Association between non-invasive liver fibrosis indices and neuroretinal thickness from a nationwide cross-sectional study in South Korea
- 1Department of Biomedical Engineering, Yonsei University, Wonju, South Korea
- 2Department of Ophthalmology, Hangil Eye Hospital, Incheon, South Korea
- 3Bright St. Mary Eye Clinic, Seoul, South Korea
Abstract
Objective: To evaluate associations of non-invasive liver fibrosis indices with optical coherence tomography (OCT)-derived retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) thickness in Korean adults.
Methods: This cross-sectional study used Korea National Health and Nutrition Examination Survey data from 2019–2021. The analytic cohort included 5,830 adults contributing 10,814 eyes after excluding chronic liver disease, ocular disease, and missing or invalid laboratory or ocular data. Primary exposures were fibrosis-4 index (FIB-4) and aspartate aminotransferase-to-platelet ratio index (APRI), standardized to z scores. Outcomes were corrected average RNFL thickness and average GCIPL thickness. Generalized estimating equation models accounted for inter-eye correlation and adjusted for demographic, ocular, cardiometabolic, and lifestyle covariates.
Results: Corrected average RNFL and GCIPL thickness decreased across FIB-4 categories. In fully adjusted models, higher FIB-4 was associated with thinner corrected average RNFL thickness (β=−0.438 µm; 95% CI, −0.679 to −0.197; P<0.001), as was higher APRI (β=−0.270 µm; 95% CI, −0.461 to −0.078; P=0.006). GCIPL associations were weaker but nominally significant. After false discovery rate correction, only FIB-4 and APRI remained significantly associated with corrected average RNFL thickness. RNFL associations persisted after non-linear age adjustment and in survey-weighted participant-level analyses.
Conclusions: Higher non-invasive liver fibrosis indices were associated with slightly thinner OCT-derived neuroretinal measurements, most robustly corrected average RNFL thickness. The small effect sizes support population-level epidemiologic interpretation rather than individual-level clinical use.
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BibTeX
@article{choi2026association,
title = {{Association between non-invasive liver fibrosis indices and neuroretinal thickness from a nationwide cross-sectional study in South Korea}},
author = {Joon Yul Choi and Chan Ho Lee and Tae Keun Yoo},
journal = {Science Progress},
year = {2026},
month = sep,
doi = {10.1177/00368504261492910},
url = {https://doi.org/10.1177/00368504261492910},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Association between non-invasive liver fibrosis indices and neuroretinal thickness from a nationwide cross-sectional study in South Korea
AU - Joon Yul Choi
AU - Chan Ho Lee
AU - Tae Keun Yoo
PY - 2026
DA - 2026/09/29
JO - Science Progress
DO - 10.1177/00368504261492910
UR - https://doi.org/10.1177/00368504261492910
AB - Objective: To evaluate associations of non-invasive liver fibrosis indices with optical coherence tomography (OCT)-derived retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) thickness in Korean adults. Methods: This cross-sectional study used Korea National Health and Nutrition Examination Survey data from 2019–2021. The analytic cohort included 5,830 adults contributing 10,814 eyes after excluding chronic liver disease, ocular disease, and missing or invalid laboratory or ocular data. Primary exposures were fibrosis-4 index (FIB-4) and aspartate aminotransferase-to-platelet ratio index (APRI), standardized to z scores. Outcomes were corrected average RNFL thickness and average GCIPL thickness. Generalized estimating equation models accounted for inter-eye correlation and adjusted for demographic, ocular, cardiometabolic, and lifestyle covariates. Results: Corrected average RNFL and GCIPL thickness decreased across FIB-4 categories. In fully adjusted models, higher FIB-4 was associated with thinner corrected average RNFL thickness (β=−0.438 µm; 95% CI, −0.679 to −0.197; P<0.001), as was higher APRI (β=−0.270 µm; 95% CI, −0.461 to −0.078; P=0.006). GCIPL associations were weaker but nominally significant. After false discovery rate correction, only FIB-4 and APRI remained significantly associated with corrected average RNFL thickness. RNFL associations persisted after non-linear age adjustment and in survey-weighted participant-level analyses. Conclusions: Higher non-invasive liver fibrosis indices were associated with slightly thinner OCT-derived neuroretinal measurements, most robustly corrected average RNFL thickness. The small effect sizes support population-level epidemiologic interpretation rather than individual-level clinical use.
SN - 0036-8504
SN - 2047-7163
ER -