Background
Aging and lifestyle affect the eye and can be risk factors for ocular diseases or confounders for their diagnosis. Many lifestyle-related parameters, such as obesity, high blood pressure, unfavorable cholesterol values, the lack of physical activity, or the consumption of alcohol or tobacco, may impair retinal structure. While lifestyle-related retinal changes are often too small to be noticed by people, they may impose risk factors for severe ocular diseases, including potentially blinding optic neuropathies.
As reported, exfoliation syndrome (XFS), a degenerative age-related condition that can develop into glaucoma, was increasing with age and more frequent in women and asthma patients. And people with frequent dietary fiber-rich vegetables and fruit consumption were less likely to have XFS. Aging and many factors have been approved to increase the onset and progress risk of diabetic retinopathy, such as long duration of diabetes, hyperglycemia, hypertension, hyperlipidemia, smoking, moderate alcohol consumption, obesity, and pregnancy, etc. Similarly, identified risk factors for retinal artery occlusion include hyperglycemia, hypertension, hyperlipidemia, smoking, and advanced age.
Previous studies infer that it’s necessary to deeply and comprehensively investigate the effects of aging and lifestyle on eyes, which requires a large population-based systemic clinical cohort study. It will be much beneficial to both patients and healthcare providers to find crucial factors that lead to the development and progression of certain ocular diseases like glaucoma, age-related macular degeneration, and diabetic retinopathy, especially during the early stage. Thus, healthcare providers will be able to work out a plan to better control the diseases before the onset and retard the progression.
We mainly use the LIFE dataset to study how aging and lifestyle affect the eye. LIFE-Adult-Study is a population-based study conducted by the Leipzig Research Centre for Civilization Diseases (LIFE) in Leipzig, Germany. The study collects the baseline examination and follow-up results of 10,000 participants who were randomly selected from 550,000 inhabitants in Leipzig. The baseline examination was finished before November 2014, and the follow-up examination commenced in 2016 and is running till now. The measurements are not limited to ophthalmic measurements like high-quality non-mydriatic fundus imaging and optical coherence tomography (OCT) results, but also comprise structured personal interviews, self-administered questionnaires, physical and medical examinations, psychometric tests, more than 80 clinical chemical biomarkers as well as comprehensive molecular-genetic profiling comprising genotyping, transcriptome, metabolome, and proteome analyses based on blood and urine samples. Some participants have additional cognition and depression tests and an MRI scan of the brain.
What We Do
Our team is curious about how aging and lifestyle factors affect the eye. We are participating in a population-based study (with about 10 thousand participants) that includes ocular imaging and a large number of physiological and cognitive parameters to systematically investigate the relationship between retinal parameters obtained via fundus photography and optical coherence tomography (OCT) and age, as well as various groups of lifestyle-related variables, such as cardiovascular parameters (e.g., blood pressure, cholesterol, history of strokes), anthropometric parameters (e.g., body mass index, waist-to-hip ratio), substances (e.g., alcohol and tobacco consumption), or neurological diseases (e.g., Parkinson’s disease, neuro-cognitive disorders, multiple sclerosis). This project contributes directly and immediately to public health by exploring the relationship between ocular diseases, demographic characteristics, and lifestyle-related parameters. Check out our open-source code repositories on our Harvard Ophthalmology AI Lab GitHub account.
Selected Publications
- Rauscher, F.G., Elze, T., Francke, M., Martinez-Perez, M.E., Li, Y., Wirkner, K., Tönjes, A., Engel, C., Thiery, J., Blüher, M. and Stumvoll, M., 2024. Glucose tolerance and insulin resistance/sensitivity associate with retinal layer characteristics: the LIFE-Adult-Study. Diabetologia, 67(5), pp.928-939.
- Rauscher, F.G., Wang, M., Francke, M., Wirkner, K., Tönjes, A., Engel, C., Thiery, J., Stenvinkel, P., Stumvoll, M., Loeffler, M. and Elze, T., 2021. Renal function and lipid metabolism are major predictors of circumpapillary retinal nerve fiber layer thickness—the LIFE-Adult Study. BMC medicine, 19(1), pp.1-12.
- Girbardt, J., Luck, T., Kynast, J., Rodriguez, F.S., Wicklein, B., Wirkner, K., Engel, C., Girbardt, C., Wang, M., Polyakova, M. and Witte, A.V., 2021. Reading cognition from the eyes: association of retinal nerve fibre layer thickness with cognitive performance in a population-based study. Brain Communications, 3(4), p.fcab258.
- Li, D., Rauscher, F.G., Choi, E.Y., Wang, M., Baniasadi, N., Wirkner, K., Kirsten, T., Thiery, J., Engel, C., Loeffler, M. and Elze, T., 2020. Sex-specific differences in circumpapillary retinal nerve fiber layer thickness. Ophthalmology, 127(3), pp.357-368.