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.
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.
| Original language | English |
|---|---|
| Journal | Ophthalmology Science |
| Early online date | 19 Jan 2024 |
| DOIs | |
| Publication status | E-pub ahead of print - 19 Jan 2024 |
Bibliographical note
Financial SupportSKW is funded by the Medical Research Council (MR/T000953/1) and the Rank Prize. KVS is in receipt of a UCL Overseas Research Scholarship and is supported by the Desmond Foundation and Fight for Sight, London (1956A). CJC is supported by a Wellcome Clinical Research Career Development Fellowship (224586/Z/21/Z). APK is supported by a UK Research & Innovation Future Leaders Fellowship (MR/T040912/1), an Alcon Research Institute Young Investigator Award and a Lister Institute Fellowship. PAK is supported by a UK Research & Innovation Future Leaders Fellowship (MR/T019050/1). PJF is supported by donations to UCL from the Desmond Foundation, and is a recipient of an Alcon Research Institute Award. APK, PJF, AP, and PAK all receive salary support from NIHR through a grant to the Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology. This research was supported by the National Institute for Health Research (NIHR) Biomedical Research Centres of Moorfields Eye Hospital and UCL Institute of Ophthalmology, Great Ormond Street Hospital, and University of Birmingham. The sponsor or funding organization had no role in the design or conduct of this research.
Meeting presentation: This work was presented at the annual UK Biobank Eye & Vision Consortium Meeting in February 2023 and at the Annual Association for Research in Vision and Ophthalmology Meeting, New Orleans, 2023.
