Abstract

Volume.125 Number.11

A Review

Association between Impaired Glucose Tolerance and Circumpapillary Retinal Nerve Fiber Layer Thickness
Kohta Fujiwara1,2
1 Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University
2 Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University

Optical coherence tomography (OCT) enables the quantitative evaluation of changes in the optic disc and retinal structure, and their relationship with systematic factors has been reported. Diabetes mellitus has been acknowledged to be a risk factor for glaucoma, as shown by a meta-analysis. However, there are only a few reports that have examined the relationships between impaired glucose tolerance that causes diabetes mellitus and circumpapillary retinal nerve fiber layer thickness (cpRNFLT).
Therefore, we investigated the relationship between impaired glucose tolerance and cpRNFLT in the general Japanese population. After excluding those receiving glaucoma treatment and those with diabetic retinopathy, we included 1,324 residents from the town of Hisayama aged 40-79 years. All had undergone eye examinations, including cpRNFLT measurement with spectral domain OCT (SD-OCT). A 75 g oral glucose tolerance test was performed to determine their glucose tolerance status. After adjusting for confounding factors, the subjects with prediabetes or diabetes mellitus had significantly lower mean values of cpRNFLT than those with normal group. Furthermore, when referring to different categories of glycemic index, the multivariable-adjusted mean values of cpRNFLT decreased significantly with elevated fasting plasma glucose or 2-hour postload glucose levels.
These results suggest that the changes in retinal nerve fiber layer in the eye begin at the prediabetic stage. In future studies, it would be necessary to examine the association with systemic factors, including follow-up data, and to accumulate epidemiological evidence for providing new insights.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 125: 1048-1054, 2021.

Key words
Glaucoma, Epidemiology, Retinal nerve fiber layer thickness, Diabetes mellitus, Impaired glucose tolerance
Reprint requests to
Kohta Fujiwara, M. D., Ph. D. Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University. 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, 812-8582, Japan