Ambient air pollution associations with retinal morphology in the UK Biobank

Sharon Y.L. Chua, Anthony P. Khawaja, Andrew D. Dick, James Morgan, Baljean Dhillon, Andrew J. Lotery, Nicholas G. Strouthidis, Charles Reisman, Tunde Peto, Peng T. Khaw, Paul J. Foster, Praveen J. Patel, Thomas Littlejohns, Naomi Allen, Eleni Beli, Denize Atan, Tariq Aslam, Sarah A. Barman, Jenny H. Barrett, Paul BishopCatey Bunce, Roxana O. Carare, Usha Chakravarthy, Michelle Chan, David P. Crabb, Alexander Day, Parul Desai, Bal Dhillon, Cathy Egan, Sarah Ennis, Marcus Fruttiger, John E.J. Gallacher, David F. Garway-Heath, Jane Gibson, Dan Gore, Jeremy A. Guggenheim, Chris J. Hammond, Alison Hardcastle, Simon P. Harding, Ruth E. Hogg, Pirro Hysi, Pearse A. Keane, Gerassimos Lascaratos, Tom Macgillivray, Sarah Mackie, Michelle McGaughey, Bernadette McGuinness, Gareth J. McKay, Martin McKibbin, Tony Moore, James E. Morgan, Zaynah A. Muthy, Eoin O’Sullivan, Chris G. Owen, Euan Paterson, Axel Petzold, Jugnoo S. Rahi, Alicja R. Rudnikca, Jay Self, Sobha Sivaprasad, David Steel, Irene Stratton, Nicholas Strouthidis, Cathie Sudlow, Dhanes Thomas, Emanuele Trucco, Adnan Tufail, Veronique Vitart, Stephen A. Vernon, Ananth C. Viswanathan, Cathy Williams, Katie Williams, Jayne V. Woodside, Max M. Yates, Yalin Zheng

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PURPOSE. Because air pollution has been linked to glaucoma and AMD, we characterized the relationship between pollution and retinal structure. 

METHODS. We examined data from 51,710 UK Biobank participants aged 40 to 69 years old. Ambient air pollution measures included particulates and nitrogen oxides. SD-OCT imaging measured seven retinal layers: retinal nerve fiber layer, ganglion cell–inner plexiform layer, inner nuclear layer, outer plexiform layer + outer nuclear layer, photoreceptor inner segments, photoreceptor outer segments, and RPE. Multivariable regression was used to evaluate associations between pollutants (per interquartile range increase) and retinal thickness, adjusting for age, sex, race, Townsend deprivation index, body mass index, smoking status, and refractive error. 

RESULTS. Participants exposed to greater particulate matter with an aerodynamic diameter of <2.5 μm (PM2.5) and higher nitrogen oxides were more likely to have thicker retinal nerve fiber layer (β = 0.28 μm; 95% CI, 0.22–0.34; P = 3.3 × 10−20 and β = 0.09 μm; 95% CI, 0.04–0.14; P = 2.4 × 10−4, respectively), and thinner ganglion cell–inner plexiform layer, inner nuclear layer, and outer plexiform layer + outer nuclear layer thicknesses (P < 0.001). Participants resident in areas of higher levels of PM2.5 absorbance were more likely to have thinner retinal nerve fiber layer, inner nuclear layer, and outer plexiform layer + outer nuclear layers (β = –0.16 [95% CI, –0.22 to –0.10; P = 5.7 × 10−8]; β = –0.09 [95% CI, –0.12 to –0.06; P = 2.2 × 10−12]; and β = –0.12 [95% CI, –0.19 to –0.05; P = 8.3 × 10−4], respectively). 

CONCLUSIONS. Greater exposure to PM2.5, PM2.5 absorbance, and nitrogen oxides were all associated with apparently adverse retinal structural features.

Original languageEnglish
Article number32
Number of pages10
JournalInvestigative Opthalmology and Visual Science
Issue number5
Publication statusPublished - 19 May 2020


  • Air pollution
  • OCT
  • Retinal layers


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