Systemic and Ocular Determinants of Peripapillary Retinal Nerve Fiber Layer Thickness Measurements in the European Eye Epidemiology (E3) Population

Matthias M. Mauschitz, Pieter W.M. Bonnemaijer, Kersten Diers, Franziska G. Rauscher, Tobias Elze, Christoph Engel, Markus Loeffler, Johanna Maria Colijn, M. Arfan Ikram, Johannes R. Vingerling, Katie Williams, Christopher Hammond, Catherine Creuzot-Garcher, Alain M. Bron, Rufino Silva, Sandrina Nunes, Cécile Delcourt, Audrey Cougnard-Grégoire, Frank Holz, Caroline KlaverMonique M.B. Breteler, Robert P. Finger*, Niyazi Acar, Eleftherios Anastosopoulos, Augusto Azuara-Blanco, Tos Berendschot, Arthur Bergen, Geir Bertelsen, Christine Binquet, Alan Bird, Martin Bobak, Morten Bøgelund Larsen, Camiel Boon, Rupert Bourne, Lionel Brétillon, Rebecca Broe, Alain Bron, Gabrielle Buitendijk, Maria Luz Cachulo, Vittorio Capuano, Isabelle Carrière, Usha Chakravarthy, Michelle Chan, Petrus Chang, Johanna Colijn, Paul Foster, Ruth Hogg, Alyson Muldrew, Tunde Peto, Giuliana Silvestri, European Eye Epidemiology (E3) Consortium

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)


Purpose: To investigate systemic and ocular determinants of peripapillary retinal nerve fiber layer thickness (pRNFLT) in the European population. Design: Cross-sectional meta-analysis. Participants: A total of 16 084 European adults from 8 cohort studies (mean age range, 56.9±12.3–82.1±4.2 years) of the European Eye Epidemiology (E3) consortium. Methods: We examined associations with pRNFLT measured by spectral-domain OCT in each study using multivariable linear regression and pooled results using random effects meta-analysis. Main Outcome Measures: Determinants of pRNFLT. Results: Mean pRNFLT ranged from 86.8±21.4 μm in the Rotterdam Study I to 104.7±12.5 μm in the Rotterdam Study III. We found the following factors to be associated with reduced pRNFLT: Older age (β = –0.38 μm/year; 95% confidence interval [CI], –0.57 to –0.18), higher intraocular pressure (IOP) (β = –0.36 μm/mmHg; 95% CI, –0.56 to –0.15), visual impairment (β = –5.50 μm; 95% CI, –9.37 to –1.64), and history of systemic hypertension (β = –0.54 μm; 95% CI, –1.01 to –0.07) and stroke (β = –1.94 μm; 95% CI, –3.17 to –0.72). A suggestive, albeit nonsignificant, association was observed for dementia (β = –3.11 μm; 95% CI, –6.22 to 0.01). Higher pRNFLT was associated with more hyperopic spherical equivalent (β = 1.39 μm/diopter; 95% CI, 1.19–1.59) and smoking (β = 1.53 μm; 95% CI, 1.00–2.06 for current smokers compared with never-smokers). Conclusions: In addition to previously described determinants such as age and refraction, we found that systemic vascular and neurovascular diseases were associated with reduced pRNFLT. These may be of clinical relevance, especially in glaucoma monitoring of patients with newly occurring vascular comorbidities.

Original languageEnglish
Early online date30 Apr 2018
Publication statusEarly online date - 30 Apr 2018

ASJC Scopus subject areas

  • Ophthalmology


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