Influence of physical activity and sleep duration on the retinal and choroidal structure in diabetic patients: An SS-OCT study

ABSTRACT Purpose To assess the association between physical activity, sleep duration, sitting time, and alterations of posterior segment structures with swept-source optical coherence tomography (SS-OCT). Methods Patients with diabetic retinopathy (DR) were recruited, and diabetic patients without retinopathy (non-DR) who matched for age and duration of diabetes were used as control. The physical activity, siting time, and sleep duration were obtained by using standardized questionnaire. OCT parameters included: retinal nerve fibre layer (RNFL) thickness, ganglion cell inner plexiform layer (GC-IPL) thickness, retinal thickness, and choroidal thickness (CT). Linear regression was conducted to analyse the association. Results Each group included 116 diabetic patients. Average macular CT was positively correlated with metabolic equivalents (MET) only in the DR group, independent of age, gender, and other potential confounding factors (β = 1.163, P = 0.006). Average macular CT was also positively correlated with sleep duration only in the non-DR group, independent of age, gender, and other potential confounding factors (β = 10.54, P = 0.031). No correlation was found between MET, sleep duration, and other OCT parameters. Sitting time was not significantly correlated with OCT parameters either. Conclusions Physical activity and sleep duration are both positively correlated with macular choroidal thickness; this suggests that more time in physical activity and sleep benefit the retina, while there was no association between sedentary time and OCT parameters. Further studies are warranted to clarify the underlying mechanisms and the role of physical activity and sleep in CT alterations and DR.