Epidemiologic analyses of large-scale ophthalmic datasets

Abstract

In this thesis different epidemiological approaches were used to gather and evaluate various large datasets in order to address specific research questions in the field of ophthalmology. According to the individual research questions and the scientific intention it is crucial to select the adequate and preferred data and corresponding analysis plan à priori. <br /> Within the different projects we underscore the entanglement of the eyes with the rest of the body. Our data indicate a close relation of AMD with several factors that play a role in other age-related systemic diseases. We provide evidence for a beneficial impact of high physical activity (PA) on AMD development. Future public health messages on AMD prevention strategies should include high PA as modifiable risk factor. In addition, we found a lower prevalence of AMD in participants who used lipid-lowering and anti-diabetic drugs. Firstly, our data indicate the involvement of both, the lipid metabolism and oxidative stress in AMD pathogenesis. Secondly, given the frequent use, additional longitudinal studies are needed to re-evaluate our findings and establish therapy recommendations. <br /> Apart from AMD, we identified several potential ophthalmic biomarkers for systemic neurodegenerative diseases resulting in brain atrophy using large-scale population data. Implications include the usefulness of retinal measurements in the longitudinal monitoring of neurological and neurodegenerative diseases that can cause brain atrophy. <br /> Lastly, we used multicenter data and epidemiological analyses to confirm the usability of the Yokoyama procedure in esotropic patients with high myopia. <br /> Moreover, the composition of this thesis underscores the relevance of international collaborations in ophthalmic research such as the European Eye epidemiology (E3) – consortium. <br /> In conclusion, this thesis highlights the advantages and benefits of analyzing large-scale high-quality datasets and illustrates the need for various analytical approaches. Hence, the included studies of this thesis enhanced the knowledge within the field of ophthalmo-epidemiology and lay foundation for further (international) collaborations. <br />