Liver fibrosis and retinal features in an older Mediterranean population: Results from the Salus in Apulia study

Abstract

BackgroundAge is a leading contributor to the liver fibrosis rate and a gradual deterioration of optical function, but this association in older populations is still under-explored. The present study aimed to explore the link between vascular and neural retinal characteristics and the risk of liver fibrosis in 731 older adults from the population-based Salus in Apulia study.MethodsRetinal features were obtained using optical coherence tomography (OCT) and OCT-angiography (OCT-A). Liver fibrosis risk was taken as the fibrosis-4 (FIB-4) score. Generalized linear models (logistic regression) were used to estimate the association effect between each unit increase of OCT and OCT-A parameters as independent variables and a FIB-4 ≥ 2.67 score as an outcome. Generalized additive models were used to assess the non-linear association between OCT-A features and the linear FIB-4 score.ResultsIncreased gangliar cell complex (GCC) thickness was inversely associated with a FIB-4 score above the cut-off in both the raw model (OR: 0.98; 95% CI: 0.96–0.99; SE: 0.01) and after adjustment for age, sex, education, hypertension, diabetes, total cholesterol, and triglycerides (OR: 0.98; 95% CI: 0.97–0.99; SE: 0.01).ConclusionOur findings add to the growing volume of scientific literature demonstrating that liver fibrosis is associated with retinal neurodegeneration. This study raises a number of new questions, including whether OCT-A may be used to track the progression of metabolic abnormalities and define exact thresholds for predicting and classifying liver disease.

Retinal Microvasculature and Neural Changes and Dietary Patterns in an Older Population in Southern Italy

“…Each participant underwent a complete ophthalmic examination (described in detail elsewhere) [ 17 ]. Briefly, the examination included best-corrected visual acuity (BCVA) measurement, slit-lamp biomicroscopy, intraocular pressure (IOP) measurement, and funduscopy.…”

“…Moreover, findings in the retina provide a noninvasive way to investigate the systemic health of the human body. Particularly, subjects with an increased risk of liver fibrosis [ 17 ] or hypertension [ 18 ] had thinner neuroretinal layers, according to high-resolution retinal scan images taken with optical coherence tomography (OCT) technology. OCT-angiography (OCT-A) allows for the study of retinal health and its microvascular network; this innovative version uses OCT technology to obtain a noninvasive depth-resolved visualization of the retinal microvasculature [ 19 , 20 ].…”

Insights into the liver-eyes connections, from epidemiological, mechanical studies to clinical translation

“…In addition, chorioretinal structures of the eyes could serve as a noninvasive proxy of hepatic microvasculature due to correlations between reduced retinal thickness/macular volumes and increased cirrhosis severity irrelevant to primary etiologies [ 54 ]. Particularly, there is an inverse correlation between increased ganglion cell complex (GCC) thickness and Fibrosis-4 scores (a liver fibrosis risk index) when above the minimum cut-off value (score ≥ 2.67) in elderly people (defined as > 65 years old) [ 55 ].…”