Associations between retinal nerve fiber layer defect and systemic indices according to the KNHNES 2010-2012

Purpose: To investigate the associations between retinal nerve fiber layer (RNFL) defects and systemic factors in the Korean population. Methods: Based on data from the 5th Korean National Health and Nutritional Examination Survey (2010-2012), 2,999 non-glaucomatous patients and 424 glaucoma patients were included. We compared body mass index (BMI), blood pressure, and blood test values according to the presence and location of RNFL defects in the groups and analyzed whether these defects were associated with various underlying diseases. Results: In the non-glaucomatous group, RNFL defects were significantly and linearly related with BMI (p = 0.035), systolic blood pressure (p < 0.001), diastolic blood pressure (p = 0.018), fasting blood glucose (p < 0.001), HbA1c (p < 0.001), serum ferritin (p = 0.008), and RNFL defects were also significantly associated with diabetes mellitus (p = 0.001), hypertension (p < 0.001), dyslipidemia (p = 0.003), a history of myocardial infarction or angina (p = 0.037), and migraines (p = 0.004). In the glaucoma group, patients who had superior RNFL defects had a significantly lower systolic blood pressure (p = 0.034) than patients who had inferior RNFL defects. The other systemic indices did not differ significantly between these two subgroups. Superior RNFL defects were significantly associated with diabetes mellitus (p = 0.047) and a history of cerebrovascular accident (p = 0.031). Conclusions: RNFL defects in both the non-glaucomatous and glaucoma groups were associated with systemic factors. We could identify that the possibility of RNFL defects can be deduced from these systemic abnormalities and active treatment is needed in abnormal systemic condition.