Rachel S Chong1, Miao-Li Chee1, Yih-Chung Tham1, Shivani Majithia1, Sahil Thakur1, Zhen Ling Teo1, Zhi Da Soh1, Jacqueline Chua1, Bingyao Tan2, Damon W K Wong2, Leopold Schmetterer3, Charumathi Sabanayagam1, Ching-Yu Cheng4. 1. Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School Singapore, Singapore. 2. Singapore Eye Research Institute, Singapore; SERI-NTU Advanced Ocular Engineering (STANCE), Singapore; NTU Institute of Health Technologies, Singapore. 3. Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School Singapore, Singapore; SERI-NTU Advanced Ocular Engineering (STANCE), Singapore; NTU Institute of Health Technologies, Singapore; School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore; Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria; Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria; Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland. 4. Singapore National Eye Centre, Singapore; Singapore Eye Research Institute, Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School Singapore, Singapore. Electronic address: chingyu.cheng@duke-nus.edu.sg.
Abstract
PURPOSE: To evaluate the association between different classes of antihypertensive medication with retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GC-IPL) thickness in a nonglaucomatous multiethnic Asian population. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: A total of 9144 eyes for RNFL analysis (2668 Malays, 3554 Indians, and 2922 Chinese) and 8549 eyes for GC-IPL analysis (2460 Malays, 3230 Indians, and 2859 Chinese) aged 44 to 86 years. METHODS: Participants underwent standardized systemic and ocular examinations and interviewer-administered questionnaires for collection of data on medication and other variables. Intraocular pressure (IOP) readings were obtained by Goldmann applanation tonometry before pupil dilation for fundoscopy and OCT imaging. Blood pressure (BP) was measured with an automatic BP monitor. Mean arterial pressure (MAP) was defined as diastolic BP plus 1/3 (systolic BP - diastolic BP). Regression models were used to investigate the association of antihypertensive medication with OCT measurements of RNFL and GC-IPL. MAIN OUTCOME MEASURES: Average and sectoral RNFL and GC-IPL thickness. RESULTS: After adjusting for age, gender, ethnicity, MAP, IOP, body mass index (BMI), and presence of diabetes, we found that participants taking any type of antihypertensive medication (β = -0.83; 95% confidence interval [CI], -1.46 to -0.02; P = 0.01), specifically angiotensin-converting enzyme inhibitors (ACEIs) (β = -1.66; 95% CI, -2.57 to -0.75; P < 0.001) or diuretics (β = -1.38; 95% CI, -2.59 to -0.17; P < 0.05), had thinner average RNFL in comparison with participants who were not receiving antihypertensive treatment. Use of a greater number of antihypertensive medications was significantly associated with thinner average RNFL (P for trend = 0.001). This association was most evident in the inferior RNFL quadrant in participants using ACEIs (β = -2.44; 95% CI, -3.99 to -0.89; P = 0.002) or diuretics (β = -2.76; 95% CI, -4.76 to -0.76; P = 0.007). A similar trend was noted in our analysis of macular GC-IPL thickness. CONCLUSIONS: Use of 2 or more antihypertensive medications, ACEI, and diuretics were associated with a loss of structural markers of retinal ganglion cell health in a multiethnic Asian population.
PURPOSE: To evaluate the association between different classes of antihypertensive medication with retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GC-IPL) thickness in a nonglaucomatous multiethnic Asian population. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: A total of 9144 eyes for RNFL analysis (2668 Malays, 3554 Indians, and 2922 Chinese) and 8549 eyes for GC-IPL analysis (2460 Malays, 3230 Indians, and 2859 Chinese) aged 44 to 86 years. METHODS:Participants underwent standardized systemic and ocular examinations and interviewer-administered questionnaires for collection of data on medication and other variables. Intraocular pressure (IOP) readings were obtained by Goldmann applanation tonometry before pupil dilation for fundoscopy and OCT imaging. Blood pressure (BP) was measured with an automatic BP monitor. Mean arterial pressure (MAP) was defined as diastolic BP plus 1/3 (systolic BP - diastolic BP). Regression models were used to investigate the association of antihypertensive medication with OCT measurements of RNFL and GC-IPL. MAIN OUTCOME MEASURES: Average and sectoral RNFL and GC-IPL thickness. RESULTS: After adjusting for age, gender, ethnicity, MAP, IOP, body mass index (BMI), and presence of diabetes, we found that participants taking any type of antihypertensive medication (β = -0.83; 95% confidence interval [CI], -1.46 to -0.02; P = 0.01), specifically angiotensin-converting enzyme inhibitors (ACEIs) (β = -1.66; 95% CI, -2.57 to -0.75; P < 0.001) or diuretics (β = -1.38; 95% CI, -2.59 to -0.17; P < 0.05), had thinner average RNFL in comparison with participants who were not receiving antihypertensive treatment. Use of a greater number of antihypertensive medications was significantly associated with thinner average RNFL (P for trend = 0.001). This association was most evident in the inferior RNFL quadrant in participants using ACEIs (β = -2.44; 95% CI, -3.99 to -0.89; P = 0.002) or diuretics (β = -2.76; 95% CI, -4.76 to -0.76; P = 0.007). A similar trend was noted in our analysis of macular GC-IPL thickness. CONCLUSIONS: Use of 2 or more antihypertensive medications, ACEI, and diuretics were associated with a loss of structural markers of retinal ganglion cell health in a multiethnic Asian population.
Authors: Sidra Zafar; Kristen A Staggers; Jie Gao; Yao Liu; Praveen J Patel; Paul J Foster; Benjamin J Frankfort; Michael Abramoff; Charles G Minard; Alasdair Warwick; Anthony P Khawaja; Roomasa Channa Journal: Br J Ophthalmol Date: 2021-12-24 Impact factor: 5.908
Authors: Jun Yong Chow; Poh Fong She; Xu Kent Pee; Wan Norliza Wan Muda; Mae-Lynn Catherine Bastion Journal: PLoS One Date: 2022-04-06 Impact factor: 3.240
Authors: Henry Marshall; Sean Mullany; Xikun Han; Ella C Berry; Mark M Hassall; Ayub Qassim; Thi Nguyen; Georgina L Hollitt; Lachlan S W Knight; Bronwyn Ridge; Joshua Schmidt; Caroline Crowley; Angela Schulz; Richard A Mills; Ashish Agar; Anna Galanopoulos; John Landers; Paul R Healey; Stuart L Graham; Alex W Hewitt; Robert J Casson; Stuart MacGregor; Owen M Siggs; Jamie E Craig Journal: Ophthalmol Sci Date: 2021-12-23