Localised retinal nerve fibre layer defects (RNFLDs) are reported to indicate the degree of glaucomatous damage but can also be sequelae of retinal vascular insufficiency as a result of systemic vascular factors. We investigated the association between RNFLDs and cardiovascular risk factors. RNFLDs were detected in 440 (29.2%) of 1508 subjects. The presence of RNFLDs was associated with higher HbA1c (odds ratio [OR] 1.289, p < 0.001), higher 24-h mean systolic blood pressure (SBP; OR 1.013, p < 0.005), and lower estimated glomerular filtration rate (eGFR; OR 0.995, p < 0.005). An increasing number of RNFLDs was correlated with higher SBP (r = 0.186, p < 0.001), higher HbA1c (r = 0.128, p < 0.010), lower eGFR (r = −0.112, p < 0.020), and younger age (r = −0.303, p < 0.001). Subjects with RNFLDs had a higher predicted 10-year risk of atherosclerotic cardiovascular disease than did those without RNFLDs (9.7% vs 7.9%, p = 0.008 in middle-aged subjects, 25.6% vs 23.2%, p = 0.040 in older subjects). In conclusion, RNFLDs are associated with SBP, eGFR, and HbA1c. Concomitant cardiovascular risk factors should be considered when evaluating patients with localised RNFLDs.
Bibliographical noteFunding Information:
This research was supported by the Korea Health Technology R & D Project through the Korea Health Industry Development Institute funded by the Ministry of Health and Welfare, Republic of Korea (grants HI13C0715 and HI17C1567). The authors declare that no competing interests exist with the funder. The funders had no role in study design, data collection and analysis, the decision to publish, or preparation of the manuscript. The authors would like to thank Professor Hyoung Won Bae (Department of Ophthalmology, Yonsei University College of Medicine) for evaluating the glaucoma data.
© 2019, The Author(s).
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