Retinal damages have been suggested a surrogate marker of end-organ damage and prognostic marker in hypertensive patients. Recent study reported that localized retinal nerve fiber layer defect (RNFLD) assessed by noninvasive optical coherence tomography (OCT) was related to the degree of hypertension severity and cerebrovascular disease.Design and Method:
RNFLD and coronary artery calcium score (CACS) were assessed by retinal OCT and coronary calcium scan in 765 consecutive subjects enrolled in Cardiovascular and Metabolic Disease Etiology Research Center - HIgh Risk Cohort (CMERC-HI, NCT02003781). We excluded patients with glaucoma, which is known to be related to RNFLD independently of cardiovascular (CV) risk factors. The 2013 AHA/ACC guideline defined high risk coronary artery calcium score (CACS) group as 300 ≥ Agatston Units (AU).Results:
RNFLD was found in 170 (22.2%) patients. The patients with RNFLD were higher in frequency in men and had lower estimated glomerular filtration rate (eGFR) compare to those without RNFLD. The RNFLD patients had higher CACS (306 ± 613 vs. 192 ± 500AU, p = 0.028) compared to those without RNFLD. There were higher prevalence of high risk CACS group (23.5% vs. 15.1%, p = 0.015) and lower prevalence of zero CACS group (29.4% vs. 42.0%, p = 0.003) in RNFLD patients. Multivariate logistic regression analysis revealed that RNFLD was independently associated with high CACS after controlling for other CV risk factors including smoking, eGFR (odd ratio; 1.650, 95% confidence interval; 1.014–2.684, p = 0.044).Conclusions:
We reported that RNFLD on OCT was related to higher CACS for the first time. Further studies which validate RNFLD as a cardiovascular surrogate and end organ damage marker should be warranted.