Retinal nerve fibre layer cross-sectional area, neuroretinal rim area and body mass index

To examine associations between body mass index, neuroretinal rim area and retinal nerve fibre layer cross-sectional area (RNFLCRA) in a population-based setting.

The Central India Eye and Medical Study is a population-based study performed in a rural region of Central India. The study included 4711 subjects (aged 30 + years). A detailed ophthalmic and medical examination was performed. Inclusion criteria for this study were an intra-ocular pressure ≤21 mmHg, open anterior chamber angles and an axial length ≤26.5 mm. Neuroretinal rim area and RNFLCRA were measured by confocal laser scanning tomography.

The study included 3959 subjects fulfilling the inclusion criteria. Larger neuroretinal rim area (mean: 1.63 ± 0.32 mm(2) ) was significantly (p = 0.004) associated with a higher body mass index after adjusting for larger disc area (p < 0.001), younger age (p < 0.001), lower intraocular pressure (p < 0.001), and hyperopic refractive error (p < 0.001). Larger retinal nerve fibre layer cross-sectional area (mean:1.29 ± 0.39 mm(2) ) was significantly associated with higher body mass index (p = 0.001) after adjusting for younger age (p < 0.001), shorter axial length (p < 0.001), larger optic disc area (p < 0.001), taller body height (p < 0.001) and male gender (p = 0.04).

In a rural Central Indian population, neuroretinal rim area and RNFLCRA as surrogates of the optic nerve fibres were related to a higher body mass index. Because body mass index is associated with cerebrospinal fluid pressure, the higher cerebrospinal fluid pressure may be associated with a larger neuroretinal rim area. It may vaguely point towards an association between cerebrospinal fluid pressure and glaucomatous optic neuropathy.