| Title: | Association between retinal nerve fiber layer thickness and cardiovascular-kidney-metabolic syndrome: A UK Biobank cohort study |
| Journal: | American Journal of Ophthalmology |
| Published: | 28 Apr 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42061672/ |
| DOI: | https://doi.org/10.1016/j.ajo.2026.04.023 |
Publication 17841
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Abstract
OBJECTIVE: To examine the association between retinal nerve fiber layer (RNFL) thickness and the severity of cardiovascular-kidney-metabolic (CKM) syndrome in a large community cohort.</p>
DESIGN: Retrospective cross-sectional analysis of a community-based cohort.</p>
PARTICIPANTS: UK residents 40 to 60 years of age at enrollment of UK Biobank.</p>
METHODS: The cohort underwent baseline examination from April 2007 to October 2010. We analyzed high-quality optical coherence tomography images and identified the presence of CKM syndrome. We explored associations between RNFL and CKM syndrome severity using multivariable logistic regression.</p>
MAIN OUTCOME MEASURES: Odds ratios (OR) for having advanced CKM syndrome (stage 3 or higher) at baseline were calculated after adjustment for age, sex, ethnicity, intraocular pressure, education and socioeconomic status.</p>
RESULTS: A total of 17,082 participants were included (mean age 57.63±7.66 years old, 56.8% females) in the study, and 15,892 participants (93.0%) had CKM syndrome stage 1 or higher at baseline. Advanced CKM syndrome was observed more frequently in the thinnest quintile of RNFL thickness (14.8%) in comparison to the thickest quintile (9.1%). A multivariate regression controlling for potential confounders showed that decrease in RNFL thickness by 1 µm increased the risk of having advanced CKM syndrome by 2.4% (OR 1.024, 95% CI 1.010-1.039, P=0.001) at baseline.</p>
CONCLUSIONS: Thinner RNFL is associated with advanced CKM syndrome in individuals without a previous neurodegenerative or ocular disease. Our findings suggest that RNFL may serve as a valuable marker for monitoring disease severity of CKM syndrome. Further research, however, is warranted to investigate the pathways linking RNFL and CKM syndrome and to validate RNFL as a prognostic marker for CKM syndrome in larger populations.</p>
5 Authors
- Jihei Sara Lee
- Seok-Jae Heo
- David Myung
- Chan Yun Kim
- Sang Yeop Lee
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