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      Associations between Optic Cup-to-disc Ratio and Systemic Factors in the Healthy Korean Population

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          Abstract

          Purpose

          To assess the relationships between optic cup-to-disc ratio (CDR) and age, sex, and other demographic and health characteristics in the healthy Korean population.

          Methods

          The study design was retrospective and population-based. A total of 28,377 subjects who participated in the Korea National Health and Nutrition Examination Survey between 2008 and 2011 were enrolled in this study. Participants underwent structured interviews as well as systemic and ophthalmic examinations. Patients with glaucoma who were diagnosed using the International Society of Geographical and Epidemiological Ophthalmology classification were excluded. Changes in vertical CDR were examined by age in relation to systemic variables on multiple regression analysis.

          Results

          The mean vertical CDR was 0.34 ± 0.12. The vertical CDR increased with age from subjects in their 20s to those in their 80s ( p < 0.001). The mean CDR in males was significantly higher than that of females ( p < 0.001). On multiple regression analysis, the vertical CDR was positively associated with age ( p < 0.001), male sex ( p < 0.001), diastolic blood pressure ( p = 0.009), and intraocular pressure ( p < 0.001) but was negatively associated with body mass index ( p < 0.001).

          Conclusions

          Greater vertical CDR was related to age, male sex, higher diastolic blood pressure, higher intraocular pressure, and lower body mass index in healthy Koreans.

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          Most cited references27

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          Risk factors for open-angle glaucoma. The Barbados Eye Study.

          Justin C Y Wu, M. Leske, Paul L. Hyman … (1995)
          To evaluate risk factors for open-angle glaucoma among black participants in the Barbados Eye Study. Population-based study of demographic, medical, ocular, familial, and other factors possibly related to open-angle glaucoma. The Barbados Eye Study included 4709 Barbados residents identified by a simple random sample of Barbadian-born citizens, 40 to 84 years of age; participation was 84%. This report is based on the 4314 black participants examined at the study site; 302 (7%) met the Barbados Eye Study criteria for open-angle glaucoma. A standardized protocol included applanation tonometry, Humphrey perimetry, fundus photography, blood pressure, anthropometry, and an interview. An ophthalmologic examination was performed for participants who met specific criteria. Open-angle glaucoma was defined by the presence of both characteristic visual field defects and optic disc damage. Association of open-angle glaucoma with specific factors was evaluated in logistic regression analyses. Age, male gender, high intraocular pressure, and family history of open-angle glaucoma were major risk factors; the latter association was stronger in men than women. Lean body mass and cataract history were the only other factors related to open-angle glaucoma. Although hypertension and diabetes were common in Barbados Eye Study participants, they were unrelated to the prevalence of open-angle glaucoma. However, associations were found with low diastolic blood pressure-intraocular pressure differences and low systolic and diastolic blood pressure/intraocular pressure ratios. In the Barbados Eye Study black population, persons most likely to have open-angle glaucoma were older men and had a family history of open-angle glaucoma, high intraocular pressure, lean body mass, and cataract history. These results suggest the importance of possible genetic or familial factors in open-angle glaucoma. The role of vascular risk factors is consistent with our finding of low blood pressure to intraocular pressure relationships, but the results could be explained by the high intraocular pressure in open-angle glaucoma.
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            Hypertension, perfusion pressure, and primary open-angle glaucoma. A population-based assessment.

            Marc A. Sommer, J Tielsch, J Javitt … (1995)
            To evaluate the association of vascular factors with primary open-angle glaucoma (POAG). A population-based prevalence survey of ocular disease among black and white residents. Communities of east Baltimore, Md. A stratified cluster sample of 5308 residents 40 years of age or older. Primary open-angle glaucoma as defined by demonstrable glaucomatous optic nerve damage based on visual fields and/or optic disc findings. Intraocular pressure level was not a criterion for diagnosis. Systolic and diastolic blood pressure showed modest, positive association with POAG. The effect of blood pressure on POAG was modified by age, with a stronger association among older subjects. Lower perfusion pressure (blood pressure-intraocular pressure) was strongly associated with an increased prevalence of POAG, with a sixfold excess for those in the lowest category of perfusion pressure. These results suggest that POAG is associated with an alteration in factors related to ocular blood flow and a breakdown of autoregulation.
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              Obesity and eye diseases.

              Ning Cheung, Tien Wong (2015)
              The prevalence of obesity has reached epidemic proportions in many countries. Although its impact on overall health is well documented, less is known about the ocular manifestations of obesity. Among different eye diseases, obesity has been linked with age-related cataract, glaucoma, age-related maculopathy, and diabetic retinopathy. Numerous population-based and prospective studies support an association between obesity and risk of age-related cataract. However, the nature and strength of these associations, particularly with the different cataract subtypes, remains to be determined. There is strong evidence that obesity is associated with elevated intraocular pressure, but there is no convincing data to support a more direct association between obesity and glaucomatous optic neuropathy. Studies to date have not found a consistent pattern of association between obesity and risk of age-related maculopathy or diabetic retinopathy. Thus, although obesity may be a risk factor for many ocular conditions, the present literature is inadequate to establish any convincing associations. Furthermore, whether weight loss reduces the risk of eye diseases remains unresolved. Because of the potential public health impact of obesity, there is a greater need to understand its ocular effects.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Korean J Ophthalmol
                Journal ID (iso-abbrev): Korean J Ophthalmol
                Journal ID (publisher-id): KJO
                Title: Korean Journal of Ophthalmology : KJO
                Publisher: The Korean Ophthalmological Society
                ISSN (Print): 1011-8942
                ISSN (Electronic): 2092-9382
                Publication date (Print): October 2015
                Publication date (Electronic): 22 September 2015
                Volume: 29
                Issue: 5
                Pages: 336-343
                Affiliations
                [1 ]Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
                [2 ]Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
                Author notes
                Corresponding Author: Joon Mo Kim, MD. Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, #29 Saemunan-ro, Jongno-gu, Seoul 03181, Korea. Tel: 82-2-2001-2257, Fax: 82-2-2001-2262, kjoonmo1@ 123456gmail.com
                Article
                DOI: 10.3341/kjo.2015.29.5.336
                PMC ID: 4595260
                PubMed ID: 26457040
                SO-VID: 88c3ed35-ad0e-40f5-af0d-5ebc1231ea75
                Copyright © © 2015 The Korean Ophthalmological Society
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 26 March 2015
                Date accepted : 15 April 2015
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: cup-to-disc ratio,korea national health and nutrition examination survey,koreans,population based,systemic factor
                Data availability:
                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: cup-to-disc ratio, korea national health and nutrition examination survey, koreans, population based, systemic factor

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