Abstract
ObjectiveTo explore the association between retinal microvascular parameters and glaucoma. DesignProspective study. SubjectsThe UK Biobank subjects with fundus images and without a history of glaucoma. MethodsWe employed the Retina-based Microvascular Health Assessment System (RMHAS) to utilize the noninvasive nature of fundus photography and quantify retinal microvascular parameters including retinal vascular skeleton density (VSD) and fractal dimension (FD). We also utilized propensity score matching (PSM) to pair individuals with glaucoma and healthy controls (HC). PSM was implemented via a logistic regression model with a caliper of 0.1 and a matching ratio of 1:4 sans replacements. We conducted univariable Cox regression analyses to study the association between retinal microvascular parameters and incident glaucoma, in both continuous and quartile forms. Main outcome measureVSD, FD, and glaucoma. ResultsIn a study of 41,632 participants without prior glaucoma, 482 cases of glaucoma were recorded during a median follow-up of 11.0 years. In the Cox proportional hazards regression model post-PSM, we found that incident glaucoma has significant negative associations with arteriolar VSD (HR = 0.24, 95% CI 0.11–0.52, P < 0.001), venular VSD (HR = 0.34, 95% CI 0.15–0.74, P = 0.007), arteriolar FD (HR = 0.24, 95% CI 0.10–0.60, P = 0.002) and venular FD (HR = 0.31, 95% CI 0.12–0.85, P = 0.022). Subgroup analysis using covariates revealed that individuals aged 60 and above, non-smokers, moderate alcohol consumers, and those with hypertension and myopia exhibited P values below 0.05 consistently pre- and post-matching, differing from other subgroups within this covariate. ConclusionOur study found that reduced retinal VSD and lower FD are linked to elevated glaucoma risk.
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