You are here

  • Home
  • Online First
  • Association between metformin use with circumpapillary retinal nerve fibre layer thickness and capillary vessel density in glaucoma

Article Text

Article menu
Download PDFPDF
Glaucoma
Association between metformin use with circumpapillary retinal nerve fibre layer thickness and capillary vessel density in glaucoma
  1. Takashi Nishida1,
  2. Sasan Moghimi1,
  3. Gopikasree Gunasegaran1,
  4. Evan Walker1,
  5. Jo-Hsuan Wu1,
  6. Kamran Rahmatnejad1,
  7. Linda M Zangwill1,
  8. Sally L Baxter2,3,
  9. Robert N Weinreb1
  1. 1Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
  2. 2Division of Ophthalmology Informatics and Data Science and Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, USA
  3. 3Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, California, USA
  1. Correspondence to Dr Robert N Weinreb, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA; rweinreb{at}ucsd.edu

Abstract

Background/aims To investigate the association between use of metformin and circumpapillary retinal nerve fibre layer (cpRNFL) thickness, as well as whole image capillary density (wiCD), in patients with glaucoma.

Methods This cross-sectional study included patients with glaucoma suspect or primary open-angle glaucoma (POAG) underwent optical coherence tomography angiography imaging. Use and duration of antidiabetic medications were assessed at the time of imaging. Multivariable linear mixed-effect modelling was used to estimate the effect of diabetes medication on wiCD and cpRNFL while controlling for covariates including age, race, body mass index, diagnosis, 24–2 visual field mean deviation, and intraocular pressure, average signal strength index as well as any variables that showed a p <0.1 in the univariable analysis.

Results A total of 577 eyes (330 POAG and 247 glaucoma suspect) of 346 patients were included. Sixty-five patients (23%) had diabetes, of whom 55 (78.5%) used metformin, and 17 (26.2%) used insulin. After adjusting for covariates, the association between metformin use and wiCD (1.56 (95% CI 0.40 to 2.71); p=0.008), duration of metformin use and wiCD (0.12 (95% CI 0.02 to 0.22) per 1 year longer; p=0.037), and metformin use and cpRNFL thickness (5.17 (95% CI 1.24 to 9.10) µm; p=0.010) had statistically significant associations in each model.

Conclusions Metformin use was associated with higher wiCD and thicker cpRNFL. These findings indicate a potential association, underscoring the need for longitudinal studies to determine if metformin plays a role in the retinal conditions of patients with glaucoma.

Trial registration number NCT00221897

  • Glaucoma

Data availability statement

Data are available upon reasonable request. The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.

https://doi.org/10.1136/bjo-2023-325035

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    Data are available upon reasonable request. The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.

    View Full Text

    Footnotes

    • X @SallyLiuBaxter

    • Contributors Involved in design and conduct of study: TN and RNW. Data collection: TN. Analysis and interpretation of data: TN, SM, LZ and RNW. Writing: TN and GG. Critical revision: all authors. Approval of the manuscript: all authors. Guarantor of work: RNW.

    • Funding National Institutes of Health/National Eye Institute Grants (R01EY029058, R01EY034146, R01EY034148, R01EY011008, R01EY019869, R01EY027510, R01EY026574, R01EY018926, P30EY022589, and DP5OD029610; University of California Tobacco Related Disease Research Program grant# T31IP1511; and an unrestricted grant from Research to Prevent Blindness (New York, NY).

    • Disclaimer The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

    • Competing interests TN: consultant—Topcon. LMZ: consultant—Abbvie, Topcon; financial support—Carl Zeiss Meditec, Heidelberg Engineering GmbH, Optovue, Topcon Medical Systems. Patent: Zeiss Meditec, AISight Health (founder); SLB: Consultant—voxelcloud.io; Recipient—iVista Medical Education; financial support—Optomed, Topcon; RNW: Consultant—Abbvie, Aerie Pharmaceuticals, Allergan, Amydis, Editas, Equinox, Eyenovia, Iantrek, IOPtic, Implandata, iSTAR Medical, Nicox, Santen, Tenpoint and Topcon; financial support—Heidelberg Engineering, Carl Zeiss Meditec, Konan Medical, Optovue, Zilia, Centervue, Topcon, Zilia. Patent: Toromedes, Carl Zeiss Meditec.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.