Laser Scanning Tomography in the EPIC-Norfolk Eye Study: Principal Components and Associations

Overview

Journal Invest Ophthalmol Vis Sci

Specialty Ophthalmology

Date 2013 Sep 14

PMID 24030456

Citations 7

Authors

Anthony P Khawaja

Michelle P Y Chan

David C Broadway

David F Garway-Heath

Robert Luben

Jennifer L Y Yip

Shabina Hayat

Kay-Tee Khaw

Paul J Foster

Affiliations

Soon will be listed here.

Abstract

Purpose: To describe Heidelberg Retina Tomograph (HRT) measures, their principal components, and their associations in a British population.

Methods: The European Prospective Investigation of Cancer (EPIC)-Norfolk Eye Study is nested within a multicenter cohort study. Measurements were taken with the HRT-2 and the software subsequently updated to yield HRT-3 parameters. Principal components analysis (PCA) was used to identify distinct components of the HRT variables. Generalized estimating equation models were used to examine associations of these components with age, sex, height, body mass index (BMI), blood pressure, social class, education, alcohol intake, smoking status, axial length, IOP, and lens status.

Results: Complete data were available from 10,859 eyes of 6430 participants with a mean age of 68 years. Principal components analysis identified three components with an eigenvalue greater than 1, explaining 79.9% of the variance of all the HRT measures. These were named cup, retinal nerve fiber layer (RNFL), and rim based on the factor loadings they were most correlated with. Older age was significantly associated with a greater cup (P = 0.003), smaller RNFL (P < 0.001), and smaller rim (P < 0.001). Female sex (P = 0.001), higher education (P < 0.001), and shorter axial length (P < 0.001) were associated with a greater RNFL. Lower BMI and higher IOP were associated with a greater cup (both, P < 0.001) and a smaller rim (BMI, P = 0.001; IOP, P < 0.001).

Conclusions: Heidelberg Retina Tomograph measures in this cohort were largely explained by three principal components related to optic disc cup, RNFL, and rim. Associations with cup and rim were distinct to associations with RNFL, suggesting different underlying determinants.

Citing Articles

Association of Retinal Nerve Fiber Layer Thickness, an Index of Neurodegeneration, With Depressive Symptoms Over Time.

van der Heide F, Steens I, Geraets A, Foreman Y, Henry R, Kroon A JAMA Netw Open. 2021; 4(11):e2134753.

PMID: 34783825 PMC: 8596200. DOI: 10.1001/jamanetworkopen.2021.34753.

Large-scale machine-learning-based phenotyping significantly improves genomic discovery for optic nerve head morphology.

Alipanahi B, Hormozdiari F, Behsaz B, Cosentino J, McCaw Z, Schorsch E Am J Hum Genet. 2021; 108(7):1217-1230.

PMID: 34077760 PMC: 8322934. DOI: 10.1016/j.ajhg.2021.05.004.

A Common Glaucoma-risk Variant of SIX6 Alters Retinal Nerve Fiber Layer and Optic Disc Measures in a European Population: The EPIC-Norfolk Eye Study.

Khawaja A, Chan M, Yip J, Broadway D, Garway-Heath D, Viswanathan A J Glaucoma. 2018; 27(9):743-749.

PMID: 30005032 PMC: 6119604. DOI: 10.1097/IJG.0000000000001026.

Incidence of glaucomatous visual field loss after two decades of follow-up: the Rotterdam Study.

Springelkamp H, Wolfs R, Ramdas W, Hofman A, Vingerling J, Klaver C Eur J Epidemiol. 2017; 32(8):691-699.

PMID: 28608186 PMC: 5591359. DOI: 10.1007/s10654-017-0270-y.

Retinal Nerve Fiber Layer Measures and Cognitive Function in the EPIC-Norfolk Cohort Study.

Khawaja A, Chan M, Yip J, Broadway D, Garway-Heath D, Luben R Invest Ophthalmol Vis Sci. 2016; 57(4):1921-6.

PMID: 27092718 PMC: 4849871. DOI: 10.1167/iovs.16-19067.

References

Wang Y, Pan Z, Zhao L, You Q, Xu L, Jonas J . Retinal nerve fiber layer thickness. The Beijing Eye Study 2011. PLoS One. 2013; 8(6):e66763. PMC: 3691254. DOI: 10.1371/journal.pone.0066763. View

Vajaranant T, Nayak S, Wilensky J, Joslin C . Gender and glaucoma: what we know and what we need to know. Curr Opin Ophthalmol. 2010; 21(2):91-9. PMC: 4326058. DOI: 10.1097/ICU.0b013e3283360b7e. View

Kashiwagi K, Tamura M, Abe K, Kogure S, Tsukahara S . The influence of age, gender, refractive error, and optic disc size on the optic disc configuration in Japanese normal eyes. Acta Ophthalmol Scand. 2000; 78(2):200-3. DOI: 10.1034/j.1600-0420.2000.078002200.x. View

Mukesh B, McCarty C, Rait J, Taylor H . Five-year incidence of open-angle glaucoma: the visual impairment project. Ophthalmology. 2002; 109(6):1047-51. DOI: 10.1016/s0161-6420(02)01040-0. View

Hulsman C, Westendorp I, Ramrattan R, Wolfs R, Witteman J, Vingerling J . Is open-angle glaucoma associated with early menopause? The Rotterdam Study. Am J Epidemiol. 2001; 154(2):138-44. DOI: 10.1093/aje/154.2.138. View

Riboli E, Kaaks R . The EPIC Project: rationale and study design. European Prospective Investigation into Cancer and Nutrition. Int J Epidemiol. 1997; 26 Suppl 1:S6-14. DOI: 10.1093/ije/26.suppl_1.s6. View

Foster P, Buhrmann R, Quigley H, Johnson G . The definition and classification of glaucoma in prevalence surveys. Br J Ophthalmol. 2002; 86(2):238-42. PMC: 1771026. DOI: 10.1136/bjo.86.2.238. View

Cheung C, Chen D, Wong T, Tham Y, Wu R, Zheng Y . Determinants of quantitative optic nerve measurements using spectral domain optical coherence tomography in a population-based sample of non-glaucomatous subjects. Invest Ophthalmol Vis Sci. 2011; 52(13):9629-35. DOI: 10.1167/iovs.11-7481. View

Khor C, Ramdas W, Vithana E, Cornes B, Sim X, Tay W . Genome-wide association studies in Asians confirm the involvement of ATOH7 and TGFBR3, and further identify CARD10 as a novel locus influencing optic disc area. Hum Mol Genet. 2011; 20(9):1864-72. DOI: 10.1093/hmg/ddr060. View

10.

Koh V, Loon S, Wong W, Wong T, Aung T . Comparing stereometric parameters between Heidelberg Retinal Tomography 2 and 3 in Asian eyes: the Singapore Malay Eye Study. J Glaucoma. 2011; 21(2):102-6. DOI: 10.1097/IJG.0b013e3182027937. View

11.

Xu L, Wang Y, Wang S, Jonas J . Neuroretinal rim area and body mass index. PLoS One. 2012; 7(1):e30104. PMC: 3253809. DOI: 10.1371/journal.pone.0030104. View

12.

Khawaja A, Chan M, Hayat S, Broadway D, Luben R, Garway-Heath D . The EPIC-Norfolk Eye Study: rationale, methods and a cross-sectional analysis of visual impairment in a population-based cohort. BMJ Open. 2013; 3(3). PMC: 3612817. DOI: 10.1136/bmjopen-2013-002684. View

13.

Garway-Heath D, Poinoosawmy D, Wollstein G, Viswanathan A, Kamal D, Fontana L . Inter- and intraobserver variation in the analysis of optic disc images: comparison of the Heidelberg retina tomograph and computer assisted planimetry. Br J Ophthalmol. 1999; 83(6):664-9. PMC: 1723062. DOI: 10.1136/bjo.83.6.664. View

14.

Coleman A, Miglior S . Risk factors for glaucoma onset and progression. Surv Ophthalmol. 2008; 53 Suppl1:S3-10. DOI: 10.1016/j.survophthal.2008.08.006. View

15.

Jonas J, Budde W, Lang P . Neuroretinal rim width ratios in morphological glaucoma diagnosis. Br J Ophthalmol. 1999; 82(12):1366-71. PMC: 1722465. DOI: 10.1136/bjo.82.12.1366. View

16.

Bourne R, Foster P, Bunce C, Peto T, Hitchings R, Khaw P . The morphology of the optic nerve head in the Singaporean Chinese population (the Tanjong Pagar study): part 2--Biometric and systemic associations. Br J Ophthalmol. 2008; 92(3):310-4. DOI: 10.1136/bjo.2007.123349. View

17.

Abe H, Shirakashi M, Tsutsumi T, Araie M, Tomidokoro A, Iwase A . Laser scanning tomography of optic discs of the normal Japanese population in a population-based setting. Ophthalmology. 2008; 116(2):223-30. DOI: 10.1016/j.ophtha.2008.09.013. View

18.

Quigley H . Glaucoma. Lancet. 2011; 377(9774):1367-77. DOI: 10.1016/S0140-6736(10)61423-7. View

19.

Wang Y, Xu L, Zhang L, Yang H, Ma Y, Jonas J . Optic disc size in a population based study in northern China: the Beijing Eye Study. Br J Ophthalmol. 2006; 90(3):353-6. PMC: 1856964. DOI: 10.1136/bjo.2005.081521. View

20.

Alasil T, Wang K, Keane P, Lee H, Baniasadi N, de Boer J . Analysis of normal retinal nerve fiber layer thickness by age, sex, and race using spectral domain optical coherence tomography. J Glaucoma. 2012; 22(7):532-41. DOI: 10.1097/IJG.0b013e318255bb4a. View