellitus, Hypertension, Retinal nerve fiber layer defect

Figures and Tables

Table 1

Clinical characteristics and comparisons according to existence of RNFL defect in non-glaucomatous subjects

Values are presented as mean ± standard deviation or number (%) unless otherwise indicated.

RNFL = retinal nerve fiber layer; FHx = family history; SE = spherical equivalent; OPP = ocular perfusion pressure.

^*Student t-test; ^†chi square test.

Table 2

Comparisons of systemic risk factors according to existence of RNFL defect in non-glaucomatous subjects

Values are presented as mean ± standard deviation or number (%).

RNFL = retinal nerve fiber layer; BMI = body mass index; BP = blood pressure; HDL = high density lipoprotein; LDL = low density lipoprotein; Hb = hemoglobin; TIBC = total iron binding capacity; CVA = cerebrovascular accident; MI = myocardial infarction; CRF = chronic renal failure.

^*Student t-test; ^†chi square test.

Table 3

Factors associated with the presence of RNFL defect in non-glaucomatous subjects

RNFL = retinal nerve fiber layer; OR = odds ratio; CI = confidence intervals; BMI = body mass index; BP = blood pressure; HDL = high density lipoprotein; LDL = low density lipoprotein; Hb = hemoglobin; TIBC = total iron binding capacity; CVA = cerebrovascular accident; MI = myocardial infarction; CRF = chronic renal failure.

^*Statistically significant. Statistics were analyzed in logistic regression. Factors with p < 0.10 were entered in the multivariate analysis.

Table 4

Clinical characteristics and comparisons according to location of RNFL defect in glaucoma subjects

Values are presented as mean ± standard deviation or number (%) unless otherwise indicated.

RNFL = retinal nerve fiber layer; FHx = family history; SE = spherical equivalent; CDR = cup-to-disc ratio; OPP = ocular perfusion pressure.

^*Student t-test; ^†chi square test.

Table 5

Comparisons of systemic risk factors according to location of RNFL defect in glaucoma subjects

Values are presented as mean ± standard deviation or number (%).

^*Student t-test; ^†chi square test.

Notes

^{Conflicts of Interest} The authors have no conflicts to disclose.

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