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Periodontitis and outer retinal thickness: A cross-sectional analysis of the UK Biobank cohort

Wagner, Siegfried K; Patel, Praveen J; Huemer, Josef; Khalid, Hagar; Stuart, Kelsey V; Chu, Colin J; Williamson, Dominic J; ... UK Biobank Eye & Vision Consortium, .; + view all (2024) Periodontitis and outer retinal thickness: A cross-sectional analysis of the UK Biobank cohort. Ophthalmology Science , 4 (4) , Article 100472. 10.1016/j.xops.2024.100472. Green open access

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Abstract

Purpose: Periodontitis, a ubiquitous severe gum disease affecting the teeth and surrounding alveolar bone can heighten systemic inflammation. We investigated the association between very severe periodontitis and early biomarkers of age-related macular degeneration, in individuals with no eye disease. / Design: Cross-sectional analysis of the prospective community-based cohort United Kingdom (UK) Biobank. / Participants: Sixty-seven thousand three hundred eleven UK residents aged 40-70 years recruited between 2006-2010 underwent retinal imaging. / Methods: Macular-centered optical coherence tomography images acquired at the baseline visit were segmented for retinal sublayer thicknesses. Very severe periodontitis was ascertained through a touchscreen questionnaire. Linear mixed effects regression modeled the association between very severe periodontitis and retinal sublayer thicknesses adjusting for age, sex, ethnicity, socioeconomic status, alcohol consumption, smoking status, diabetes mellitus, hypertension, refractive error, and previous cataract surgery. / Main Outcome Measures: Photoreceptor layer (PRL) and retinal pigment epithelium-Bruch’s membrane (RPE-BM) thicknesses. / Results: Among 36,897 participants included in the analysis, 1,571 (4.3%) reported very severe periodontitis. Affected individuals were older, lived in areas of greater socioeconomic deprivation and were more likely to be hypertensive, diabetic and current smokers (all p<0.001). On average, those with very severe periodontitis were myopic (-0.29 ± 2.40 diopters) while those unaffected were hyperopic (0.05 ± 2.27 diopters, p<0.001). Following adjusted analysis, very severe periodontitis was associated with thinner PRL (-0.55 μm, 95% CI: -0.97, -0.12, p=0.022) but there was no difference in RPE-BM thickness (0.00 μm, 95% CI: -0.12, 0.13, p=0.97). The association between PRL thickness and very severe periodontitis was modified by age (p<0.001). Stratifying individuals by age, thinner PRL was seen among those aged 60-69 years with disease (-1.19 μm, 95% CI: -1.85, -0.53, p<0.001) but not among those under 60 years. / Conclusions: Among those with no known eye disease, very severe periodontitis is statistically associated with a thinner PRL, consistent with incipient age-related macular degeneration. Optimizing oral hygiene may hold additional relevance for people at risk of degenerative retinal disease.

Type: Article
Title: Periodontitis and outer retinal thickness: A cross-sectional analysis of the UK Biobank cohort
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.xops.2024.100472
Publisher version: https://doi.org/10.1016/j.xops.2024.100472
Language: English
Additional information: Copyright 2024 by the American Academy of Ophthalmology. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Keywords: Periodontitis, Age-related macular degeneration, Optical coherence tomography
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
URI: https://discovery.ucl.ac.uk/id/eprint/10186279
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