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The following is a summary of “Associations between a healthy lifestyle score and retinal neurovascular health,” published in the February 2025 issue of Ophthalmology by Zeng et al. 

Researchers conducted a retrospective study to examine the relationship between a healthy lifestyle score and retinal neurovascular health and to determine whether lower inflammation levels mediated this association.  

They used data from the UK Biobank to study associations between a healthy lifestyle score (ranging from 0 to 6, based on physical activity, diet, sleep duration, smoking status, alcohol intake, and body weight) and retinal health. Retinal disease outcomes included age-related macular degeneration (AMD) and retinal vascular occlusion (RVO) from hospital admission records (3,78,648 participants). Retinal vascular metrics were assessed through retinal photography (32,226 participants), and retinal neural metrics were measured using optical coherence tomography (42,557 participants). Inflammation levels were characterized using the INFLA-score.  

The results showed that participants with a healthy lifestyle score of 5 to 6 had a 29% lower risk of AMD and a 25% lower risk of RVO compared to those with a score of 0 to 1 (all P trend <0.01). Retinal metrics included a 2% increase in artery-to-vein ratio (AVR), a 0.22 µm increase in central retinal artery equivalent, a 0.36 µm decrease in central retinal vein equivalent (CRVE), and a 0.004 increase in fractal dimension. Improvements were also noted in retinal neural layers, including a 0.38 µm increase in the retinal nerve fiber layer, a 0.69 µm increase in the ganglion cell-inner plexiform layer (GCIPL), and a 0.35 µm increase in the photoreceptor segment (PS) compared with those with worst lifestyle score (scored from 0 to 1) (all P_trend <0.01) The INFLA-score partially mediated associations with AMD (mediated proportion (MP): 14.8%), higher AVR (MP: 12.76%), narrower CRVE (MP: 24.49%), thicker GCIPL (MP: 4.97%), and thicker PS (MP: 26.86%).  

Investigators concluded that greater adherence to a healthier lifestyle was associated with better retinal health in a dose-response manner, with lower inflammation partially mediating the association. 

Source: bjo.bmj.com/content/early/2025/02/09/bjo-2024-326184