Alexander K Schuster1, Anja Leuschner2, Constantin Feretos3,4, Philipp Blumenstein3,4, Sven-Oliver Troebs2,5,6, Sören Schwuchow2, Andreas Schulz2, Stefan Nickels3, Alireza Mirshahi4, Maria Blettner7, Manfred E Beutel8, Karl J Lackner9, Thomas Münzel5,10, Norbert Pfeiffer3, Philipp S Wild2,10,6. 1. Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany. alexander.schuster@uni-mainz.de. 2. Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany. 3. Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany. 4. Dardenne Eye Clinic, Bonn-Bad Godesberg, Germany. 5. Center for Cardiology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany. 6. DZHK (German Center for Cardiovascular Research), Partner Site Rhine-Main, Mainz, Germany. 7. Department of Biomedical Statistics, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany. 8. Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany. 9. Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany. 10. Center for Thrombosis and Hemostasis, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany.
Abstract
BACKGROUND: Choroidal thickness is associated with several cardiovascular parameters in case-control studies including patients with manifest disease. So far, it was unclear whether underlying cardiovascular risk factors or the continuum of heart failure may lead to alterations of the choroid. Therefore, our hypothesis was to test in a population-based study, whether choroidal thickness is associated with cardiovascular risk factors and heart disease. METHODS: A population-based cross-sectional study was carried out in Germany. A comprehensive medical examination including assessment of cardiovascular risk factors, echocardiography and ophthalmological examinations with spectral-domain optical coherence tomography of the choroid was performed. Subfoveal choroidal thickness as well as left ventricular ejection fraction (LVEF) and a surrogate marker for left ventricular end-diastolic pressure (E/e') were measured. Linear regression analyses were carried out to determine the relationship between subfoveal choroidal thickness and age, sex, body mass index, systolic blood pressure, dyslipidemia, HbA1c level, hematocrit, estimated glomerular filtration rate (eGFR), LVEF, E/e' and left ventricular mass index adjusted for ocular parameters. RESULTS: 1.742 subjects (48% females) with a mean age 59.3 ± 10.6 years were included in this study. Mean subfoveal thickness was 252 ± 77 µm (right eyes) and 255 ± 77 µm (left eyes). Unadjusted linear regression analysis revealed that subfoveal choroidal thickness is associated with sex, age, systolic blood pressure, hematocrit, eGFR, left ventricular end-diastolic pressure, left ventricular mass index (all p < 0.001) and dyslipidemia (p = 0.009). Adjusted linear regression only revealed age as associated parameter (p < 0.001). CONCLUSIONS: We did find evidence for an association between subfoveal choroidal thickness and cardiovascular risk factors which was mediated by aging.
BACKGROUND: Choroidal thickness is associated with several cardiovascular parameters in case-control studies including patients with manifest disease. So far, it was unclear whether underlying cardiovascular risk factors or the continuum of heart failure may lead to alterations of the choroid. Therefore, our hypothesis was to test in a population-based study, whether choroidal thickness is associated with cardiovascular risk factors and heart disease. METHODS: A population-based cross-sectional study was carried out in Germany. A comprehensive medical examination including assessment of cardiovascular risk factors, echocardiography and ophthalmological examinations with spectral-domain optical coherence tomography of the choroid was performed. Subfoveal choroidal thickness as well as left ventricular ejection fraction (LVEF) and a surrogate marker for left ventricular end-diastolic pressure (E/e') were measured. Linear regression analyses were carried out to determine the relationship between subfoveal choroidal thickness and age, sex, body mass index, systolic blood pressure, dyslipidemia, HbA1c level, hematocrit, estimated glomerular filtration rate (eGFR), LVEF, E/e' and left ventricular mass index adjusted for ocular parameters. RESULTS: 1.742 subjects (48% females) with a mean age 59.3 ± 10.6 years were included in this study. Mean subfoveal thickness was 252 ± 77 µm (right eyes) and 255 ± 77 µm (left eyes). Unadjusted linear regression analysis revealed that subfoveal choroidal thickness is associated with sex, age, systolic blood pressure, hematocrit, eGFR, left ventricular end-diastolic pressure, left ventricular mass index (all p < 0.001) and dyslipidemia (p = 0.009). Adjusted linear regression only revealed age as associated parameter (p < 0.001). CONCLUSIONS: We did find evidence for an association between subfoveal choroidal thickness and cardiovascular risk factors which was mediated by aging.
Authors: Elżbieta Krytkowska; Monika Masiuk; Miłosz P Kawa; Aleksandra Grabowicz; Paweł Rynio; Arkadiusz Kazimierczak; Krzysztof Safranow; Piotr Gutowski; Anna Machalińska Journal: J Ophthalmol Date: 2020-03-02 Impact factor: 1.909