Comparison of Associations with Different Macular Inner Retinal Thickness Parameters in a Large Cohort: The UK Biobank

Anthony P. Khawaja, Sharon Chua, Pirro G. Hysi, Stelios Georgoulas, Hannah Currant, Tomas W. Fitzgerald, Ewan Birney, Fang Ko, Qi Yang, Charles Reisman, David F. Garway-Heath, Chris J. Hammond, Peng T. Khaw, Paul J. Foster, Praveen J. Patel, Nicholas Strouthidis, UK Biobank Eye and Vision Consortium

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Purpose: To describe and compare associations with macular retinal nerve fiber layer (mRNFL), ganglion cell complex (GCC), and ganglion cell–inner plexiform layer (GCIPL) thicknesses in a large cohort. Design: Cross-sectional study. Participants: We included 42 044 participants in the UK Biobank. The mean age was 56 years. Methods: Spectral-domain OCT macular images were segmented and analyzed. Corneal-compensated intraocular pressure (IOPcc) was measured with the Ocular Response Analyzer (Reichert, Corp., Buffalo, NY). Multivariable linear regression was used to examine associations with mean mRNFL, GCC, and GCIPL thicknesses. Factors examined were age, sex, ethnicity, height, body mass index (BMI), smoking status, alcohol intake, Townsend deprivation index, education level, diabetes status, spherical equivalent, and IOPcc. Main Outcome Measures: Thicknesses of mRNFL, GCC, and GCIPL. Results: We identified several novel independent associations with thinner inner retinal thickness. Thinner inner retina was associated with alcohol intake (most significant for GCIPL: –0.46 μm for daily or almost daily intake compared with special occasion only or never [95% confidence interval (CI), 0.61–0.30]; P = 1.1×10–8), greater social deprivation (most significant for GCIPL: –0.28 μm for most deprived quartile compared with least deprived quartile [95% CI, –0.42 to –0.14]; P = 6.6×10–5), lower educational attainment (most significant for mRNFL: –0.36 μm for less than O level compared with degree level [95% CI, –0.45 to 0.26]; P = 2.3×10–14), and nonwhite ethnicity (most significant for mRNFL comparing blacks with whites: –1.65 μm [95% CI, –1.86 to –1.43]; P = 2.4×10–50). Corneal-compensated intraocular pressure was associated most significantly with GCIPL (–0.04 μm/mmHg [95% CI, –0.05 to –0.03]; P = 4.0×10–10) and was not associated significantly with mRNFL (0.00 μm/mmHg [95% CI, –0.01 to 0.01]; P = 0.77). The variables examined explained a greater proportion of the variance of GCIPL (11%) than GCC (6%) or mRNFL (7%). Conclusions: The novel associations we identified may be important to consider when using inner retinal parameters as a diagnostic tool. Associations generally were strongest with GCIPL, particularly for IOP. This suggests that GCIPL may be the superior inner retinal biomarker for macular pathophysiologic processes and especially for glaucoma.
Original languageEnglish
Pages (from-to)62-71
Number of pages10
JournalOphthalmology
Volume127
Issue number1
DOIs
Publication statusPublished - 1 Jan 2020

Cite this

Khawaja, A. P., Chua, S., Hysi, P. G., Georgoulas, S., Currant, H., Fitzgerald, T. W., ... UK Biobank Eye and Vision Consortium (2020). Comparison of Associations with Different Macular Inner Retinal Thickness Parameters in a Large Cohort: The UK Biobank. Ophthalmology, 127(1), 62-71. https://doi.org/10.1016/j.ophtha.2019.08.015
Khawaja, Anthony P. ; Chua, Sharon ; Hysi, Pirro G. ; Georgoulas, Stelios ; Currant, Hannah ; Fitzgerald, Tomas W. ; Birney, Ewan ; Ko, Fang ; Yang, Qi ; Reisman, Charles ; Garway-Heath, David F. ; Hammond, Chris J. ; Khaw, Peng T. ; Foster, Paul J. ; Patel, Praveen J. ; Strouthidis, Nicholas ; UK Biobank Eye and Vision Consortium. / Comparison of Associations with Different Macular Inner Retinal Thickness Parameters in a Large Cohort: The UK Biobank. In: Ophthalmology. 2020 ; Vol. 127, No. 1. pp. 62-71.
@article{62c868f79f2b44798ab097f211331ac4,
title = "Comparison of Associations with Different Macular Inner Retinal Thickness Parameters in a Large Cohort: The UK Biobank",
abstract = "Purpose: To describe and compare associations with macular retinal nerve fiber layer (mRNFL), ganglion cell complex (GCC), and ganglion cell–inner plexiform layer (GCIPL) thicknesses in a large cohort. Design: Cross-sectional study. Participants: We included 42 044 participants in the UK Biobank. The mean age was 56 years. Methods: Spectral-domain OCT macular images were segmented and analyzed. Corneal-compensated intraocular pressure (IOPcc) was measured with the Ocular Response Analyzer (Reichert, Corp., Buffalo, NY). Multivariable linear regression was used to examine associations with mean mRNFL, GCC, and GCIPL thicknesses. Factors examined were age, sex, ethnicity, height, body mass index (BMI), smoking status, alcohol intake, Townsend deprivation index, education level, diabetes status, spherical equivalent, and IOPcc. Main Outcome Measures: Thicknesses of mRNFL, GCC, and GCIPL. Results: We identified several novel independent associations with thinner inner retinal thickness. Thinner inner retina was associated with alcohol intake (most significant for GCIPL: –0.46 μm for daily or almost daily intake compared with special occasion only or never [95{\%} confidence interval (CI), 0.61–0.30]; P = 1.1×10–8), greater social deprivation (most significant for GCIPL: –0.28 μm for most deprived quartile compared with least deprived quartile [95{\%} CI, –0.42 to –0.14]; P = 6.6×10–5), lower educational attainment (most significant for mRNFL: –0.36 μm for less than O level compared with degree level [95{\%} CI, –0.45 to 0.26]; P = 2.3×10–14), and nonwhite ethnicity (most significant for mRNFL comparing blacks with whites: –1.65 μm [95{\%} CI, –1.86 to –1.43]; P = 2.4×10–50). Corneal-compensated intraocular pressure was associated most significantly with GCIPL (–0.04 μm/mmHg [95{\%} CI, –0.05 to –0.03]; P = 4.0×10–10) and was not associated significantly with mRNFL (0.00 μm/mmHg [95{\%} CI, –0.01 to 0.01]; P = 0.77). The variables examined explained a greater proportion of the variance of GCIPL (11{\%}) than GCC (6{\%}) or mRNFL (7{\%}). Conclusions: The novel associations we identified may be important to consider when using inner retinal parameters as a diagnostic tool. Associations generally were strongest with GCIPL, particularly for IOP. This suggests that GCIPL may be the superior inner retinal biomarker for macular pathophysiologic processes and especially for glaucoma.",
author = "Khawaja, {Anthony P.} and Sharon Chua and Hysi, {Pirro G.} and Stelios Georgoulas and Hannah Currant and Fitzgerald, {Tomas W.} and Ewan Birney and Fang Ko and Qi Yang and Charles Reisman and Garway-Heath, {David F.} and Hammond, {Chris J.} and Khaw, {Peng T.} and Foster, {Paul J.} and Patel, {Praveen J.} and Nicholas Strouthidis and Denize Atan and Tariq Aslam and Barman, {Sarah A.} and Barrett, {Jenny H.} and Paul Bishop and Peter Blows and Catey Bunce and Carare, {Roxana O.} and Usha Chakravarthy and Michelle Chan and Chua, {Sharon Y. L.} and Crabb, {David P.} and Cumberland, {Philippa M.} and Alexander Day and Parul Desai and Bal Dhillon and Dick, {Andrew D.} and Cathy Egan and Sarah Ennis and Paul Foster and Marcus Fruttiger and Gallacher, {John E. J.} and Jane Gibson and Dan Gore and Guggenheim, {Jeremy A.} and Alison Hardcastle and Harding, {Simon P.} and Hogg, {Ruth E.} and Pirro Hysi and Keane, {Pearse A.} and Khaw, {Sir Peng T.} and Gerassimos Lascaratos and Lotery, {Andrew J.} and Axel Petzold and {UK Biobank Eye and Vision Consortium} and Yates, {Max M.} and J. Yip and Yalin Zheng",
year = "2020",
month = "1",
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doi = "10.1016/j.ophtha.2019.08.015",
language = "English",
volume = "127",
pages = "62--71",
journal = "Ophthalmology",
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Khawaja, AP, Chua, S, Hysi, PG, Georgoulas, S, Currant, H, Fitzgerald, TW, Birney, E, Ko, F, Yang, Q, Reisman, C, Garway-Heath, DF, Hammond, CJ, Khaw, PT, Foster, PJ, Patel, PJ, Strouthidis, N & UK Biobank Eye and Vision Consortium 2020, 'Comparison of Associations with Different Macular Inner Retinal Thickness Parameters in a Large Cohort: The UK Biobank' Ophthalmology, vol. 127, no. 1, pp. 62-71. https://doi.org/10.1016/j.ophtha.2019.08.015

Comparison of Associations with Different Macular Inner Retinal Thickness Parameters in a Large Cohort: The UK Biobank. / Khawaja, Anthony P.; Chua, Sharon; Hysi, Pirro G.; Georgoulas, Stelios; Currant, Hannah; Fitzgerald, Tomas W.; Birney, Ewan; Ko, Fang; Yang, Qi; Reisman, Charles; Garway-Heath, David F.; Hammond, Chris J.; Khaw, Peng T.; Foster, Paul J.; Patel, Praveen J.; Strouthidis, Nicholas; UK Biobank Eye and Vision Consortium.

In: Ophthalmology, Vol. 127, No. 1, 01.01.2020, p. 62-71.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Comparison of Associations with Different Macular Inner Retinal Thickness Parameters in a Large Cohort: The UK Biobank

AU - Khawaja, Anthony P.

AU - Chua, Sharon

AU - Hysi, Pirro G.

AU - Georgoulas, Stelios

AU - Currant, Hannah

AU - Fitzgerald, Tomas W.

AU - Birney, Ewan

AU - Ko, Fang

AU - Yang, Qi

AU - Reisman, Charles

AU - Garway-Heath, David F.

AU - Hammond, Chris J.

AU - Khaw, Peng T.

AU - Foster, Paul J.

AU - Patel, Praveen J.

AU - Strouthidis, Nicholas

AU - Atan, Denize

AU - Aslam, Tariq

AU - Barman, Sarah A.

AU - Barrett, Jenny H.

AU - Bishop, Paul

AU - Blows, Peter

AU - Bunce, Catey

AU - Carare, Roxana O.

AU - Chakravarthy, Usha

AU - Chan, Michelle

AU - Chua, Sharon Y. L.

AU - Crabb, David P.

AU - Cumberland, Philippa M.

AU - Day, Alexander

AU - Desai, Parul

AU - Dhillon, Bal

AU - Dick, Andrew D.

AU - Egan, Cathy

AU - Ennis, Sarah

AU - Foster, Paul

AU - Fruttiger, Marcus

AU - Gallacher, John E. J.

AU - Gibson, Jane

AU - Gore, Dan

AU - Guggenheim, Jeremy A.

AU - Hardcastle, Alison

AU - Harding, Simon P.

AU - Hogg, Ruth E.

AU - Hysi, Pirro

AU - Keane, Pearse A.

AU - Khaw, Sir Peng T.

AU - Lascaratos, Gerassimos

AU - Lotery, Andrew J.

AU - Petzold, Axel

AU - UK Biobank Eye and Vision Consortium

AU - Yates, Max M.

AU - Yip, J.

AU - Zheng, Yalin

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Purpose: To describe and compare associations with macular retinal nerve fiber layer (mRNFL), ganglion cell complex (GCC), and ganglion cell–inner plexiform layer (GCIPL) thicknesses in a large cohort. Design: Cross-sectional study. Participants: We included 42 044 participants in the UK Biobank. The mean age was 56 years. Methods: Spectral-domain OCT macular images were segmented and analyzed. Corneal-compensated intraocular pressure (IOPcc) was measured with the Ocular Response Analyzer (Reichert, Corp., Buffalo, NY). Multivariable linear regression was used to examine associations with mean mRNFL, GCC, and GCIPL thicknesses. Factors examined were age, sex, ethnicity, height, body mass index (BMI), smoking status, alcohol intake, Townsend deprivation index, education level, diabetes status, spherical equivalent, and IOPcc. Main Outcome Measures: Thicknesses of mRNFL, GCC, and GCIPL. Results: We identified several novel independent associations with thinner inner retinal thickness. Thinner inner retina was associated with alcohol intake (most significant for GCIPL: –0.46 μm for daily or almost daily intake compared with special occasion only or never [95% confidence interval (CI), 0.61–0.30]; P = 1.1×10–8), greater social deprivation (most significant for GCIPL: –0.28 μm for most deprived quartile compared with least deprived quartile [95% CI, –0.42 to –0.14]; P = 6.6×10–5), lower educational attainment (most significant for mRNFL: –0.36 μm for less than O level compared with degree level [95% CI, –0.45 to 0.26]; P = 2.3×10–14), and nonwhite ethnicity (most significant for mRNFL comparing blacks with whites: –1.65 μm [95% CI, –1.86 to –1.43]; P = 2.4×10–50). Corneal-compensated intraocular pressure was associated most significantly with GCIPL (–0.04 μm/mmHg [95% CI, –0.05 to –0.03]; P = 4.0×10–10) and was not associated significantly with mRNFL (0.00 μm/mmHg [95% CI, –0.01 to 0.01]; P = 0.77). The variables examined explained a greater proportion of the variance of GCIPL (11%) than GCC (6%) or mRNFL (7%). Conclusions: The novel associations we identified may be important to consider when using inner retinal parameters as a diagnostic tool. Associations generally were strongest with GCIPL, particularly for IOP. This suggests that GCIPL may be the superior inner retinal biomarker for macular pathophysiologic processes and especially for glaucoma.

AB - Purpose: To describe and compare associations with macular retinal nerve fiber layer (mRNFL), ganglion cell complex (GCC), and ganglion cell–inner plexiform layer (GCIPL) thicknesses in a large cohort. Design: Cross-sectional study. Participants: We included 42 044 participants in the UK Biobank. The mean age was 56 years. Methods: Spectral-domain OCT macular images were segmented and analyzed. Corneal-compensated intraocular pressure (IOPcc) was measured with the Ocular Response Analyzer (Reichert, Corp., Buffalo, NY). Multivariable linear regression was used to examine associations with mean mRNFL, GCC, and GCIPL thicknesses. Factors examined were age, sex, ethnicity, height, body mass index (BMI), smoking status, alcohol intake, Townsend deprivation index, education level, diabetes status, spherical equivalent, and IOPcc. Main Outcome Measures: Thicknesses of mRNFL, GCC, and GCIPL. Results: We identified several novel independent associations with thinner inner retinal thickness. Thinner inner retina was associated with alcohol intake (most significant for GCIPL: –0.46 μm for daily or almost daily intake compared with special occasion only or never [95% confidence interval (CI), 0.61–0.30]; P = 1.1×10–8), greater social deprivation (most significant for GCIPL: –0.28 μm for most deprived quartile compared with least deprived quartile [95% CI, –0.42 to –0.14]; P = 6.6×10–5), lower educational attainment (most significant for mRNFL: –0.36 μm for less than O level compared with degree level [95% CI, –0.45 to 0.26]; P = 2.3×10–14), and nonwhite ethnicity (most significant for mRNFL comparing blacks with whites: –1.65 μm [95% CI, –1.86 to –1.43]; P = 2.4×10–50). Corneal-compensated intraocular pressure was associated most significantly with GCIPL (–0.04 μm/mmHg [95% CI, –0.05 to –0.03]; P = 4.0×10–10) and was not associated significantly with mRNFL (0.00 μm/mmHg [95% CI, –0.01 to 0.01]; P = 0.77). The variables examined explained a greater proportion of the variance of GCIPL (11%) than GCC (6%) or mRNFL (7%). Conclusions: The novel associations we identified may be important to consider when using inner retinal parameters as a diagnostic tool. Associations generally were strongest with GCIPL, particularly for IOP. This suggests that GCIPL may be the superior inner retinal biomarker for macular pathophysiologic processes and especially for glaucoma.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85072997299&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/31585827

U2 - 10.1016/j.ophtha.2019.08.015

DO - 10.1016/j.ophtha.2019.08.015

M3 - Article

VL - 127

SP - 62

EP - 71

JO - Ophthalmology

JF - Ophthalmology

SN - 0161-6420

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