Cardiovascular health and ocular health may overlap, a recent study suggests. Photo: Robina Weermeijer on Unsplash.

Systemic risk factors such as blood pressure and weight are thought to play a role in glaucomatous and retinal diseases. Recent research on the intersections of cardiovascular risk factors and eye health provides further support for this theory. A group in Norway found that blood pressure and weight explained 12.6% of the variance in the ganglion cell complex-inner plexiform layer (GCIPL).1 Similarly, a multicohort study investigating glaucoma and weight associations reported that body mass index was correlated with glaucomatous outcomes.2

The population-based Tromsø Study consisted of longitudinal (n=2,595) and cross-sectional (n=8,288) analyses of HD-OCT images of patients with diabetes and glaucoma in Norway.1 The research team reported the following findings:

  • GCIPL was negatively associated with age.

  • Females had a thicker GCIPL than males at an older age and thinner outer retinal layers at all ages.

  • Systolic blood pressure was negatively associated with the GCIPL and retinal nerve fiber layer (RNFL).

  • There’s a U-shaped relationship with the GCIPL in females.

  • Males had a stronger negative association than women with BMI and RNFL/GCIPL/outer retinal layer.

  • Higher baseline BMI was associated with a reduction in GCIPL over eight years.

In the second study, a multicohort analysis that included the Progression Risk of Glaucoma: RElevant SNPs with Significant Association (PROGRESSA) study, the UK Biobank study and the Canadian Longitudinal Study of Aging (CLSA).2 Here are the findings:

  • In the retrospective longitudinal analysis of PROGRESSA’s primary open-angle glaucoma cases (n=471), a lower BMI was associated with a faster rate of visual field progression.

  • In the UK Biobank study, a one-standard-deviation-lower BMI was associated with a worse cross-sectional vertical cup-to-disc ratio and a 10% greater likelihood of glaucoma diagnosis. BMI was positively correlated with IOP.

  • In the CLSA, a lower BMI was associated with a greater vertical cup-to-disc ratio change.

Overall, both studies concluded that studying cardiovascular risk factors in relation to retinal diseases and glaucoma may provide more insight into disease mechanisms.

1. von Hanno T, Hareide LL, Småbrekke L, et al. Macular layer thickness and effect of BMI, body fat, and traditional cardiovascular risk factors: the Tromsø Study. Invest Ophthalmol Vis Sci. 2022;63(9):16.

2. Marshall H, Berry EC, Diaz Torres S, et al. Association between body mass index and primary open-angle glaucoma in three cohorts. Am J Ophthalmol. August 4, 2022. [Epub ahead of print].