Associations with Retinal Pigment Epithelium Thickness Measures in a Large Cohort: Results from the UK Biobank

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• 作者：Fang Ko ; MD¹ ; Paul J. Foster ; PhD ; FRCOphth¹ ; Nicholas G. Strouthidis ; PhD ; FRCOphth¹ ; Yusrah Shweikh ; MBChB ; MRes¹ ; Qi Yang ; PhD² ; Charles A. Reisman ; MS² ; Zaynah A. Muthy ; BSc¹ ; Usha Chakravarthy ; MD ; PhD³ ; Andrew J. Lotery ; MD ; FRCOphth⁴ ; Pearse A. Keane ; MD ; MRCOphth¹ ; Adnan Tufail ; MD ; FRCOphth¹ ; Carlota M. Grossi ; PhD¹ ; Praveen J. Patel ; MD ; FRCOphth¹ ; ^{praveen.patel@moorfields.nhs.uk} ; on behalf of the UK Biobank Eye & Vision Consortium^&lowast ;
• 关键词：BM ; Bruch's membrane ; BMI ; body mass index ; BP ; blood pressure ; CI ; confidence interval ; D ; diopter ; ETDRS ; Early Treatment of Diabetic Retinopathy Study ; ILM ; internal limiting membrane ; IOP ; intraocular pressure ; NFL ; nerve fiber layer ; OCT ; optical coherence tomography ; RPE ; retinal pigment epithelium ; SD ; standard deviation ; SE ; standard error ; TABS ; Topcon Advanced Boundary Segmentation
• 刊名：Ophthalmology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：124
• 期：1
• 页码：105-117
• 全文大小：2004 K
• 卷排序：124

文摘

To describe associations of ocular and systemic factors with retinal pigment epithelium (RPE)–Bruch's membrane (BM) complex thickness as measured by spectral-domain (SD) optical coherence tomography (OCT).DesignMultisite community-based study. This research has been conducted using the UK Biobank Resource.ParticipantsSixty-seven thousand three hundred eighteen people 40 to 69 years old received questionnaires, physical examination, and eye examination, including macular SD OCT. Systematic selection process identified 34 652 eyes with high-quality SD OCT images from normal individuals for analysis.MethodsWe included people with no self-reported ocular disease, diabetes, or neurologic disorders; visual acuity of ≥20/25; refraction between –6 diopters (D) to 6 D, and IOP of 6 to 21 mmHg. Only high-quality, well-centered SD OCT images with central, stable fixation were included. Descriptive statistics, t tests, and regression analyses were performed. Multivariate regression modeling was used to adjust for covariates and to identify relationships between RPE–BM thickness and ocular and systemic features.Main Outcome MeasuresRetinal pigment epithelium–BM thickness, as measured by SD OCT segmentation using Topcon Advanced Boundary Segmentation at 9 Early Treatment of Diabetic Retinopathy Study subfields.ResultsMean RPE–BM thickness was 26.3 μm (standard deviation, 4.8 μm) at central subfield. Multivariate regression with age stratification showed that RPE thinning became apparent after age 45. Among those aged ≤45, RPE–BM was significantly thicker among those of black or mixed/other race (+3.61 and +1.77 μm vs. white, respectively; P < 0.001) and higher hyperopia (+0.4 μm/D; P < 0.001), but not for other variables considered. Among those age >45, RPE–BM was significantly thinner with older age (–0.10 μm/year; P < 0.001), Asian ethnicity (–0.45 μm vs. white; P = 0.02), taller height (–0.02 μm/cm; P < 0.001), higher IOP (–0.03 μm/mmHg; P < 0.001), and regular smoking (–0.27 μm vs. nonsmokers; P = 0.02). In contrast, RPE–BM was significantly thicker among black or mixed/other race (+3.29 μm and +0.81 μm vs. white, respectively; P < 0.001) and higher hyperopia (+0.28 μm/D; P < 0.001). There was no significant association with sex or Chinese ethnicity.ConclusionsWe describe novel findings of RPE–BM thickness in normal individuals, a structure that varies with age, ethnicity, refraction, IOP, and smoking. The significant association with IOP is especially interesting and may have relevance for the etiology of glaucoma, while the association between age and smoking may have relevance for the etiology of age-related macular degeneration.